中国人糖尿病前期致病危险因素的系统评价  

Risk factors associated with prediabetes in Chinese: a meta-analysis

作　　者：任明[1] 孙晓 王美娜[1] 霍达[2] 李岩 郭利平[2] REN Ming;SUN Xiao;WANG Meina;HUO Da;LI Yan;GUO Liping(Baokang Hospital,Tianjin University of TCM,Tianjin,300193,P.R.China;Tianjin University of TCM,Tianjin,300000,P.R.China)

机构地区：[1]天津中医药大学附属保康医院,天津300193 [2]天津中医药大学,天津300000

出　　处：《中国循证医学杂志》2019年第2期140-146,共7页Chinese Journal of Evidence-based Medicine

基　　金：国家重点研发计划课题(编号:2018YFC1707403);中医药行业科研专项(编号:201107006);天津市科技计划项目(编号:15ZXLCSY00020);天津市滨海新区卫计委重点支持项目(编号:2016BWKZ001);教育部创新团队发展计划项目(编号:IRT-16R54)

摘　　要：目的系统评价糖尿病前期致病危险因素,为糖尿病防治及健康教育提供参考依据。方法计算机检索PubMed、EMbase、SinoMed、CNKI、WanFang Data和VIP数据库,搜集有关糖尿病前期致病危险因素的病例-对照研究,检索时限均从建库至2018年2月20日。由2名评价者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3进行meta分析。结果共纳入13个研究,包括49 168例患者。meta分析结果显示:饮酒[OR=1.31,95%CI(1.04,1.65),P=0.02]、高血压[OR=1.75,95%CI(1.11,2.76),P=0.02]、腹型肥胖[OR=1.26,95%CI(1.12,1.42),P=0.000 1]、腰臀比[OR=1.77,95%CI=(1.27,2.45),P=0.000 6]可能是糖尿病前期的风险因素。但血脂异常、吸烟、体育运动、糖尿病家族史、体重指数和腰围可能与糖尿病前期无相关性。结论当前证据显示,饮酒、高血压、腹型肥胖和腰臀比可能是糖尿病前期的影响因素,其余风险因素相关性有待进一步研究。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。Objectives To systematically review the risk factors associated with prediabetes, and to provide reference for prevention and treatment of diabetes mellitus and health education. Methods PubMed, EMbase, SinoMed,CNKI, WanFang Data and VIP databases were electronically searched to collect case-control studies on the risk factors associated with prediabetes from inception to February 20 th, 2018. Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software. Results A total of 13 studies involving 49 168 patients were included. The results of meta-analysis showed that:drinking(OR=1.31, 95%CI 1.04 to 1.65, P=0.02), hypertension(OR=1.75, 95%CI 1.11 to 2.76, P=0.02), abdominal obesity(OR=1.26, 95%CI 1.12 to 1.42, P=0.000 1), and waist to hip ratio(OR=1.77, 95%CI 1.27 to 2.45, P=0.000 6) might be the risk factors for prediabetes. However, dyslipidemia, smoking, physical activity, family history of diabetes, body mass index and waist circumference might not be risk factors for prediabetes. Conclusions Current evidence shows that drinking,hypertension, abdominal obesity and waist-hip ratio may be the influencing factors of pre-diabetes, while other related risk factors are required to be further studied. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.

关 键 词：糖尿病前期 危险因素 META分析 系统评价 病例-对照研究 

分 类 号：R587.1[医药卫生—内分泌]