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Prognostic Biomarkers in Pituitary Tumours: A Systematic Review. 垂体瘤的预后生物标志物:系统综述。
Pub Date : 2023-11-01 Epub Date: 2023-08-09 DOI: 10.17925/EE.2023.19.2.12
Eirini Papadimitriou, Eleftherios Chatzellis, Anastasia Dimitriadi, Gregory A Kaltsas, Stamatios Theocharis, Krystallenia I Alexandraki

Pituitary tumours (PTs) are the second most common intracranial tumour. Although the majority show benign behaviour, they may exert aggressive behaviour and can be resistant to treatment. The aim of this review is to report the recently identified biomarkers that might have possible prognostic value. Studies evaluating potentially prognostic biomarkers or a therapeutic target in invasive/recurrent PTs compared with either non-invasive or non-recurrent PTs or normal pituitaries are included in this review. In the 28 included studies, more than 911 PTs were evaluated. A systematic search identified the expression of a number of biomarkers that may be positively correlated with disease recurrence or invasion in PT, grouped according to role: (1) insensitivity to anti-growth signals: minichromosome maintenance protein 7; (2) evasion of the immune system: cyclooxygenase 2, arginase 1, programmed cell death protein 1 (PD-1)/programmed death ligand 2, cluster of differentiation (CD) 80/CD86; (3) sustained angiogenesis: endothelial cell-specific molecule, fibroblast growth factor receptor, matrix metalloproteinase 9, pituitary tumour transforming gene; (4) self-sufficiency in growth signals: epidermal growth factor receptor; and (5) tissue invasion: matrix metalloproteinase 9, fascin protein. Biomarkers with a negative correlation with disease recurrence or invasion include: (1) insensitivity to anti-growth signals: transforming growth factor β1, Smad proteins; (2) sustained angiogenesis: tissue inhibitor of metalloproteinase 1; (3) tissue invasion: Wnt inhibitory factor 1; and (4) miscellaneous: co-expression of glial fibrillary acidic protein and cytokeratin, and oestrogen receptors α36 and α66. PD-1/programmed cell death ligand 1 showed no clear association with invasion or recurrence, while cyclin A, cytotoxic T lymphocyte-associated protein 4, S100 protein, ephrin receptor, galectin-3 , neural cell adhesion molecule, protein tyrosine phosphatase 4A3 and steroidogenic factor 1 had no association with invasion or recurrence of PT. With the aim to develop a more personalized approach to the treatment of PT, and because of the limited number of molecular targets currently studied in the context of recurrent PT and invasion, a better understanding of the most relevant of these biomarkers by well-d esigned interventional studies will lead to a better understanding of the molecular profile of PT. This should also meet the increased need of treatable molecular targets.

垂体瘤(PTs)是第二大最常见的颅内肿瘤。虽然大多数垂体瘤表现为良性,但也可能具有侵袭性,并对治疗产生抗药性。本综述旨在报告最近发现的可能具有预后价值的生物标志物。与非侵袭性或非复发性垂体癌或正常垂体癌相比,评估侵袭性/复发性垂体癌的潜在预后生物标志物或治疗靶点的研究被纳入本综述。在纳入的 28 项研究中,对超过 911 例 PT 进行了评估。通过系统性检索发现了一些可能与PT疾病复发或侵袭呈正相关的生物标志物的表达,这些标志物根据作用进行了分组:(1)对抗生长信号不敏感:小染色体维护蛋白7;(2)逃避免疫系统:环氧化酶 2、精氨酸酶 1、程序性细胞死亡蛋白 1(PD-1)/程序性死亡配体 2、分化簇(CD)80/CD86;(3) 持续血管生成:内皮细胞特异性分子、成纤维细胞生长因子受体、基质金属蛋白酶 9、垂体瘤转化基因;(4) 生长信号自给自足:表皮生长因子受体;(5) 组织侵袭:基质金属蛋白酶 9、筋膜蛋白。与疾病复发或侵袭呈负相关的生物标志物包括(1) 对抗生长信号不敏感:转化生长因子 β1、Smad 蛋白;(2) 持续血管生成:金属蛋白酶组织抑制剂 1;(3) 组织侵袭:Wnt抑制因子1;(4) 其他:胶质纤维酸性蛋白和细胞角蛋白的共同表达,以及雌激素受体α36和α66。而细胞周期蛋白A、细胞毒性T淋巴细胞相关蛋白4、S100蛋白、ephrin受体、galectin-3、神经细胞粘附分子、蛋白酪氨酸磷酸酶4A3和类固醇生成因子1与PT的侵袭或复发无明显关联。为了开发更个性化的 PT 治疗方法,同时由于目前针对复发性 PT 和侵袭研究的分子靶点数量有限,通过精心设计的介入研究更好地了解这些生物标志物中最相关的生物标志物将有助于更好地了解 PT 的分子特征。这也将满足对可治疗分子靶点的更多需求。
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引用次数: 0
The Clinical Septet of Van Wyk-Grumbach Syndrome: A Case Series from a Tertiary Care Centre in Kalyana Karnataka, India. Van Wyk-Grumbach综合征的临床特征:来自印度卡纳塔克邦Kalyana三级保健中心的病例系列。
Pub Date : 2023-05-01 DOI: 10.17925/EE.2023.19.1.98
Swaraj Waddankeri, Meenakshi Waddankeri, Shrikant Waddankeri, Kshitij Arora

Van Wyk-Grumbach syndrome is a rare, female juvenile hypothyroidism disorder that is characterized by precocious puberty with clinical, radiological and hormonal pathologies. We present a case series of three patients with this unusual condition who were evaluated and followed up over a 3-year period between January 2017 and June 2020. All three patients presented with short stature (<3rd centile), low weight (<3rd centile), absence of goitre, no axillary or pubic hair, delayed bone age by more than 2 years, elevated thyroid-stimulating hormone with low T3 and T4 (primary hypothyroidism), and raised follicle-stimulating hormone with pre-pubertal levels of luteinizing hormone. Abdominal ultrasonography showed bilateral multi-cystic ovaries in two patients and a right-sided bulky ovary in the third patient. One of the patients also had a pituitary 'macroadenoma'. All the patients were successfully managed with levothyroxine. We discuss the pathophysiological mechanisms with a brief literature review.

Van Wyk-Grumbach综合征是一种罕见的女性青少年甲状腺功能减退症,以性早熟为特征,伴有临床、放射学和激素病理学。我们提出了一个由三名患有这种不寻常疾病的患者组成的病例系列,他们在2017年1月至2020年6月的3年期间进行了评估和随访。三名患者均表现为身材矮小(
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引用次数: 0
Thyrotoxic Cardiomyopathy: State of the Art. 甲亢性心肌病:最新进展
Pub Date : 2023-05-01 Epub Date: 2023-02-07 DOI: 10.17925/EE.2023.19.1.78
Juan Eduardo Quiroz-Aldave, María Del Carmen Durand-Vásquez, Carlos Jhonatan Lobato-Jeri, Juan-Manuel Muñoz-Moreno, Diana Carolina Deutz Gómez Condori, Sofía Pilar Ildefonso-Najarro, Felipe Contreras-Yametti, Francisca Zavaleta-Gutiérrez, Luis Concepción-Urteaga, Marcio José Concepción-Zavaleta

Thyroid hormones, mainly triiodothyronine, have genomic and non-genomic effects on cardiomyocytes related to the contractile function of the heart. Thyrotoxicosis, which is the set of signs and symptoms derived from the excess of circulating thyroid hormones, leads to increased cardiac output and decreased systemic vascular resistance, increasing the volume of circulating blood and causing systolic hypertension. In addition, the shortening of the refractory period of cardiomyocytes produces sinus tachycardia and atrial fibrillation. This leads to heart failure. Approximately 1% of patients with thyrotoxicosis develop thyrotoxic cardiomyopathy, a rare but potentially fatal form of dilated cardiomyopathy. Thyrotoxic cardiomyopathy represents a diagnosis of exclusion, and prompt identification is crucial as it is a reversible cause of heart failure, and heart function can be recovered after achieving a euthyroid state using antithyroid drugs. Radioactive iodine therapy and surgery are not the best initial therapeutic approach. Moreover, it is important to manage cardiovascular symptoms, for which beta blockers are the first-line therapeutic option.

甲状腺激素,主要是三碘甲状腺原氨酸,对与心脏收缩功能有关的心肌细胞具有基因组和非基因组效应。甲亢是循环中甲状腺激素过量引起的一系列症状和体征,会导致心输出量增加,全身血管阻力降低,循环血量增加,引起收缩期高血压。此外,心肌细胞的折返期缩短会产生窦性心动过速和心房颤动。这会导致心力衰竭。约有1%的甲亢患者会发生甲亢性心肌病,这是一种罕见但可能致命的扩张型心肌病。甲亢性心肌病是一种排除性诊断,及时发现至关重要,因为它是心力衰竭的可逆性病因,在使用抗甲状腺药物达到甲状腺功能亢进状态后,心脏功能可以恢复。放射性碘治疗和手术并非最佳的初始治疗方法。此外,控制心血管症状也很重要,β受体阻滞剂是一线治疗方案。
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引用次数: 0
Surgical Treatment of Solitary Metachronous Adrenal Metastasis from Urothelial Carcinoma of the Urinary Bladder. 膀胱尿路上皮癌单发异时性肾上腺转移的手术治疗。
Pub Date : 2023-05-01 DOI: 10.17925/EE.2023.19.1.94
Dimitrios Politis, Panagiota Konstantakou, Konstantinos Bramis, Krystallenia I Alexandraki, Ariadni Spyroglou, George Mastorakos, Ioannis Anastasiou, Ioannis Papaconstantinou, Meletios A Dimopoulos

Urothelial cancer is a common neoplasm and metastatic disease correlates with a poor prognosis. Isolated adrenal gland metastases of urothelial carcinoma are quite rare, and management options can decide a patient's prognosis. Herein we report the case of a 76-year-old man with a metachronous solitary adrenal metastasis from a bladder carcinoma, who underwent adrenalectomy as part of his treatment. Furthermore, we discuss the cases of solitary adrenal metastases of urothelial carcinoma available in the literature, to identify key features to direct appropriate treatment of this rare metastatic site of urothelial cancer and improve prognosis and survival. Still, further prospective studies are needed to design effective therapeutic strategies.

尿路上皮癌是一种常见的肿瘤和转移性疾病,预后较差。孤立的肾上腺转移的尿路上皮癌是相当罕见的,治疗方案可以决定病人的预后。我们在此报告一名76岁男性膀胱癌异时性孤立性肾上腺转移的病例,他接受了肾上腺切除术作为治疗的一部分。此外,我们讨论了文献中可用的尿路上皮癌单发肾上腺转移的病例,以确定关键特征,指导这种罕见的尿路上皮癌转移部位的适当治疗,改善预后和生存率。然而,需要进一步的前瞻性研究来设计有效的治疗策略。
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引用次数: 0
Coexistence of Thyrolipomatosis and Tongue Squamous Cell Carcinoma: A Case Report. 甲状腺脂肪瘤病与舌鳞癌共存1例。
Pub Date : 2023-05-01 DOI: 10.17925/EE.2023.19.1.103
Jose Paz-Ibarra, Marcio Concepción-Zavaleta, Daniel Mendoza-Quispe, Jacsel Suárez-Rojas, Katia Rivera Fabián, Diana Deutz-Gómez, Juan Quiroz-Aldave, José Somocurcio Peralta, Tula Ayquipa Arróspide

Thyrolipomatosis, a diffuse non-neoplastic infiltration of fatty tissue in the thyroid gland, is an extremely rare condition with only about 30 cases reported worldwide. A few of these cases report the concurrency of thyrolipomatosis and malignant neoplasms in the thyroid or colon, but never with tongue cancer. A 44-year-old female patient with an infiltrative tongue mass suggestive of carcinoma presented for an outpatient consultation. Cervical imaging revealed multiple lymphadenopathies and a multinodular goitre with diffuse fatty infiltration, suggestive of thyrolipomatosis. Surgical intervention included partial resection of the tongue and thyroid (left hemiglossectomy and right hemithyroidectomy, respectively) and lymphadenectomy. The thyroid specimen showed diffuse fat metaplasia of the stromal thyroid tissue, confirming incidental thyrolipomatosis. During post-operative follow-up, the patient presented with recurrence of squamous cell carcinoma as indicated by new right-sided thyroid nodules, left-sided lymphadenopathies with confirmatory biopsy, and a growing neck mass that became infected. The patient developed septic shock and later died. Thyrolipomatosis causes thyroid swelling and can be clinically detected as goitres or as an incidental finding. Diagnosis is suggested by cervical imaging (ultrasonography, computed tomography or magnetic resonance), but confirmation is histological after thyroidectomy. Although thyrolipomatosis is benign, it could develop concurrently with neoplastic diseases, especially on embryologically related tissues (e.g. thyroid and tongue). This case report is the first in the literature describing the coexistence between thyrolipomatosis and tongue cancer in an adult Peruvian patient.

甲状腺脂肪瘤病是一种甲状腺脂肪组织的弥漫性非肿瘤性浸润,是一种极其罕见的疾病,全世界仅报道了约30例。这些病例中有少数报告甲状腺脂肪瘤病和甲状腺或结肠恶性肿瘤的并发,但从未报告舌癌。一个44岁的女性患者浸润性舌肿块提示癌提出门诊咨询。宫颈影像显示多发性淋巴结病变及弥漫性脂肪浸润的多结节性甲状腺肿,提示甲状腺脂肪瘤病。手术干预包括舌和甲状腺部分切除(分别为左侧半胱氨酸切除术和右侧半甲状腺切除术)和淋巴结切除术。甲状腺标本显示甲状腺间质组织弥漫性脂肪化生,证实偶发性甲状腺脂肪瘤病。在术后随访中,患者出现鳞状细胞癌复发,表现为右侧新发甲状腺结节,左侧淋巴结病变,活检证实,颈部肿块不断扩大并感染。病人出现感染性休克,后来死亡。甲状腺脂肪瘤病引起甲状腺肿胀,临床上可作为甲状腺肿或偶然发现。诊断建议通过宫颈影像学检查(超声、计算机断层扫描或磁共振),但在甲状腺切除术后需要组织学证实。虽然甲状腺脂肪瘤病是良性的,但它可以并发肿瘤疾病,特别是胚胎相关组织(如甲状腺和舌)。本病例报告是文献中第一个描述甲状腺脂肪瘤病和舌癌共存的秘鲁成年患者。
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引用次数: 0
The AACE 2022 Guideline: An Academic Appraisal. AACE 2022指南:学术评估。
Pub Date : 2023-05-01 DOI: 10.17925/EE.2023.19.1.2
Saptarshi Bhattacharya, Sanjay Kalra

The American Association of Clinical Endocrinology (AACE) 2022 guideline provides comprehensive and evidence-based guidance on contemporary diabetes management. The statement reiterates the importance of person-centred, team-based care for optimum outcomes. The recent strides to prevent cardiovascular and renal complications have been aptly incorporated. The recommendations on virtual care, continuous glucose monitors, cancer screening, infertility and mental health are relevant. However, focused discussions on non-alcoholic fatty liver disease and geriatric diabetes care could have been helpful. Outlining targets for prediabetes care is a notable addition and is likely to be the most effective strategy in addressing the rising burden of diabetes.

美国临床内分泌学会(AACE) 2022指南为当代糖尿病管理提供了全面的循证指导。声明重申了以人为本、以团队为基础的护理对最佳结果的重要性。最近在预防心血管和肾脏并发症方面取得的进展已被适当地纳入。关于虚拟护理、连续血糖监测、癌症筛查、不孕症和精神健康的建议是相关的。然而,集中讨论非酒精性脂肪性肝病和老年糖尿病的护理可能会有所帮助。概述糖尿病前期护理的目标是一个值得注意的补充,可能是解决糖尿病日益增加的负担的最有效策略。
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引用次数: 0
Early Recognition of Overweight Hyperglycaemia May Improve Clinical Outcomes in Type 2 Diabetes. 早期识别超重高血糖可改善2型糖尿病的临床预后
Pub Date : 2023-05-01 DOI: 10.17925/EE.2023.19.1.33
Anand Chockalingam, Pandiyan Natarajan, Smrita Dorairajan, Uzma Khan

Diabetes is the ninth leading cause of death, directly accounting for 1.5 million deaths annually worldwide. Despite several breakthrough discoveries, little progress has been made in type 2 diabetes outcomes over the past 100 years. Younger age (below 60 years), a diet high in calories and processed food, and severe obesity (body mass index >35 kg/m2) may identify reversible beta cell dysfunction. Much of the clinical presentation pertains to flooding the body's adaptive limits with overnutrition. Recognizing this as a global societal trend brought about by lifestyle changes, sedentary work, mental stress and unlimited access to calorie-dense foods is crucial. Insulin resistance and genetic abnormalities cannot account for the dramatic increase in diabetes, from only 1% five decades ago to nearly 10% today. Obesity - and not insulin resistance - is at the core of the problem. As well as hyperglycaemia, end-organ damage can also be reversed with diet and weight loss in many affected individuals. We present the evolution of our understanding and compelling reasons to reframe diabetes in the severely obese to what it really is - overweight hyperglycaemia. This may shift societal perception, governmental funding, workplace reformations and individual engagement with healthy lifestyles. The objective of this review is to better understand global trends and the potential to improve outcomes by reframing the diabetes narrative towards remission. This may shift societal perception, governmental funding, workplace reformations and individual engagement with healthy lifestyles.

糖尿病是第九大死因,每年直接导致全世界150万人死亡。尽管有一些突破性的发现,但在过去的100年里,2型糖尿病的治疗进展甚微。年龄较小(60岁以下),高热量饮食和加工食品,以及严重肥胖(体重指数>35 kg/m2)可识别可逆性β细胞功能障碍。许多临床表现与营养过剩淹没身体的适应极限有关。认识到这是生活方式改变、久坐不动的工作、精神压力和无限获取高热量食物所带来的全球社会趋势是至关重要的。胰岛素抵抗和基因异常不能解释糖尿病的急剧增加,从50年前的1%到今天的近10%。肥胖——而不是胰岛素抵抗——才是问题的核心。与高血糖一样,终末器官损伤也可以通过饮食和减肥来逆转。我们提出了我们的理解的演变和令人信服的理由,将严重肥胖的糖尿病重新定义为它的真实面目-超重高血糖。这可能会改变社会观念、政府资助、工作场所改革和个人对健康生活方式的参与。本综述的目的是更好地了解全球趋势,并通过重塑糖尿病缓解叙事来改善预后的潜力。这可能会改变社会观念、政府资助、工作场所改革和个人对健康生活方式的参与。
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引用次数: 1
The Important Role of Intermuscular Adipose Tissue on Metabolic Changes Interconnecting Obesity, Ageing and Exercise: A Systematic Review. 肌肉间脂肪组织对肥胖、老化和运动之间代谢变化的重要作用:系统综述》。
Pub Date : 2023-05-01 Epub Date: 2023-05-17 DOI: 10.17925/EE.2023.19.1.54
I Gusti Putu Suka Aryana, Ivana Beatrice Paulus, Sanjay Kalra, Dian Daniella, Raden Ayu Tuty Kuswardhani, Ketut Suastika, Sony Wibisono

As age increases, adipose tissue infiltrates muscle tissue and leads to sarcopenia. When excessive accumulation of adipose tissue accompanied progressive decrease in lean body mass especially visceral fat, termed as sarcopenic obesity (SO) and related metabolic intermuscular adipose tissue (IMAT) is an ectopic tissue found between muscle groups, and is distinct from subcutaneous adipose tissue. Until now, the association between IMAT and metabolic health was not understood. This study is the first systematic review assessing the association between IMAT and metabolic health. The PubMed, Science Direct and Cochrane databases were searched for studies reporting IMAT and metabolic risk. The descriptions of the extracted data are guided by the Preferred Reporting Items for Systematic Reviews (PRISMA) statement with a Grading of Recommendations Assessment, Development and Evaluation approach. This study is registered at PROSPERO (identifier: CRD42022337518). Six studies were pooled and reviewed using critical appraisal by the Newcastle Ottawa Scale and Centre for Evidence-Based Medicine checklist. Two clinical trials and four observational trials were included. Our results reveal that IMAT is associated with metabolic risk, especially in older adults and patients with obesity. However, in a person with abdominal obesity, VAT has a more significant role in metabolic risk than IMAT. The largest decrease in IMAT was achieved by combining aerobic with resistance training.

随着年龄的增长,脂肪组织会渗入肌肉组织,导致肌肉疏松症。当脂肪组织过度堆积并伴随着瘦体重(尤其是内脏脂肪)的逐渐减少时,就被称为肌肉疏松性肥胖症(SO)和相关的代谢肌间脂肪组织(IMAT),它是一种存在于肌肉群之间的异位组织,有别于皮下脂肪组织。到目前为止,人们还不了解肌间脂肪组织与代谢健康之间的关系。本研究是首次对 IMAT 与代谢健康之间的关系进行评估的系统性综述。我们在 PubMed、Science Direct 和 Cochrane 数据库中搜索了报告 IMAT 和代谢风险的研究。对提取数据的描述以系统性综述首选报告项目(PRISMA)声明为指导,并采用了建议分级评估、开发和评价方法。本研究已在 PROSPERO 注册(标识符:CRD42022337518)。采用纽卡斯尔渥太华量表和循证医学中心检查表对六项研究进行了汇总和审查。其中包括两项临床试验和四项观察性试验。我们的研究结果表明,IMAT 与代谢风险有关,尤其是在老年人和肥胖症患者中。然而,对于腹型肥胖患者来说,VAT 在代谢风险中的作用比 IMAT 更大。将有氧训练与阻力训练相结合可最大程度地降低 IMAT。
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引用次数: 0
Is Type 2 Diabetes Mellitus a Behavioural Disorder? An Evidence Review for Type 2 Diabetes Mellitus Prevention and Remission through Lifestyle Modification. 2型糖尿病是一种行为障碍吗?通过改变生活方式预防和缓解2型糖尿病的证据综述
Pub Date : 2023-05-01 DOI: 10.17925/EE.2023.19.1.7
Matthias Li, Mohammad Sadiq Jeeyavudeen, Ganesan Arunagirinathan, Joseph Pappachan

The prevalence of type 2 diabetes mellitus (T2DM) is steadily rising worldwide due to an increasingly sedentary lifestyle combined with unhealthy food habits. Currently, the burden of diabetes on healthcare systems is unprecedented and rising daily. Several observational studies and randomized controlled trials provide clinical evidence that T2DM remission is possible by adopting dietary interventions and a strict exercise training protocol. Notably, these studies provide ample evidence for remission in patients with T2DM or for prevention in those with risk factors for the disease through various non-pharmacological behavioural interventions. In this article, we present two clinical cases of individuals who showed remission from T2DM/prediabetes via behavioural changes, especially through the adoption of a low-energy diet and exercise. We also discuss the recent advances in T2DM and obesity research, focusing on nutritional interventions and exercise and their benefits for weight loss, improved metabolic profile, enhanced glycaemic control and remission of diabetes.

由于越来越多的久坐不动的生活方式和不健康的饮食习惯,2型糖尿病(T2DM)的患病率在全球范围内稳步上升。目前,糖尿病给卫生保健系统造成的负担是前所未有的,而且每天都在增加。一些观察性研究和随机对照试验提供了临床证据,表明采用饮食干预和严格的运动训练方案可以缓解2型糖尿病。值得注意的是,这些研究为T2DM患者缓解或通过各种非药物行为干预预防具有该疾病危险因素的患者提供了充分的证据。在这篇文章中,我们介绍了两个临床病例,他们通过行为改变,特别是通过采用低能量饮食和运动,显示了T2DM/前驱糖尿病的缓解。我们还讨论了T2DM和肥胖研究的最新进展,重点关注营养干预和运动及其对减肥、改善代谢状况、加强血糖控制和糖尿病缓解的益处。
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引用次数: 0
Effect of Intermittent Fasting on Glycaemic Control in Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis of Randomized Controlled Trials. 间歇性禁食对2型糖尿病患者血糖控制的影响:随机对照试验的系统回顾和荟萃分析
Pub Date : 2023-05-01 DOI: 10.17925/EE.2023.19.1.25
Suresh K Sharma, Shiv Kumar Mudgal, Sanjay Kalra, Rakhi Gaur, Kalpana Thakur, Rajat Agarwal

Background: Type 2 diabetes mellitus (T2DM) is a severe public health issue notably impacting human life and health expenditure. It has been observed in literature that intermittent fasting (IF) addresses diabetes and its underlying cause, which benefits people with diabetes. Therefore, this study aimed to evaluate the effectiveness of IF treatment on glycaemic control in people with T2DM compared with control group. Methods: Systematic review and meta-analysis of interventional studies among patients with T2DM with glycated haemoglobin (HbA1c) as an outcome was performed. A comprehensive search of electronic databases, including PubMed, Embase and Google Scholar, for articles published before 24 April 2022, was done. Studies reporting 24 hours of complete fasting or intermittent restricted energy intake (feeding permitted for only 4-8 hours daily, with 16-20 hours of fasting) and reporting changes in HbA1c and fasting glucose levels were eligible. Meta-analysis was performed using Cochrane's Q statistic and the I2 statistical approach. Results: Eleven studies (13 arms) measuring the effect of IF on patients' HbA1c level were analysed. There was no statistically significant difference between IF and control groups (Standardized mean difference [SMD] -0.08, 95% confidence interval [CI] -0.20 to 0.04;p=0.19, I2=22%). Overall, seven studies on patients' fasting blood glucose were analysed, and the meta-analysis revealed no significant difference between the two groups i.e. IF and control groups (SMD 0.06, 95% CI -0.25 to 0.38;p=0.69, I2=76%). Conclusion: IF and usual diet pattern have no difference in terms of glycaemic control. Although, IF may be used as a preventative diet pattern in the pre-diabetic population, as it works well in the long-term to achieve controlled sugar levels. Study registration: The protocol of this study was registered in The International Prospective Register of Systematic Reviews (PROSPERO) with a registration number CRD42022328528.

背景:2型糖尿病(T2DM)是严重的公共卫生问题,严重影响人类的生活和健康支出。文献中已经观察到,间歇性禁食(IF)可以解决糖尿病及其潜在原因,这对糖尿病患者有益。因此,本研究旨在评价IF治疗对T2DM患者血糖控制的效果,并与对照组进行比较。方法:对以糖化血红蛋白(HbA1c)为结局的T2DM患者的介入研究进行系统回顾和荟萃分析。对PubMed、Embase和Google Scholar等电子数据库进行全面检索,检索2022年4月24日之前发表的文章。报告24小时完全禁食或间歇性限制能量摄入(每天只允许进食4-8小时,禁食16-20小时)和报告HbA1c和空腹血糖水平变化的研究符合条件。采用Cochrane’s Q统计量和I2统计方法进行meta分析。结果:分析了11项研究(13组)测量IF对患者HbA1c水平的影响。IF组与对照组间差异无统计学意义(标准化平均差[SMD] -0.08, 95%可信区间[CI] -0.20 ~ 0.04;p=0.19, I2=22%)。总的来说,我们分析了7项关于患者空腹血糖的研究,meta分析显示两组即IF和对照组之间无显著差异(SMD为0.06,95% CI为-0.25 ~ 0.38;p=0.69, I2=76%)。结论:空腹饮食与常规饮食在血糖控制方面无显著差异。虽然,IF可以作为糖尿病前期人群的预防性饮食模式,因为它在长期控制血糖水平方面效果很好。研究注册:本研究的方案已在国际前瞻性系统评价登记册(PROSPERO)上注册,注册号为CRD42022328528。
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引用次数: 3
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TouchREVIEWS in endocrinology
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