系统评价和荟萃分析评估 2 型糖尿病患者颈动脉内膜中层厚度和血脂谱的状况。
Systematic review and meta-analysis assessing the status of carotid intima-media thickness and lipid profiles in type 2 diabetes mellitus.
机构信息
Life and Consumer Sciences, University of South Africa College of Agriculture and Environmental Sciences, Florida, Gauteng, South Africa.
DIMAMO Population Health Research Centre, University of Limpopo - Turfloop Campus, Mankweng, South Africa.
出版信息
BMJ Open. 2024 Nov 9;14(11):e087496. doi: 10.1136/bmjopen-2024-087496.
OBJECTIVES
Carotid intima-media thickness (CIMT) is a measurement for subclinical atherosclerosis and has been associated with overall cardiovascular diseases, especially in type 2 diabetes mellitus (T2DM). We aimed to assess the status of carotid health and lipid profile in T2DM.
DESIGN
This systematic review and meta-analysis synthesised data published from clinical studies.
DATA SOURCES
Google Scholar, PubMed and Scopus were searched from inception to 18 January 2024.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Studies conducted in patients with T2DM and those without T2DM were included. Studies conducted in T2DM adults evaluating carotid status and lipid profile were considered.
DATA EXTRACTION AND SYNTHESIS
Two authors independently used standardised methods to comprehensively search, screen and extract data from all relevant studies. The risk of bias was assessed using the Newcastle-Ottawa checklist. Meta-analysis was conducted using Review Manager and metaHun through random effects models. The random effect model was used due to high heterogeneity.
RESULTS
Evidence was analysed from 57 studies with a sample size of 29 502 (8254 T2DM and 21 248 people without T2DM). There was a significantly higher CIMT, with a standardised mean difference (SMD) of 1.01 (95% CI 0.75, 1.26, p<0.00001). Additionally, there was an elevated triglyceride (TG) (SMD=1.12, 95% CI 0.82, 1.41, p<0.00001), total cholesterol (TC), (SMD=0.24, 95% CI 0.02, 0.46, p=0.03) and low-density lipoprotein-cholesterol (LDL-C), (SMD=0.35, 95% CI 0.11, 0.59, p=0.004) in patients with T2DM compared with those without T2DM. Furthermore, a significant decrease in high-density lipoprotein cholesterol (HDL-C) was observed in the T2DM compared with people without T2DM, SMD=0.79, 95% CI 0.96, -0.62, p<0.00001). Age, body mass index and hypertension were associated with increased CIMT and TG and decreased HDL-C in T2DM. Additionally, age, gender and hypertension were associated with an increased LDL-C in T2DM.
CONCLUSION
Our findings suggest that an increased CIMT is accompanied by increased TG, TC, LDL-C and HDL-C reduction in patients with T2DM.
PROSPERO REGISTRATION NUMBER
CRD42023451731.
目的
颈动脉内膜中层厚度（CIMT）是亚临床动脉粥样硬化的一种测量方法，与整体心血管疾病有关，尤其是 2 型糖尿病（T2DM）。本研究旨在评估 T2DM 患者的颈动脉健康和血脂状况。
设计
这是一项系统综述和荟萃分析，综合了来自临床研究的数据。
数据来源
从谷歌学术、PubMed 和 Scopus 数据库中检索从开始到 2024 年 1 月 18 日的数据。
选择研究的资格标准
纳入了 T2DM 患者和非 T2DM 患者的研究。纳入了评估颈动脉状况和血脂状况的 T2DM 成年患者的研究。
数据提取和综合
两名作者独立使用标准方法，从所有相关研究中全面搜索、筛选和提取数据。使用纽卡斯尔-渥太华量表评估偏倚风险。使用 Review Manager 和 metaHun 通过随机效应模型进行荟萃分析。由于存在高度异质性，因此使用了随机效应模型。
结果
分析了来自 57 项研究的数据，样本量为 29502 人（8254 例 T2DM 和 21248 例非 T2DM）。T2DM 患者的 CIMT 显著升高，标准化均数差（SMD）为 1.01（95%CI 0.75，1.26，p<0.00001）。此外，T2DM 患者的甘油三酯（TG）（SMD=1.12，95%CI 0.82，1.41，p<0.00001）、总胆固醇（TC）（SMD=0.24，95%CI 0.02，0.46，p=0.03）和低密度脂蛋白胆固醇（LDL-C）（SMD=0.35，95%CI 0.11，0.59，p=0.004）均升高，而高密度脂蛋白胆固醇（HDL-C）降低（SMD=0.79，95%CI 0.96，-0.62，p<0.00001）。与非 T2DM 患者相比，T2DM 患者的年龄、体重指数和高血压与 CIMT 和 TG 升高以及 HDL-C 降低有关。此外，年龄、性别和高血压与 T2DM 患者的 LDL-C 升高有关。
结论
我们的研究结果表明，T2DM 患者的 CIMT 增加伴随着 TG、TC、LDL-C 和 HDL-C 的降低。
PROSPERO 注册号：CRD42023451731。
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