门冬胰岛素联合维生素D治疗对妊娠期糖尿病患者血糖水平及围产儿并发症影响Meta分析

目的 评估门冬胰岛素联合维生素 D(vitamin D, VD)补充对妊娠期糖尿病患者的临床疗效。方法 通过检索中国知网、万方、PubMed等数据库,收集以门冬胰岛素及VD为干预方法治疗妊娠期糖尿病的随机对照试验,检索时间为开始建库到2020年7月1日。2位研究者独立筛选符合纳入标准的试验,对符合标准的随机对照实验进行资料的提取,参照 Cochrane 质量评价的标准评价文献质量,采用RevMan 5.3软件行Meta分析。结果 最终纳入12篇文献,1 130例患者(试验组563例,对照组567例)。Meta分析结果表明,门冬胰岛素联合VD补充能够降低患者空腹血糖、餐后2 h血糖、空腹胰岛素、胰岛素抵抗指数;Meta分析结果还表明,门冬胰岛素联合VD补充可以显著降低新生儿低血糖、剖宫产、早产及巨大儿的发生率。结论 门冬胰岛素合并VD补充能够改善妊娠期糖尿病患者的血糖代谢、降低胰岛素抵抗以及减少围产期不良结局的发生。但仍需更多高质量的RCT加以验证。

Effects of insulin aspart combined with vitamin D in treatment of blood glucose levels and perinatal complications of patients with gestational diabetes mellitus: A meta-analysis

Objective To evaluate the clinical efficacy of insulin aspart combined with vitamin D (VD) supplementation for patients with gestational diabetes mellitus(GDM).Methods The randomized controlled trials (RCTs) of insulin aspart and VD in treating GDM were collected by searching electronic databases including CNKI, Wanfang, PubMed, etc, and the retrieval time extended from the creation of database to July 1, 2020. Two researchers independently screened trials that met the inclusion criteria and extracted the data of randomized controlled trials meeting inclusion criteria; the quality of literatures was evaluated by referring to the criterion for Cochrane quality evaluation, and RevMan 5.3 software was used to conduct the meta analysis.Results Twelve literature and 1130 cases (563 cases in the experimental group and 567 cases in the control group) were finally included. Meta analysis results showed that insulin aspart combined with VD supplementation could significantly reduce the fasting plasma glucose, 2 h postprandial glucose, fasting insulin, insulin resistance index. Meta analysis results also suggested that insulin aspart combined with VD supplementation significantly reduced the incidence of neonatal hypoglycemia, cesarean section, premature delivery and giant children.Conclusion Insulin aspart combined with VD supplementation can improve blood glucose metabolism, decrease insulin resistance and reduce the occurrence of adverse perinatal outcomes in patients with GDM. However, more high-quality RCTs remain to be verified.