Diabetes & Metabolic Syndrome-Clinical Research & Reviews最新文献_第5页

ٍEffects of Sumac Consumption on Blood Pressure, Glycemic Indices, and Body Composition in Adults: A GRADE-assessed Systematic Review and Dose-response Meta-analysis ٍ食用黄栌对成人血压、血糖指数和身体成分的影响：经 GRADE 评估的系统综述和剂量反应元分析

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-09-01 DOI: 10.1016/j.dsx.2024.103122

Shaghayegh Taheri , Zahra Sohrabi , Hossein Bahari , Seyedeh Nooshan Mirmohammadali , Mohammad Hashem Hashempur , Haniyeh Golafrouz , Neda Haghighat , Omid Asbaghi

Background

Owing to the rich phytochemical content of Rhus coriaria L. (Anacardiaceae), known as Sumac, it may affect blood pressure, glycemic, and anthropometric indices. We, therefore, aimed to examine evidence on effect of Sumac on these factors by conducting a meta-analysis of RCTs.

Methods

A systematic literature search up to January 2024 was completed in PubMed/Medline, Scopus, and Web of Science. Heterogeneity tests of the selected trials were performed using the I² statistic. Random effects models were assessed based on the heterogeneity tests, and pooled data were determined as weighted mean differences (WMD) with a 95 % confidence interval (CI).

Results

Fifteen RCTs were included in this meta-analysis. Our findings showed that Sumac consumption significantly reduced diastolic blood pressure (DBP) (WMD = −2.88 mmHg; 95 %CI, −4.22 to −1.54; P = 0.001), fasting blood glucose (FBG) (WMD = −5.15 mg/dL; 95 %CI, −8.73 to −1.57; P = 0.005), insulin (WMD = −1.95 uIU/ml; 95 %CI, 3.11 to −0.79; P = 0.001), Hemoglobin A1c (WMD = −0.48 %; 95 %CI -0.84 to −0.12; P = 0.001), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (WMD = −0.71; 95 %CI, −1.14 to −0.27; P = 0.001), and waist to hip ratio (WHR) (WMD = −0.01; 95 %CI, −0.02 to −0.00; P = 0.017). Sumac consumption had no significant effects on weight, body mass index, and waist circumference.

Conclusion

We found that Sumac consumption could improve DBP, glycemic indices, and WHR. Also, supplementation of this herb in higher doses or longer durations had more promising effects on FBG, HOMA-IR, and WHR.

背景由于黄栌（Rhus coriaria L.，Anacardiaceae）含有丰富的植物化学物质，可能会影响血压、血糖和人体测量指数。因此，我们旨在通过对研究性临床试验进行荟萃分析，研究黄栌对这些因素影响的证据。方法在 PubMed/Medline、Scopus 和 Web of Science 上完成了截至 2024 年 1 月的系统文献检索。使用 I2 统计量对所选试验进行异质性检验。根据异质性检验结果评估随机效应模型，并以加权平均差（WMD）和 95 % 置信区间（CI）确定汇总数据。我们的研究结果表明，服用苏木可明显降低舒张压 (DBP) (WMD = -2.88 mmHg; 95 %CI, -4.22 to -1.54; P = 0.001)、空腹血糖 (FBG) (WMD = -5.15 mg/dL; 95 %CI, -8.73 to -1.57; P = 0.005)、胰岛素 (WMD = -1.95 uIU/ml; 95 %CI, 3.11 至 -0.79；P = 0.001）、血红蛋白 A1c（WMD = -0.48 %；95 %CI，-0.84 至 -0.12；P = 0.001）、胰岛素抵抗静态模型评估（HOMA-IR）（WMD = -0.71；95 %CI，-1.14 至 -0.27；P = 0.001）和腰臀比（WHR）（WMD = -0.01；95 %CI，-0.02 至 -0.00；P = 0.017）。结论我们发现，服用黄栌可改善DBP、血糖指数和WHR。此外，补充较高剂量或较长时间的这种草药对 FBG、HOMA-IR 和 WHR 有更大的影响。

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引用次数: 0

Decreased risk of recurrent acute pancreatitis with semaglutide and tirzepatide in people with type 2 diabetes or obesity with a history of acute pancreatitis: A propensity matched global federated TriNetX database-based retrospective cohort study 有急性胰腺炎病史的 2 型糖尿病或肥胖症患者使用塞马鲁肽和替扎帕肽可降低复发急性胰腺炎的风险：基于TriNetX数据库的倾向匹配全球联合回顾性队列研究

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-09-01 DOI: 10.1016/j.dsx.2024.103116

Mahmoud Nassar MD, PhD, MSc, MHA, MPA, CPHQ, SSBB , Omar Nassar , Hazem Abosheaishaa , Anoop Misra

Background

Acute pancreatitis (AP) is a significant health concern with potential for recurrent episodes and serious complications. The risk of recurrence in type 2 diabetes (T2D) or obesity can be influenced by various factors and treatments, including GLP-1 receptor agonists (GLP-1RAs). This study evaluates the risk of recurrent AP among patients with a history of the condition, focusing on the effects of different GLP-1RA treatments.

Objectives

Our objective is to compare the recurrence risks of AP between patients treated with different GLP-1RAs.

Methods

We conducted a retrospective cohort study using the TriNetX platform, encompassing 258,238 individuals with T2D or obesity who have a history of AP. We assessed the recurrence of AP over a five-year period, analyzing data on treatment regimens, with a focus on the use of Semaglutide, Tirzepatide, and other GLP-1RAs.

Results

GLP-1RA users experienced significantly lower recurrence rates of AP, with those without risk factors showing GLP-1RA users had a recurrence rate of 13.8 % compared to 40.9 % for non-users. Semaglutide and Tirzepatide showed the most favorable outcomes; Semaglutide users had lower recurrence rates than Exenatide (10.1 % vs. 27 %) and slightly lower than Dulaglutide (13.6 % vs. 15.4 %), though not statistically significant with Dulaglutide. Tirzepatide users displayed the lowest recurrence risk at 6.2 %, significantly lower than those on Semaglutide (11.7 %).

Conclusions

GLP-1RAs, particularly Semaglutide and Tirzepatide, are associated with a reduced risk of recurrent AP in people with T2D or obesity. The differential risk profile between these drugs highlights the need for further studies and personalized treatment plans.

背景急性胰腺炎（AP）是一个重大的健康问题，有可能反复发作并引发严重并发症。2型糖尿病（T2D）或肥胖症患者的复发风险会受到各种因素和治疗方法的影响，包括GLP-1受体激动剂（GLP-1RA）。本研究评估了有 AP 病史的患者复发 AP 的风险，重点关注不同 GLP-1RA 治疗方法的影响。方法我们利用 TriNetX 平台开展了一项回顾性队列研究，研究对象包括 258,238 名有 AP 病史的 T2D 或肥胖患者。结果GLP-1RA使用者的AP复发率明显降低，无风险因素者显示GLP-1RA使用者的复发率为13.8%，而非使用者为40.9%。塞马鲁肽和替扎帕肽显示出最有利的结果；塞马鲁肽使用者的复发率低于艾塞那肽（10.1% 对 27%），略低于度拉鲁肽（13.6% 对 15.4%），但度拉鲁肽的复发率在统计学上并不显著。结论 GLP-1RA，尤其是塞马鲁肽和替唑帕肽，可降低 T2D 或肥胖症患者 AP 复发的风险。这些药物之间的风险差异凸显了进一步研究和个性化治疗方案的必要性。

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引用次数: 0

Highlights of the current issue 本期要点

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-09-01 DOI: 10.1016/j.dsx.2024.103141

Ningjian Wang (Associate Editor) , Anoop Misra (Editor-in-Chief)

引用次数: 0

Sex-specific dietary patterns and their association with metabolic syndrome: Insights from a cross-sectional analysis 性别饮食模式及其与代谢综合征的关系：横断面分析的启示

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-09-01 DOI: 10.1016/j.dsx.2024.103123

Mónica Lavinia Popescu , María Rubín-García , Laura Álvarez-Álvarez , Estefanía Toledo , Dolores Corella , Jordi Salas-Salvadó , Karla Alejandra Pérez-Vega , J Alfredo Martínez , Ángel M. Alonso-Gómez , Julia Wärnberg , Jesús Vioque , Dora Romaguera , José López-Miranda , Ramón Estruch , Francisco J. Tinahones , José Lapetra , Luís Serra-Majem , Naomi Cano-Ibáñez , Josep A. Tur , Roi Naveiro , Tania Fernández-Villa

Aims

This study aims to identify a posteriori dietary patterns with a sex approach and to evaluate their association with metabolic syndrome criteria.

Methods

Cross-sectional study conducted in 6821 men and women between 55 and 75 years of age. Forty-two food groups were analyzed from dietary information collected with food frequency questionnaires, using principal component analysis and cluster analysis and then information from both statistical methods was compared. Prevalences were calculated foreach cluster group, based on the number and types of metabolic syndrome criteria they met.

Results

Following principal component analysis, two dietary patterns labeled “healthy” and “unhealthy” were identified in both men and women, due to the presence of foods that are considered more or less healthy. These same dietary patterns were found in cluster analysis plus an “intermediate” cluster consisting of both healthy and unhealthy foods. The presence of metabolic syndrome is related to the “healthy” dietary pattern in women and to the “unhealthy” dietary pattern in men. Comparison of the two statistical approaches showed a high level of correlation between them (weighted Kappa = 0.703 in women and weighted Kappa = 0.691 in men).

Conclusions

Adherence to both healthy and unhealthy dietary pattern appears to be related to the development of MS. The differences found by sex make it necessary to develop interventions with a sex-specific approach.

方法对 6821 名 55 至 75 岁的男性和女性进行横断面研究。利用主成分分析法和聚类分析法对通过食物频率问卷收集到的膳食信息中的 42 个食物组进行了分析，然后对两种统计方法得出的信息进行了比较。根据符合代谢综合征标准的数量和类型，计算出每个聚类组的患病率。结果经过主成分分析，在男性和女性中都发现了两种饮食模式，分别标注为 "健康 "和 "不健康"，这是因为存在被认为更健康或更不健康的食物。在聚类分析中也发现了这些相同的饮食模式，外加一个由健康和不健康食物组成的 "中间 "聚类。代谢综合征的出现与女性的 "健康 "饮食模式和男性的 "不健康 "饮食模式有关。两种统计方法的比较显示，它们之间存在高度相关性（女性加权 Kappa = 0.703，男性加权 Kappa = 0.691）。由于性别差异，有必要制定针对不同性别的干预措施。

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引用次数: 0

Understanding obesity among young adults in India: A focus group study 了解印度年轻人中的肥胖症：焦点小组研究

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-09-01 DOI: 10.1016/j.dsx.2024.103121

Wareesha Anwar , Piyush Ranjan , Anita Malhotra , Nikita Madan , Archana Kumari , Amandeep Singh , Bindu Prakash , Ranveer Singh Jadon , Upendra Baitha , Naval K. Vikram

Introduction

The study aims to understand the knowledge and awareness about risk factors and consequences of obesity, barriers and motivators to weight loss, and potential solutions for weight management among young adults (YAs) in India.

Method

Six focus group discussions were conducted with an inductive approach among obese YAs (18–30 years) recruited through snowball and purposive sampling. The principle of maximum diversity was used to build a pool of varied and extensive information regarding obesity in YAs. The discussions were audio-recorded and transcribed verbatim using NVivo 1.0 by QSR International to generate codes, subthemes, and themes from the discussions.

Result

Among the thirty recruited YAs (mean age 24.7 ± 2.84 years), nearly half were from a high-income group (56.6 %) and had postgraduate education (53.3 %). Key themes included the need for increased awareness about obesity risk factors and consequences across different societal levels. Physical appearance was the primary motivator for weight loss, followed by physical endurance and social support. Major barriers included lack of energy, time, motivation, lifestyle changes, easy access to unhealthy foods, work commitments, and workplace culture. A holistic approach involving dietary changes, physical activity, and educational and policy reforms was suggested as potential solutions.

Conclusion

The challenges faced by YAs in developing countries regarding different aspects of the development and management of obesity are unique and different from the other population groups. Individualized weight management modules may be useful for managing obesity in this group.

导言：本研究旨在了解印度年轻人（YAs）对肥胖的风险因素和后果、减肥的障碍和动力以及体重管理的潜在解决方案的了解和认识。方法：通过滚雪球和有目的的抽样，在肥胖的 YAs（18-30 岁）中采用归纳法进行了六次焦点小组讨论。采用了最大限度多样性的原则，以建立一个有关青年肥胖症的多样而广泛的信息库。QSR国际公司使用NVivo 1.0对讨论进行了录音和逐字转录，以便从讨论中生成代码、次主题和主题。结果在招募的30名青年学生（平均年龄为24.7 ± 2.84岁）中，近一半来自高收入群体（56.6%），并具有研究生学历（53.3%）。关键主题包括需要提高不同社会阶层对肥胖风险因素和后果的认识。外貌是减肥的主要动力，其次是身体耐力和社会支持。主要障碍包括缺乏精力、时间、动力、改变生活方式、容易获得不健康食品、工作承诺和工作场所文化。结论发展中国家的青年学生在肥胖症发展和管理的不同方面所面临的挑战是独特的，与其他人群不同。个性化体重管理模块可能有助于管理这一群体的肥胖症。

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引用次数: 0

The effects of green coffee bean extract on blood pressure and heart rate: A systematic review and dose-response meta-analysis of randomized controlled trials 绿咖啡豆提取物对血压和心率的影响：随机对照试验的系统回顾和剂量反应荟萃分析。

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-09-01 DOI: 10.1016/j.dsx.2024.103120

Simin Samavat , Damoon Ashtary-Larky , Fatemeh Naeini , Behzad Nazarian , Sara Kashkooli , Cain C.T. Clark , Reza Bagheri , Omid Asbaghi , Maryam Babaali , Mohammad Ali Goudarzi , Ali Zamanian , Hadi Emamat

Background and aims

The existing literature on the effects of green coffee bean extract (GCBE) consumption on systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) is equivocal. This study aimed to summarize the effects of GCBE consumption on SBP, DBP and HR in adults.

Methods

Data were pooled using a random-effects model and expressed as weighted mean difference (WMD) and 95 % confidence intervals (95 % CIs).

Results

Out of 1624 records, 10 studies that enrolled 563 participants were included. GCBE consumption significantly decreased SBP (WMD: −2.95 mmHg; 95 % CI: −4.27 to −1.62; p < 0.001) and DBP (WMD: −2.15 mmHg; 95 % CI: −2.59 to −1.72; p < 0.001). However, there was no significant effect on HR (WMD: −1.20 bpm; CI: −2.93 to 0.51; p = 0.170). Subgroup analysis showed that GCBE consumption had a more significant effect on SBP and DBP in participants with high SBP and DBP and had no effect on blood pressure in females. Linear and non-linear dose-response analyses were conducted to find the optimum GCBE dosage and duration of intervention. However, no significant associations were observed for SBP, DBP, and HR in linear meta-regression and non-linear dose-response based on the dose and duration of the intervention.

Conclusion

GCBE has the potential as a hypertension-reducing supplement in hypertensive patients. However, GCBE did not significantly change HR.

背景与目的：关于饮用绿咖啡豆提取物（GCBE）对收缩压（SBP）、舒张压（DBP）和心率（HR）影响的现有文献并不明确。本研究旨在总结服用 GCBE 对成人收缩压、舒张压和心率的影响：采用随机效应模型对数据进行汇总，并以加权平均差（WMD）和 95 % 置信区间（95 % CIs）表示：在1624条记录中，有10项研究纳入了563名参与者。服用五氯苯基醚可明显降低 SBP（WMD：-2.95 mmHg；95 % CI：-4.27 至-1.62；P 结论：五氯苯基醚具有作为高血压药物的潜力：谷胱甘肽具有降低高血压患者血压的潜力。然而，谷丙转氨酶对心率并无明显改变。

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引用次数: 0

Prevalence of peripheral arterial disease among individuals with type 2 diabetes mellitus in India - A systematic review and meta-analysis 印度 2 型糖尿病患者外周动脉疾病的患病率--系统回顾和荟萃分析

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-09-01 DOI: 10.1016/j.dsx.2024.103124

Esha Arora , Raja Regan , Vyshak Uddur Surendra , Ashokan Arumugam

Background

Peripheral arterial disease (PAD) is a prevalent complication of type 2 diabetes mellitus (T2DM). As India ranks second in the population afflicted by T2DM, and the objective of this systematic review was to estimate the pooled prevalence of PAD in individuals living with T2DM in India.

Methods

Five databases (Cochrane (CENTRAL), MEDLINE (via PubMed), CINAHL (via EBSCO), PEDro, and Scopus) were searched using database-specific search terms from inception to August 2023. Inclusion criteria included studies reporting the prevalence of PAD in Indian adults diagnosed with T2DM of either or both sexes, employing ankle brachial index measurements with a Doppler test or sphygmomanometer. The risk of bias was evaluated using the JBI checklist, and the certainty of evidence was determined via the GRADE approach.

Results

Twenty-three articles met the inclusion criteria which comprised of 196,883 individuals with T2DM aged between 30 and 70 years from nine states and one union territory. Utilizing a random effects model, the meta-analysis revealed that the pooled prevalence of PAD among individuals with T2DM in India was 18 % (95 % confidence interval: 10–28 %), with statistically significant heterogeneity observed between studies (I² = 100 %, P < 0.001). Overall certainty in the evidence was low.

Conclusion

The combined prevalence of PAD among individuals with T2DM in India is 18 %, indicating a significant portion of the Indian population has been affected. Epidemiological studies utilizing precise assessment tools can enhance the early detection and prevention of PAD in T2DM and improve the certainty of findings.

背景外周动脉疾病（PAD）是 2 型糖尿病（T2DM）的一种常见并发症。本系统综述的目的是估算印度 T2DM 患者中 PAD 的总体患病率。方法使用特定的检索词检索了从开始到 2023 年 8 月的五个数据库（Cochrane (CENTRAL)、MEDLINE (通过 PubMed)、CINAHL (通过 EBSCO)、PEDro 和 Scopus）。纳入标准包括采用多普勒测试或血压计测量踝肱指数，报告印度成年 T2DM 患者中 PAD 患病率的研究，无论男女。结果有 23 篇文章符合纳入标准，其中包括来自 9 个邦和 1 个中央直辖区的 196,883 名年龄在 30 岁至 70 岁之间的 T2DM 患者。利用随机效应模型进行的荟萃分析表明，印度 T2DM 患者中 PAD 的总体患病率为 18%（95% 置信区间：10%-28%），不同研究之间存在统计学意义上的显著异质性（I2 = 100%，P <0.001）。结论印度 T2DM 患者中 PAD 的总患病率为 18%，这表明印度有相当一部分人受到了影响。利用精确的评估工具进行流行病学研究，可以加强对 T2DM 患者 PAD 的早期发现和预防，并提高研究结果的确定性。

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引用次数: 0

Individual cereals intake is associated with progression of diabetes and diabetic chronic complications 个人谷物摄入量与糖尿病和糖尿病慢性并发症的进展有关

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-09-01 DOI: 10.1016/j.dsx.2024.103127

Siying Tang , Wenjin Luo , Ting Li , Xiangjun Chen , Qinglian Zeng , Rufei Gao , Bing Kang , Chuan Peng , Zhihong Wang , Shumin Yang , Qifu Li , Jinbo Hu

Background and aims

The relationship between cereals intake and diabetes is unclear. We aimed to explore associations between individual cereals intake and risks of incident and progression of diabetes.

Methods

We included 502,490 participants from UK Biobank at baseline. A single touchscreen food frequency questionnaire was used to estimate the intake of individual cereals (bran, biscuit, oat, muesli, and other cereals). Main outcomes included incident diabetes and diabetic complications of cardiovascular disease (CVD), chronic kidney disease (CKD) and diabetic retinopathy (DR). Polygenic risk score (PRS) of glycosylated hemoglobin (HbA1c) was calculated for mediating effects analysis.

Results

Among participants without diabetes, when compared to subjects who never had cereals, hazard ratios (95%CI) of developing diabetes in those who had ≥6 bowls/week were 0.72 (0.67–0.78) for bran, 0.86 (0.81–0.92) for biscuit, 0.75(0.66–0.84) for oat, and 0.57(0.53,0.61) for muesli. Among people with diabetes without CVD, a higher intake of aforementioned four individual cereals was associated with a 13%–32 % lower risk of developing CVD. Among people with diabetes without CKD, a higher intake of aforementioned four individual cereals was associated with a 9%–28 % lower risk of developing CKD. We observed a significant mediating effect of the PRS of HbA1c for the association between aforementioned four individual cereals and developing diabetes.

Conclusion

A higher consumption of cereals was significantly associated with lower risks of diabetes and diabetic complications. Polygenic of HbA1c mediates the effect of cereals on incident diabetes.

背景和目的谷物摄入量与糖尿病之间的关系尚不清楚。我们旨在探讨谷物摄入量与糖尿病发病和恶化风险之间的关系。我们使用单个触摸屏食物频率问卷来估算各种谷物（麦麸、饼干、燕麦、麦片和其他谷物）的摄入量。主要结果包括糖尿病发病率以及心血管疾病（CVD）、慢性肾病（CKD）和糖尿病视网膜病变（DR）等糖尿病并发症。计算糖化血红蛋白（HbA1c）的多基因风险评分（PRS）以进行中介效应分析。结果在没有糖尿病的参与者中，与从未食用谷物的受试者相比，每周食用≥6碗谷物的受试者患糖尿病的危险比（95%CI）为0.72（0.67-0.78），饼干为 0.86（0.81-0.92），燕麦为 0.75（0.66-0.84），麦片为 0.57（0.53,0.61）。在未患心血管疾病的糖尿病患者中，上述四种谷物的摄入量越高，患心血管疾病的风险就会降低 13%-32%。在未患慢性肾脏病的糖尿病患者中，摄入上述四种谷物的比例越高，患慢性肾脏病的风险就会降低 9%-28%。我们观察到，HbA1c 的 PRS 对上述四种谷物与糖尿病之间的关系有明显的中介作用。HbA1c 的多基因介导了谷物对糖尿病发病的影响。

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引用次数: 0

Impact of rosuvastatin on metabolic syndrome patients with moderate to severe metabolic associated fatty liver disease without overt diabetes: A randomized clinical trial 罗伐他汀对患有中重度代谢相关性脂肪肝且无明显糖尿病的代谢综合征患者的影响：随机临床试验

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-09-01 DOI: 10.1016/j.dsx.2024.103126

Xuan Wang , Lu Lyu , Wei Li , Lingling Xu , Huabing Zhang , Shitian Wang , Yiwen Liu , Fan Ping , Yuxiu Li

Objective

This investigation aimed to evaluate the efficacy and safety of rosuvastatin in treating moderate to severe metabolic associated fatty liver disease (MAFLD).

Methods

This prospective, open-label, randomized study included non-diabetic participants with metabolic syndrome and intrahepatocellular lipid (IHCL) levels >10 %, as determined by proton magnetic resonance spectroscopy (¹H-MRS). The primary objective was the effect of a 52-week rosuvastatin treatment (10 mg/day) on IHCL content. Secondary objectives included the association between IHCL reduction and lipid metabolism parameters, along with safety indices such as glycemic control and hepatic and renal function.

Results

Thirty-two participants completed the study. Rosuvastatin resulted in a significant absolute (△IHCL: 7.61 ± 4.51 vs. 1.54 ± 5.33, p = 0.002) and relative reduction in IHCL (△IHCL%: −42.28 ± 24.90 % vs. −8.91 ± 31.93 %, p = 0.003) compared to the control. Reduction in IHCL correlated significantly with decreases in low-density lipoprotein cholesterol (LDL-C) (r = 0.574, p < 0.01), apolipoprotein B (ApoB) (r = 0.660, p < 0.001), and free fatty acids (FFA) (r = 0.563, p = 0.005). No significant safety differences were observed between groups.

Conclusions

Rosuvastatin significantly reduced hepatic steatosis in individuals with moderate to severe MAFLD and metabolic syndrome over 52 weeks, while maintaining a favorable safety profile.

方法这项前瞻性、开放标签、随机研究纳入了患有代谢综合征、肝细胞内脂质（IHCL）水平为10%（通过质子磁共振波谱（1H-MRS）测定）的非糖尿病参与者。首要目标是罗伐他汀治疗 52 周（10 毫克/天）对 IHCL 含量的影响。次要目标包括 IHCL 降低与脂质代谢参数之间的关联，以及血糖控制、肝肾功能等安全性指标。与对照组相比，瑞舒伐他汀显著降低了IHCL的绝对值（△IHCL：7.61 ± 4.51 vs. 1.54 ± 5.33，p = 0.002）和相对值（△IHCL%：-42.28 ± 24.90 % vs. -8.91 ± 31.93 %，p = 0.003）。IHCL的降低与低密度脂蛋白胆固醇（LDL-C）（r = 0.574，p = 0.01）、载脂蛋白B（ApoB）（r = 0.660，p = 0.001）和游离脂肪酸（FFA）（r = 0.563，p = 0.005）的降低显著相关。结论罗苏伐他汀能在 52 周内明显减轻中重度 MAFLD 和代谢综合征患者的肝脂肪变性，同时保持良好的安全性。

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引用次数: 0

Cardiometabolic outcomes in offspring of women treated with metformin versus insulin for gestational diabetes: A Systematic Review and meta-analysis 使用二甲双胍和胰岛素治疗妊娠糖尿病的妇女后代的心脏代谢结果：系统回顾与荟萃分析

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-09-01 DOI: 10.1016/j.dsx.2024.103134

Dimple Rawat , Yashdeep Gupta , Arun Kumar Yadav , Manoj Kumar Tembhre , Priyanka Das , Saisree Bakkireddy , Neeta Singh , K Aparna Sharma , Rinchen Zangmo , Avdhesh Chandra , Ashish Datt Upadhyay , Deepali Garg

Introduction

Gestational diabetes mellitus (GDM) is commonly managed with either metformin or insulin, but their comparative effects on offspring cardiometabolic outcomes are not fully understood.

Objective

To investigate the impact of metformin and insulin, two distinct pharmacological interventions, on cardiometabolic outcomes in offspring of mothers with GDM.

Methodology

Systematic literature review was performed for articles (randomized control trials) published from 1974 to May 2024 using a predefined search strategy. Studies were screened for title and abstract followed by full text. Quality assessment was done using a separate risk of bias tool in line with the PRISMA-2020 checklist.

Results

Among 5463 records, five studies (metformin = 409 children or insulin n = 434 children) were included. Offspring of metformin-treated mothers in the age range of 5–9 years had more fat-free mass (kg) by bioimpedance and abdominal (subcutaneous and visceral) fat volume (cm³) by MRI. Fasting plasma glucose and triglycerides were lower in the metformin-treated group for offspring aged 5–9 years. No significant differences were observed for other cardiometabolic outcomes. Limited data available for offsprings less than 5 years of age precluded meta-analysis for the available outcomes, except for body weight, and difference for this was also not significant.

Conclusion

In short term no major differences has been seen in most of the cardiometabolic outcomes evaluated in the meta-analysis. Future trials with longer follow up are required and in different ethnicities.

Systematic review registration

PROSPERO-CRD42023450990.

简介妊娠期糖尿病（GDM）通常采用二甲双胍或胰岛素进行治疗，但这两种药物对后代心脏代谢结果的比较效应尚不完全清楚。方法采用预定义的检索策略，对 1974 年至 2024 年 5 月期间发表的文章（随机对照试验）进行系统文献综述。先筛选研究的标题和摘要，然后再筛选全文。结果在 5463 条记录中，纳入了五项研究（二甲双胍 = 409 名儿童或胰岛素 n = 434 名儿童）。通过生物阻抗和核磁共振成像，二甲双胍治疗的母亲的 5-9 岁子女的去脂质量（千克）和腹部（皮下和内脏）脂肪体积（立方厘米）均有所增加。二甲双胍治疗组 5-9 岁儿童的空腹血糖和甘油三酯较低。在其他心脏代谢结果方面未观察到明显差异。由于 5 岁以下儿童的数据有限，因此无法对现有结果进行荟萃分析，但体重除外，其差异也不显著。系统综述注册PROSPERO-CRD42023450990。

{"title":"Cardiometabolic outcomes in offspring of women treated with metformin versus insulin for gestational diabetes: A Systematic Review and meta-analysis","authors":"Dimple Rawat , Yashdeep Gupta , Arun Kumar Yadav , Manoj Kumar Tembhre , Priyanka Das , Saisree Bakkireddy , Neeta Singh , K Aparna Sharma , Rinchen Zangmo , Avdhesh Chandra , Ashish Datt Upadhyay , Deepali Garg","doi":"10.1016/j.dsx.2024.103134","DOIUrl":"10.1016/j.dsx.2024.103134","url":null,"abstract":"<div><h3>Introduction</h3><div>Gestational diabetes mellitus (GDM) is commonly managed with either metformin or insulin, but their comparative effects on offspring cardiometabolic outcomes are not fully understood.</div></div><div><h3>Objective</h3><div>To investigate the impact of metformin and insulin, two distinct pharmacological interventions, on cardiometabolic outcomes in offspring of mothers with GDM.</div></div><div><h3>Methodology</h3><div>Systematic literature review was performed for articles (randomized control trials) published from 1974 to May 2024 using a predefined search strategy. Studies were screened for title and abstract followed by full text. Quality assessment was done using a separate risk of bias tool in line with the PRISMA-2020 checklist.</div></div><div><h3>Results</h3><div>Among 5463 records, five studies (metformin = 409 children or insulin n = 434 children) were included. Offspring of metformin-treated mothers in the age range of 5–9 years had more fat-free mass (kg) by bioimpedance and abdominal (subcutaneous and visceral) fat volume (cm<sup>3</sup>) by MRI. Fasting plasma glucose and triglycerides were lower in the metformin-treated group for offspring aged 5–9 years. No significant differences were observed for other cardiometabolic outcomes. Limited data available for offsprings less than 5 years of age precluded meta-analysis for the available outcomes, except for body weight, and difference for this was also not significant.</div></div><div><h3>Conclusion</h3><div>In short term no major differences has been seen in most of the cardiometabolic outcomes evaluated in the meta-analysis. Future trials with longer follow up are required and in different ethnicities.</div></div><div><h3>Systematic review registration</h3><div>PROSPERO-CRD42023450990.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 9","pages":"Article 103134"},"PeriodicalIF":4.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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