Endocrine Practice最新文献

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All That Glistens Is not Gold: Neuropathy in Diabetic Patients May not Be Exclusively due to Diabetes. 闪闪发光的并非都是金子：--糖尿病患者的神经病变可能并不完全是由糖尿病引起的。

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice

Pub Date : 2024-08-31 DOI: 10.1016/j.eprac.2024.08.011

David S H Bell

引用次数: 0

Clinical Significance of Thyroid Autoantibodies in Differential Diagnosis and Predicting the Course of Programmed Cell Death Protein-1 Inhibitor-Induced Thyroid Dysfunction. 甲状腺自身抗体在鉴别诊断和预测程序性细胞死亡蛋白-1抑制剂诱发的甲状腺功能障碍病程中的临床意义

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice

Pub Date : 2024-08-30 DOI: 10.1016/j.eprac.2024.08.012

Li Li, Xiaoxia Ding, Xihui Zhang, Shuangming Kong, Ming Chen

Objective: Thyroid immune-related thyrotoxicosis is one of the most common adverse effects in patients treated with programmed cell death protein-1 (PD-1) inhibitors. We investigated the significance of levels of serum anti-thyroglobulin antibodies (TgAbs), anti-thyroid peroxidase antibodies (TPOAbs), and thyroid-stimulating hormone receptor antibodies (TRAbs) in the identification of anti-PD-1-induced thyroid thyrotoxicosis.

Methods: We divided 161 patients with thyroid dysfunction who received PD-1 inhibitors at our hospital between January 2022 and June 2024 into 3 groups: primary hypothyroidism group, primary hyperthyroidism group, and destructive thyroiditis group. The characteristics of the 3 groups were determined, and the positivity rates of serum TgAbs, TPOAbs, and TRAbs were assessed. An additional 42 patients diagnosed with Hashimoto's thyroiditis were selected as the control group for PD-1 inhibition-induced destructive thyroiditis. Age, sex, and time of transition from thyrotoxicosis to hypothyroidism in the 2 groups were compared.

Results: In the primary hypothyroidism group, only 1 case was TPOAbs-positive (1/1%). In the destructive thyroiditis group, the positivity rate for TPOAbs or TgAbs was 92.9%, and TPOAbs and TgAbs were negative in the primary hyperthyroidism group. TRAbs were undetectable in all 3 groups. There were statistically significant differences in age, sex, and time from thyrotoxicosis to hypothyroidism in the PD-1 induced destructive thyroiditis and Hashimoto's thyroiditis groups.

Conclusions: In patients with thyrotoxicosis caused by PD-1 inhibitors, serum TgAb, and TPOAb levels can be used to distinguish between primary hyperthyroidism and destructive thyroiditis. This study provides insights into novel treatment targets and effective management strategies for PD-1-induced thyrotoxicosis.

背景：甲状腺免疫相关甲状腺毒症是接受程序性细胞死亡蛋白-1（PD-1）抑制剂治疗的患者最常见的不良反应之一。我们研究了血清抗甲状腺球蛋白抗体（TgAbs）、抗甲状腺过氧化物酶抗体（TPOAbs）和促甲状腺激素受体抗体（TRAbs）水平在识别抗PD-1诱导的甲状腺甲状腺毒症中的意义：将2022年1月至2024年6月期间在我院接受PD-1抑制剂治疗的161例甲状腺功能障碍患者分为三组：原发性甲状腺功能减退症组、原发性甲状腺功能亢进症组和破坏性甲状腺炎组。确定三组患者的特征，评估血清TgAbs、TPOAbs和TRAbs的阳性率。另外还选择了42名确诊为桥本氏甲状腺炎的患者作为PD-1抑制诱导的破坏性甲状腺炎的对照组。比较了两组患者的年龄、性别以及从甲状腺毒症转变为甲状腺功能减退症的时间：结果：原发性甲状腺功能减退症组中，仅有1例TPOAbs阳性（1/1%）。在破坏性甲状腺炎组中，TPOAbs或TgAbs的阳性率为92.9%，而在原发性甲状腺功能亢进组中，TPOAbs和TgAbs均为阴性。三组中均检测不到TRAbs。在PD-1诱导的破坏性甲状腺炎组和桥本氏甲状腺炎组中，年龄、性别和从甲亢到甲减的时间差异有统计学意义：在PD-1抑制剂导致的甲亢患者中，血清TgAb和TPOAb水平可用于区分原发性甲亢和破坏性甲状腺炎。本研究为PD-1诱导的甲状腺毒症提供了新的治疗靶点和有效的管理策略。

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引用次数: 0

Effects of Isoflavone Interventions on Bone Metabolism in Perimenopausal and Postmenopausal Women: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials. 异黄酮干预对围绝经期和绝经后妇女骨代谢的影响：随机对照试验荟萃分析综述。

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice

Pub Date : 2024-08-28 DOI: 10.1016/j.eprac.2024.08.009

Lifang Zhuge, Lanlan Chen, Weiping Pan

Objective: Previous meta-analyses have investigated the effects of isoflavones on bone metabolism in perimenopausal or postmenopausal women. However, there were still conflicting results. Thereby, this umbrella review assessed the existing meta-analysis evidence of the effects of isoflavone interventions on bone metabolism in perimenopausal and postmenopausal women.

Methods: This study was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. From the inception until August 24, 2023, PubMed, Embase, Cochrane, and Web of Science databases were searched to identify meta-analyses of randomized controlled trials. The outcomes included bone mineral densities (BMDs), and bone turnover markers of osteocalcin, bone-specific alkaline phosphatase, pyridinoline, deoxypyridinoline, Procollagen Type 1 N-Terminal Propeptide, and C-telopeptide of Type 1 Collagen. The random-effects model was used to recalculate the extracted effect sizes. Mean difference (MD) was used as a summary effect measure.

Results: Ten meta-analyses of randomized controlled trials were included. The isoflavone intervention was associated with increased BMDs in lumbar spine (MD: 11.50 mg/cm², 95% confidence interval (CI): 6.46 to 16.55), femoral neck (MD: 2.03%, 95% CI: 0.57 to 3.50), and top hip (MD: 0.31%, 95% CI: 0.03 to 0.59) in perimenopausal and postmenopausal women.

Conclusion: Our findings indicate that isoflavone interventions have the potential to improve BMD at different bone sites, including the lumbar spine, femoral neck, and total hip in perimenopausal and postmenopausal women. Isoflavone may be considered a complementary option in the bone loss of perimenopausal and postmenopausal women.

研究目的以往的荟萃分析研究了异黄酮对围绝经期或绝经后妇女骨代谢的影响。然而，结果仍然相互矛盾。因此，本综述评估了异黄酮干预对围绝经期和绝经后妇女骨代谢影响的现有荟萃分析证据：本研究遵循系统综述和荟萃分析首选报告项目（PRISMA）指南进行。从开始到 2023 年 8 月 24 日，对 PubMed、Embase、Cochrane 和 Web of Science 数据库进行了检索，以确定随机对照试验 (RCT) 的荟萃分析。研究结果包括骨矿物质密度（BMDs）、骨钙素（OC）、骨特异性碱性磷酸酶（BAP）、吡啶啉（PYD）、脱氧吡啶啉（DPD）、1型胶原蛋白N端前肽（P1NP）和1型胶原蛋白C-十肽（CTX）等骨转换标志物（BTMs）。随机效应模型用于重新计算提取的效应大小。采用平均差（MD）作为效应的总结指标：结果：共纳入了 10 项 RCT 的荟萃分析。在围绝经期和绝经后妇女中，异黄酮干预与腰椎（MD：11.50 mg/cm2，95% 置信区间（CI）：6.46 至 16.55）、股骨颈（MD：2.03%，95% CI：0.57 至 3.50）和髋上部（MD：0.31%，95% CI：0.03 至 0.59）BMD 的增加有关：我们的研究结果表明，异黄酮干预措施有可能改善围绝经期和绝经后妇女不同骨骼部位的 BMD，包括腰椎、股骨颈和全髋。异黄酮可被视为围绝经期和绝经后妇女骨质流失的一种补充选择。

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引用次数: 0

Switching to Tirzepatide 5 mg From Glucagon-Like Peptide-1 Receptor Agonists: Clinical Expectations in the First 12 Weeks of Treatment 从 GLP-1 RAs 转用 5 毫克替扎帕肽：治疗头 12 周的临床预期。

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice

Pub Date : 2024-08-01 DOI: 10.1016/j.eprac.2024.05.005

Objective

This prospective study aimed to describe the clinical course in terms of glycemic outcomes, body weight, and adverse events during the first 12 weeks following a switch from glucagon-like peptide-1 receptor agonists (GLP-1 RAs) directly to tirzepatide 5 mg.

Methods

Participants were ≥18 years with type 2 diabetes (T2D), glycated hemoglobin (HbA1c) ≥6.5% to ≤9.0%, body mass index ≥25 kg/m² and were on a stable treatment dose of GLP-1 RAs (liraglutide every day [1.2, 1.8 mg], semaglutide once-weekly [0.5, 1.0, 2.0 mg], or dulaglutide once-weekly [0.75, 1.5, 3.0, and 4.5 mg]) for ≥3 months at baseline. The primary end point was HbA1c change from baseline at week 12. Secondary end points included change from baseline in fasting serum glucose, body weight, and glucose assessed by continuous glucose monitoring. Safety was also assessed.

Results

Participants were 58.3 years on average, with baseline HbA1c 7.39%, body mass index 35.18 kg/m², T2D duration around 12.4 years, and included 55% females. Semaglutide (55%) and dulaglutide (42%) were the most commonly used GLP-1 RAs at baseline with semaglutide 1.0 mg and dulaglutide 1.5 mg being the most common treatment doses. At week 12, mean HbA1c changed from baseline by −0.43%, fasting serum glucose by −7.83 mg/dL, and body weight by −2.15 kg (all P < .01). Glycemic outcomes and body weight improved in participants in all baseline GLP-1 RA subgroups. Twenty participants (13.2%) developed gastrointestinal events. Three (2%) participants discontinued tirzepatide due to adverse events. There were no severe hypoglycemic events or deaths.

Conclusion

In this prospective study, when people with T2D on stable GLP-1 RA treatment were switched directly to tirzepatide 5 mg, they experienced improved glycemic outcomes and additional weight reduction with an acceptable risk of adverse gastrointestinal events over 12 weeks.

研究目的本前瞻性研究旨在描述从 GLP-1 RAs 直接转为替扎帕肽 5 mg 后 12 周内血糖结果、体重和不良事件方面的临床过程：参与者年龄≥18岁，患有2型糖尿病（T2D），HbA1c≥6.5%至≤9.0%，体重指数（BMI）≥25 kg/m2，正在接受稳定剂量的GLP-1 RAs（利拉鲁肽，每日一次（QD）[1.2、1.8 毫克]、塞马鲁肽每周一次 (QW) [0.5、1.0、2.0 毫克]或度拉鲁肽 QW [0.75、1.5、3.0、4.5 毫克])，基线时间≥3 个月。主要终点是第 12 周时 HbA1c 与基线相比的变化。次要终点包括空腹血清葡萄糖 (FSG)、体重和连续血糖监测评估的血糖与基线相比的变化。此外，还对安全性进行了评估：参与者平均年龄为 58.3 岁，基线 HbA1c 为 7.39%，体重指数为 35.18 kg/m2，T2D 病程约为 12.4 年，女性占 55%。杜拉鲁肽（42%）和塞马鲁肽（55%）是基线时最常用的 GLP-1 RA，杜拉鲁肽 1.5 毫克和塞马鲁肽 1.0 毫克是最常用的治疗剂量。第 12 周时，平均 HbA1c 与基线相比变化了-0.43%，FSG 变化了-7.83 mg/dL，体重变化了-2.15 kg（均为 p）：在这项前瞻性研究中，当正在接受稳定 GLP-1 RA 治疗的 T2D 患者直接改用 5 毫克替扎帕肽治疗时，他们的血糖结果得到了改善，体重也进一步减轻，而且在 12 周内发生消化道不良事件的风险是可以接受的。

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引用次数: 0

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IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice

Pub Date : 2024-08-01 DOI: 10.1016/S1530-891X(24)00582-2

引用次数: 0

The Risk of and Associated Demographic and Laboratory Variables for Amputations for Inpatients with Diabetic Foot Ulcers 与糖尿病足溃疡住院患者截肢有关的人口统计学和实验室变量。

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice

Pub Date : 2024-08-01 DOI: 10.1016/j.eprac.2024.04.019

Objective

Diabetic foot ulcers (DFUs) are a leading cause of morbidity and mortality, which disproportionately impacts underserved populations. This study aimed to provide data regarding the rates and outcomes of amputation in patients admitted with DFU in our health system, which cares for an ethnically diverse and underserved population.

Methods

This retrospective study examined the electronic medical records of adult patients hospitalized with DFU at 3 hospitals in our health system between June 1, 2016, and May 31, 2021.

Results

Among 650 patients admitted with DFU, 88% self-identified as non-White race. Male sex (odds ratio [OR], 0.62), low body mass index (OR, 0.98), and history of smoking (OR, 1.45) were significantly associated with amputation during the study period. A higher erythrocyte sedimentation rate (OR, 1.01), C-reactive protein level (OR, 1.05), and white blood cell count (OR, 1.11) and low albumin level (OR, 0.41) were found to be significantly associated with amputation versus no amputation during admission. The amputation risk during the index admission for DFU was 44%.

Conclusion

Our study identified a high DFU-related amputation risk (44%) among adult patients who were mostly Black and/or Hispanic. The significant risk factors associated with DFU amputation included male sex, low body mass index, smoking, and high levels inflammation or low levels of albumin during admission. Many of these patients required multidisciplinary care and intravenous antibiotic therapy, necessitating a longer length of stay and high readmission rate.

目标：糖尿病足溃疡（DFU）是发病和死亡的主要原因之一，对医疗服务不足的人群造成了极大的影响。本研究旨在为我们的医疗系统提供有关糖尿病足溃疡患者截肢率和截肢结果的数据：这项回顾性研究检查了本医疗系统三家医院在 2016 年 1 月 6 日至 2021 年 5 月 31 日期间因 DFU 住院的成人患者的电子病历：在650名因DFU入院的患者中，88%自认为是非白人种族。研究期间，男性（OR 0.62）、低体重指数（OR 0.98）和吸烟史（OR 1.45）与截肢显著相关。研究发现，红细胞沉降率（OR 1.01）、C 反应蛋白（OR 1.05）、白细胞（OR 1.11）和白蛋白低（OR 0.41）较高与入院期间截肢或未截肢显著相关。DFU入院时的截肢风险为44%：我们的研究发现，在大多数为黑人和/或西班牙裔的成年患者中，DFU相关截肢风险较高（44%）。与 DFU 截肢相关的重要风险因素包括男性、低体重指数、吸烟以及入院时炎症或白蛋白水平过高或过低。其中许多患者需要多学科护理和静脉注射抗生素治疗，住院时间较长，再入院率较高。

{"title":"The Risk of and Associated Demographic and Laboratory Variables for Amputations for Inpatients with Diabetic Foot Ulcers","authors":"","doi":"10.1016/j.eprac.2024.04.019","DOIUrl":"10.1016/j.eprac.2024.04.019","url":null,"abstract":"<div><h3>Objective</h3><p>Diabetic foot ulcers (DFUs) are a leading cause of morbidity and mortality, which disproportionately impacts underserved populations. This study aimed to provide data regarding the rates and outcomes of amputation in patients admitted with DFU in our health system, which cares for an ethnically diverse and underserved population.</p></div><div><h3>Methods</h3><p>This retrospective study examined the electronic medical records of adult patients hospitalized with DFU at 3 hospitals in our health system between June 1, 2016, and May 31, 2021.</p></div><div><h3>Results</h3><p>Among 650 patients admitted with DFU, 88% self-identified as non-White race. Male sex (odds ratio [OR], 0.62), low body mass index (OR, 0.98), and history of smoking (OR, 1.45) were significantly associated with amputation during the study period. A higher erythrocyte sedimentation rate (OR, 1.01), C-reactive protein level (OR, 1.05), and white blood cell count (OR, 1.11) and low albumin level (OR, 0.41) were found to be significantly associated with amputation versus no amputation during admission. The amputation risk during the index admission for DFU was 44%.</p></div><div><h3>Conclusion</h3><p>Our study identified a high DFU-related amputation risk (44%) among adult patients who were mostly Black and/or Hispanic. The significant risk factors associated with DFU amputation included male sex, low body mass index, smoking, and high levels inflammation or low levels of albumin during admission. Many of these patients required multidisciplinary care and intravenous antibiotic therapy, necessitating a longer length of stay and high readmission rate.</p></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1530891X24005123/pdfft?md5=f48b6bc6f407c0ab5dffa4e844eba7ac&pid=1-s2.0-S1530891X24005123-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Change in Body Mass Index in Youth in the First 5 Years After Type 1 Diabetes Mellitus Diagnosis 1 型糖尿病确诊后 5 年内青少年体重指数的变化。

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice

Pub Date : 2024-08-01 DOI: 10.1016/j.eprac.2024.05.003

Objective

Examine body mass index (BMI) trajectories in American youth with type 1 diabetes (T1D) over the first 5 years following diagnosis.

Methods

Retrospective record review of BMI trajectories in youth with T1D diagnosed in 2015 to 2016.

Results

Near the time of diabetes diagnosis, 35.5% of youth had BMIs in the overweight/obesity range. These rates increased over time (P < .001), with 52.8% having overweight/obesity 5 years after diagnosis. Average age when BMI rose from healthy to overweight/obese or overweight to obese (rise group) was at 12.7 years, occurring 2.5 years after diagnosis. There were no differences between hemoglobin A1c, use of continuous glucose monitors, or use of insulin pumps between the rise group and those with healthy BMI throughout the study period.

Conclusions

Alarmingly high rates of overweight/obesity in youth were observed within 5 years following T1D diagnosis. Awareness and further research are necessary to address this independent risk factor for morbidities.

目标：研究美国青年 1 型糖尿病患者在确诊后五年内的体重指数（BMI）轨迹：研究设计/方法：对2015-2016年确诊的1型糖尿病青少年的体重指数轨迹进行回顾性记录：在糖尿病确诊时，35.5%的青少年的体重指数处于超重/肥胖范围。随着时间的推移，这一比例有所上升（p < 0.001），52.8%的青少年在确诊5年后出现超重/肥胖。体重指数从健康上升到超重/肥胖或超重到肥胖（上升组）的平均年龄为 12.7 岁，发生在诊断后 2.5 年。在整个研究期间，体重指数上升组与体重指数健康组在 HbA1c、使用连续血糖监测仪 (CGM) 或使用胰岛素泵方面没有差异：结论：在确诊 1 型糖尿病后的 5 年内，观察到青少年超重/肥胖率高得惊人。有必要提高认识并开展进一步研究，以应对这一独立的发病风险因素。

引用次数: 0

Progression of Nodular Thyroid Disease in Familial Adenomatous Polyposis Syndrome: Refined Surveillance Recommendations 家族性腺瘤性息肉病综合征结节性甲状腺疾病的进展：完善的监测建议。

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice

Pub Date : 2024-08-01 DOI: 10.1016/j.eprac.2024.05.007

Background

Patients with familial adenomatous polyposis (FAP) have an increased risk of thyroid nodular disease. Previous studies demonstrated that screening thyroid ultrasound (US) will allow detection of nodules in 38% and thyroid cancer in 2.6% of patients. The aim of this study is to define the value of serial US evaluation at identifying disease progression in patients with FAP.

Methods

Retrospective review from 2008 to 2023 at a single referral center. All patients with FAP and screening thyroid US were included. Patient demographics, initial US characteristics, follow-up regarding the development of new nodules and cancer were assessed using a Kaplan-Meier analysis.

Results

A total of 556 patients underwent screening. Fifty percent were male. Median age at first screening was 38 year old. Eighty percent underwent longitudinal follow-up for a median length of 7 years. At initial screening, 169 patients (30%) had nodules. For patients with normal baseline US, 14% developed a nodule overtime. A total of 20 patients (3.6%) were diagnosed with thyroid cancer. The cumulative incidence of initial and subsequent cancer was 4% by 5 years and 6% by 10 years, while the cumulative incidence of thyroid nodules was 40% and 48%, respectively.

Conclusions

Based on the Kaplan-Meier analysis, ongoing longitudinal screening is warranted for patients with FAP as they are prone to thyroid cancer and nodule development overtime even when presenting with a baseline normal US. Additionally, these data demonstrate a slow development of thyroid cancer from a normal US, thus it is reasonable to consider selectively extending the screening interval for this population.

背景家族性腺瘤性息肉病（FAP）患者罹患甲状腺结节疾病的风险较高。以往的研究表明，甲状腺超声筛查（US）可发现 38% 的患者有甲状腺结节，2.6% 的患者有甲状腺癌。本研究旨在确定连续性甲状腺超声评估在识别FAP患者疾病进展方面的价值：方法：对一家转诊中心2008-2023年的研究进行回顾性分析。纳入了所有接受甲状腺 US 筛查的 FAP 患者。采用 Kaplan-Meier 分析法评估了患者的人口统计学特征、最初的 US 特征、有关新结节和癌症发展的随访情况：结果：共有556名患者接受了筛查。结果：共有 556 名患者接受了筛查，其中 51% 为男性。首次筛查的中位年龄为 38 岁。81%的患者接受了纵向随访，中位随访时间为 7 年。初次筛查时，169 名患者（30%）有结节。在基线 US 值正常的患者中，有 14% 的人在超时后出现了结节。共有 20 名患者（3.6%）被确诊为甲状腺癌。甲状腺结节的累积发病率分别为40%和48%：根据Kaplan-Meier分析，FAP患者即使在US检查基线正常的情况下也很容易发生甲状腺癌和甲状腺结节，因此有必要对FAP患者进行持续的纵向筛查。此外，这些数据还表明，甲状腺癌从正常的甲状腺组织检查发展而来的速度很慢，因此有理由考虑有选择性地延长这一人群的筛查间隔。

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引用次数: 0

A Review of Plant-Based Diets for Obesity Management 以植物为基础的肥胖症饮食综述。

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice

Pub Date : 2024-08-01 DOI: 10.1016/j.eprac.2024.04.020

Objective

Obesity is the most prevalent chronic disease in the United States with over 70% of the American population suffering from overweight/obesity. Recently, the popularity of plant-based diets (PBDs) has grown, with individuals adopting these diets for ethical, health and environmental reasons. Our aim is to evaluate the effect of a PBD on weight loss among patients who are overweight or obese.

Methods

A literature review of PBDs for the treatment of obesity was conducted using PubMed and Scopus. Our search yielded 27 intervention trials (3361 participants) and 6 metanalyses (9168 participants, 61 trials).

Results

Among the intervention trials evaluated, 75% showed a significant increase in weight loss or decrease in weight in the intervention group, on average −5.0 kg (range −1.8 to −12.1 kg). Other outcomes included energy intake (−420 Kcal/d), systolic blood pressure (−3.78 mmHg), fasting plasma glucose (−2.0 mmol/L), hemoglobin A1c (−0.5%, −3.4 mmol/L), total cholesterol (−0.40 mmol/L), low-density lipoprotein (−0.38 mmol/L), triglyceride levels (+0.13 mmol/L), and fiber intake (+10.8 g/d). The 6 meta-analyses showed weight loss (average −2.9 kg, range −2.02 kg to −4.1 kg), body mass index reduction, and improvements in hemoglobin A1c, low-density lipoprotein, and total cholesterol.

Conclusion

PBDs result in significant weight loss and improve metabolic outcomes. PBDs offer a sustainable approach to long-term weight loss maintenance. Health care providers should encourage open discussions with their patients regarding their dietary habits to assist them in setting feasible lifestyle goals and consider shared medical appointments to support patients in transitioning to PBDs.

目标：肥胖症是美国最普遍的慢性疾病，超过 70% 的美国人患有超重/肥胖症。近来，植物性饮食越来越受欢迎，人们出于道德、健康和环保的原因采用这些饮食。我们的目的是评估植物性饮食（PBD）对超重或肥胖患者减肥的影响：方法：我们使用 PubMed 和 Scopus 对治疗肥胖症的植物基饮食进行了文献综述。搜索结果包括 27 项干预试验（3361 名参与者）和 6 项荟萃分析（9168 名参与者，61 项试验）：结果：在接受评估的干预试验中，75%的试验表明干预组的体重明显下降，平均下降幅度为-5.0千克（范围为-1.8至-12.1千克）。其他结果包括能量摄入量（-420 千卡/天）、收缩压（-3.78 毫米汞柱）、空腹血浆葡萄糖（-2.0 毫摩尔/升）、HbA1c（-0.5%，-3.4 毫摩尔/升）、总胆固醇（-0.40 毫摩尔/升）、低密度脂蛋白（-0.38 毫摩尔/升）、甘油三酯水平（+0.13 毫摩尔/升）和纤维摄入量（+10.8 克/天）。六项荟萃分析表明体重减轻（平均-2.9 千克，范围-2.02 千克至-4.1 千克），体重指数降低，HbA1c、低密度脂蛋白和总胆固醇有所改善：结论：PBDs 可显著减轻体重并改善代谢结果。PBDs 为长期保持减肥效果提供了一种可持续的方法。医疗服务提供者应鼓励患者就其饮食习惯进行公开讨论，以帮助他们制定可行的生活方式目标，并考虑共享医疗预约，以支持患者过渡到 PBDs。

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引用次数: 0

Achieving Digital Health Equity in Diabetes Care 在糖尿病护理中实现数字健康平等。

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice

Pub Date : 2024-08-01 DOI: 10.1016/j.eprac.2024.05.006

引用次数: 0

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