The effects of folate supplementation on glucose metabolism and risk of type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials

Purpose: Observationally, homocysteine is associated with higher risk of diabetes. Folate, which reduces homocysteine, is promising for the prevention and treatment of diabetes. Previous meta-analysis of three trials suggested folate might lower hemoglobin A_1c (HbA_1c). Methods: An updated systematic review and meta-analysis of placebo-controlled randomized trials was conducted. We searched PubMed using (“folate” or “folic acid”) and trial and (“glucose” or “diabetes” or “insulin” or “hemoglobin A_1c” or “HbA_1c”) in any field until February 3, 2017. We also conducted a bibliographic search of selected studies and relevant reviews. Relative risk of diabetes and mean differences in indicators of glucose metabolism between folate and placebo were summarized in a meta-analysis using inverse variance weighting with random effects. Heterogeneity, publication bias, and risk of bias were also assessed. Results: Eighteen trials of 21,081 people with/without diabetes were identified. Folate decreased fasting glucose (?0.15 mmol/L, 95% confidence interval [CI] ?0.29 to ?0.01), homeostatic model assessment–insulin resistance (?0.83, 95% CI ?1.31 to ?0.34), and insulin (?1.94 μIU/mL, 95% CI ?3.28 to ?0.61) but had no clear effect on diabetes or HbA_1c. Conclusions: Our study suggests a potential benefit of folate on insulin resistance and glycemic control; the latter requires examination in more high-quality trials.     

不同时长运动联合二甲双胍对2型糖尿病血糖控制效果的meta分析

目的 探讨不同时长运动疗法联合二甲双胍治疗对2型糖尿病患者血糖控制的不同疗效。方法 计算机检索 PubMed、EMbase、Elsevier、CNKI、WanFang Data、Web of Science等数据库,检索相关随机对照试验（RCTs）,采用RevMan 5.3 软件进行meta分析。结果 共纳入10个 RCTs,包括974例患者。meta分析结果显示,与单纯二甲双胍治疗相比,运动疗法联合二甲双胍治疗2～3个月后,空腹血糖（FBG）显著下降（SMD = - 1.61,95%CI: - 2.68～- 0.53,P = 0.003）,糖化血红蛋白（HbA1c）明显降低（SMD = - 1.41,95%CI: - 1.75～- 1.07,P＜0.001）,空腹胰岛素（FINS）含量降低至更接近于正常范围（SMD = - 1.14,95%CI: - 2.15～- 0.13,P = 0.03）;胰岛素抵抗指数（HOMA - IR）（SMD = - 0.75,95%CI:- 1.32～- 0.18,P = 0.010）与餐后两小时血糖（2hPBG）明显降低（SMD = - 1.42,95%CI:- 2.46～- 0.39,P = 0.007）;运动疗法联合二甲双胍治疗6个月后,FBG（SMD = - 0.74,95%CI: - 1.97～0.49,P = 0.24）及2hPBG（SMD = - 1.24,95%CI: - 2.23～- 0.26,P = 0.01）的控制效果未表现出显著差异。结论 2～3个月运动联合二甲双胍治疗在控制血糖、减低胰岛素抵抗方面比单纯二甲双胍治疗效果更为显著,而干预时长延长至6个月时,运动联合二甲双胍治疗在糖尿病患者血糖控制上的叠加效应消失。由于纳入的文章数目及质量有限,上述结论还需更多高质量研究进一步论证。     

2型糖尿病患者睡眠障碍危险因素的Meta分析

目的系统评价T2DM患者睡眠障碍的危险因素及其关联强度,为建立风险预测模型提供依据。方法检索CNKI、WanFang、VIP、CBM、PubMed、EMbase、Web of Science和The Cochrane Library数据库有关T2DM患者睡眠障碍危险因素的文献,检索时限为建库至2020年6月8日。由2名研究员独立完成文献筛选、质量评价及资料提取,应用Rev Man 5.3、Stata 12.0软件进行Meta分析。结果共纳入17篇文献,5 773例研究对象。经Meta分析,各危险因素的合并OR(95%CI)分别为:年龄1.39(0.89～2.17)、性别1.49(1.04～2.14)、病程1.44(1.08～1.91)、HbA1c 1.51(1.07～2.13)、BMI1.01(0.96～1.08)、FPG 1.48(1.16～1.87)、HOMA-IR 1.55(1.11～2.17)、独居2.14(1.60～2.86)、吸烟1.68(1.16～2.41)、OSA1.82(0.58～5.76)、心血管疾病史1.76(1.26～2.48)、精神心理问题1.71(1.18～...     

中国成年人糖尿病患病率Meta分析

目的 采用Meta分析方法了解过去30年我国成年人糖尿病流行情况,为糖尿病的预防和控制提供科学依据。方法 检索中国期刊全文数据库（CNKI）、万方数据资源系统（Wanfang）、维普数据库（VIP）和PubMed数据库截至2017年10月1日收录的所有有关中国多省市糖尿病患病率研究的文献。运用随机效应模型计算合并患病率。若存在异质性,采用连续分段多项式回归模型来估计糖尿病患病率随时间变化趋势。结果 共纳入15篇文献,其中2篇文献因仅包括≥ 40岁人群未纳入主要分析。Meta分析显示,1980-2013年中国成年人糖尿病患病率为6.3%（95%CI：4.6%~8.0%）,城市合并患病率高于农村地区,男性糖尿病合并患病率略高于女性。1980-2013年,我国成年人糖尿病患病率呈非线性增长。2000年前的合并患病率为3.5%（95%CI：2.0%~4.9%）,每年增长约0.17%;2000年后的合并患病率为8.0%（95%CI：6.0%~10.1%）,每年增加约0.72%。结论 中国成年人糖尿病患病率不断升高,且在2000年后迅速增长,需采取积极的策略预防和控制糖尿病。     

Effects of aerobic exercise in the management of erectile dysfunction: a meta analysis study on randomized controlled trials

Background

Penile erection is a hemodynamic process involving increased arterial inflow and restricted venous outflow, coordinated with corpus cavernosum and penile arterial smooth muscle relaxation. Any problem in this mechanism results in Erectile Dysfunction and its etiology is generally multifactorial. This study is aimed at determining the objective outcome of aerobic training in the management of Erectile Dysfunction of arterogenic origin using Meta analysis.

Methods

Relevant publications were searched up to November 2010 in the MEDLINE (PubMed) database. The citation lists of randomized controlled trials on the effect of aerobic training and Erectile Dysfunction management using the International Index of Erectile Function (IIEF) as treatment outcome measure. Studies on different operative techniques on the effects of aerobic training for men with Erectile Dysfunction due to arterogenic Erecile Dysfunction were selected. Data on participants'' characteristics, study quality, population, intervention, treatment outcome were collected and analyzed.

Results

There were 5 randomized controlled studies using the International Index of Erectile Function as measure of treatment outcome. A total of 385 subjects were involved in 5 studies; results indicated significant effect of aerobic training on Erecile Dysfunction (t=5.856, p= .000) at p< 0.05.

Conclusion

Subjects with arterogenic Erectile Dysfunction might benefit from aerobic training. More randomized controlled studies in this area are warranted     

Walking, lipids, and lipoproteins: a meta-analysis of randomized controlled trials

BACKGROUND: The purpose of this study was to use the meta-analytic approach to examine the effects of walking on lipids and lipoproteins in adults. METHODS: Randomized controlled trials that examined the effects of walking on total cholesterol (TC), high- and low-density lipoprotein cholesterol (HDL-C and LDL-C), the ratio of TC/HDL, and triglycerides (TG) in adults ages 18 years and older were retrieved via computerized literature searches, cross-referencing, hand-searching, and expert review of our reference list. RESULTS: Twenty-five studies that included 1,176 subjects (692 walkers, 484 controls) and up to 33 outcomes were available for pooling. Using random-effects modeling, statistically significant, walking-induced decreases of 5% and 6% were observed for LDL-C and TC/HDL-C (LDL-C, mean +/- SE, -5.5 +/- 2.2 mg/dL, 95% CI, -9.9 to -1.2 mg/dL; TC/HDL-C, mean +/- SE, -0.3 +/- 0.1, 95% CI, -0.6 to -0.1). No statistically significant changes were observed for TC, HDL, or TG (P > 0.05), although changes were in the direction of benefit. No statistically significant changes occurred in body composition (P > 0.05). CONCLUSIONS: Walking reduces LDL-C and TC/HDL-C in adults independent of changes in body composition.     

A systematic review and meta-analysis of the effects of aerobic exercise interventions on cardiorespiratory fitness in adults with intellectual disability

BackgroundAdults with an intellectual disability (ID) have low cardiorespiratory fitness (CRF). Low CRF has been associated with a high risk of cardiovascular disease and all-cause mortality. Participation in regular exercise can help adults with ID increase their CRF.ObjectiveTo perform a systematic review and meta-analysis of published, peer-reviewed clinical trials that evaluated the effects of aerobic exercise (AE) interventions on CRF in adults with ID, ages 18–65 years.MethodsEnglish-language articles were searched up to June 2021 from 11 electronic databases. Data were extracted using an author-developed form. Two independent authors assessed the risk of bias using the Tool for the Assessment of Study Quality and reporting in Exercise (TESTEX). Meta-analysis was performed using the RevMan 5.3.ResultsOf the 1870 article titles and abstracts screened, 16 articles were included. The average TESTEX score (out of 15) was 8.1 (SD = 3.5, range 2–14). The pooled effect was statistically significant (SMD = 0.41, 95% CI: 0.19 to 0.63, z = 3.59; p = .000) with moderate heterogeneity (I² = 35%, p = .000). Both types of intervention produced statistically significant CRF gains, with interventions that combined AE with resistance, balance, and/or flexibility exercises being slightly more effective (SMD = 0.40, 95% CI: 0.11 to 0.70, p = .007) than non-combined interventions (SMD = 0.42, 95% CI: 0.05 to 0.79, p = .02). Heterogeneity was moderate but non-significant for both types of intervention.ConclusionsThe review supports the use of AE interventions in promoting CRF in adults with ID. The interpretation is limited by the quality of evidence and by poorly described and/or executed familiarization and measurement protocols.     

Impact of a community-based exercise programme on physical fitness in middle-aged and older patients with type 2 diabetes

ObjectivesPhysical fitness is related to all-cause mortality, quality of life and risk of falls in patients with type 2 diabetes. This study aimed to analyse the impact of a long-term community-based combined exercise program (aerobic + resistance + agility/balance + flexibility) developed with minimum and low-cost material resources on physical fitness in middle-aged and older patients with type 2 diabetes.MethodsThis was a non-experimental pre-post evaluation study. Participants (N = 43; 62.92 ± 5.92 years old) were engaged in a community-based supervised exercise programme (consisting of combined aerobic, resistance, agility/balance and flexibility exercises; three sessions per week; 70 min per session) of 9 months’ duration. Aerobic fitness (6-Minute Walk Test), muscle strength (30-Second Chair Stand Test), agility/balance (Timed Up and Go Test) and flexibility (Chair Sit and Reach Test) were assessed before (baseline) and after the exercise intervention.ResultsSignificant improvements in the performance of the 6-Minute Walk Test (Δ = 8.20%, p < 0.001), 30-Second Chair Stand Test (Δ = 28.84%, p < 0.001), Timed Up and Go Test (Δ = 14.31%, p < 0.001), and Chair Sit and Reach Test (Δ = 102.90%, p < 0.001) were identified between baseline and end-exercise intervention time points.ConclusionsA long-term community-based combined exercise programme, developed with low-cost exercise strategies, produced significant benefits in physical fitness in middle-aged and older patients with type 2 diabetes. This supervised group exercise programme significantly improved aerobic fitness, muscle strength, agility/balance and flexibility, assessed with field tests in community settings.     

中国老年2型糖尿病患者抑郁患病率的Meta分析

目的 系统评价中国老年2型糖尿病(T2DM)患者发生抑郁的患病率现状。方法 计算机检索WanFang Data、VIP、CNKI、CBM、PubMed和Embase等数据库,搜集有关中国老年T2DM患者发生抑郁情况的横断面研究。通过筛选、资料提取及质量评价后,采用Stata 14.0软件进行Meta分析。结果 纳入19项研究结果显示,老年T2DM患者发生抑郁的合并患病率为40%(95%CI:38%～41%)。亚组分析显示,不同性别、婚姻状况、抑郁程度、文化程度和调查时间的患病率差异均有统计学意义,不同区域、地区和人群来源的患病率差异均无统计学意义。其中老年T2DM患者的抑郁程度多以轻中度为主(P＜0.001),女性45%(95%CI:42%～48%)高于男性34%(95%CI:30%～37%)(P＜0.001),在婚状态的抑郁患病率37%(95%CI:33%～40%)低于离异或丧偶状态46%(95%CI:41%～52%) (P = 0.002),文化程度在高中以上的抑郁患病率47%(95%CI:42%～53%)低于高中及以下56%(95%CI:52%～59%)(P = 0.011),老年T2DM患者抑郁的患病率在1999 - 2019年期间一直持续处于较高水平(P = 0.001)。结论 我国老年T2DM患者抑郁的患病率较高,应在其临床治疗和护理干预中进一步增强心理干预,防止抑郁并发症的发生。     

Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis.

Studies designed to examine effects of weight reduction by dieting on total cholesterol (TC), low-density-lipoprotein cholesterol (LDL-C), high-density-lipoprotein cholesterol (HDL-C), very-low-density-lipoprotein cholesterol (VLDL-C), and triglycerides (TGs) have reported inconsistent results. The purpose of this study was to quantify effects of weight loss by dieting on lipids and lipoproteins through the review method of meta-analysis. Results from the 70 studies analyzed indicated that weight reduction was associated with significant decreases (P less than or equal to 0.001) and correlations (P less than or equal to 0.05) for TC (r = 0.32), LDL-C (r = 0.29), VLDL-C (r = 0.38), and TG (r = 0.32). For every kilogram decrease in body weight, a 0.009-mmol/L increase (P less than or equal to 0.01) in HDL-C occurred for subjects at a stabilized, reduced weight and a 0.007-mmol/L decrease (P less than or equal to 0.05) for subjects actively losing weight. Our results indicate that weight reduction through dieting can be a viable approach to help normalize plasma lipids and lipoproteins in overweight individuals.     

2型糖尿病患者并发轻度认知功能障碍危险因素的Meta分析

目的 系统评价2型糖尿病患者并发轻度认知功能障碍的危险因素。方法 检索CNKI、WanFang、VIP、CBM、Medline(PubMed)、EMbase、Web of Science和The Cochrane Library 数据库从建库至2020年12月2日有关2型糖尿病患者并发轻度认知功能障碍危险因素的所有文献后进行Meta分析。结果 共纳入文献18篇,研究对象3083例。各危险因素的合并OR(95%CI)为:年龄1.20(1.09,1.33)、文化程度0.67(0.55,0.82)、吸烟史1.41(0.69,2.89)、糖尿病病程1.17(1.06,1.29)、糖化血红蛋白(HbA1c)1.33(1.09,1.62)、空腹血葡萄糖(fasting blood glucose,FBG)0.88(0.75,1.03)、空腹血清C肽(Fasting c-peptide,FCP)0.41(0.16,1.04)、餐后2h血糖(2h plasma glucose,2hPG)1.90(0.52,6.87)、低密度脂蛋白胆同醇(LDL-C)1.42(1.26,1.59)、超敏C反应蛋白(high sensitive C reactive protein,hs-CRP)1.52(1.06,2.20)、胰岛素抵抗指数(HOMA-IR)1.00(0.48,2.08)、冠心病2.57(1.93,3.43)、高血压2.58(1.62,4.13)、周围神经病变1.10(0.10,12.57)。结论 高龄、文化程度低、糖尿病病程长、高HbA1c、高LDL-C、高hs-CRP、冠心病、高血压是2型糖尿病患者并发轻度认知功能障碍的主要危险因素。     

社区干预对我国2型糖尿病疗效影响的Meta分析

目的系统评价社区干预对2型糖尿病疗效的影响。方法检索万方数据库、维普资源信息系统、中国期刊全文数据库、中国生物医学文献数据库及Pubmed数据库中,2006年以来发表的有关社区干预对我国2型糖尿病疗效影响的相关文献。分析软件采用Stata 12.0。结果共纳入22篇文献,累计干预组患者1 723例,对照组患者1 674例。Meta分析结果显示,干预组空腹血糖（SMD=0.726,95%CI: 0.359～1.092）,餐后2 h血糖（SMD=0.798,95%CI: 0.407～1.127）、糖化血红蛋白（SMD=0.735,95%CI: 0.251～1.219）、总胆固醇（SMD=0.476,95%CI: 0.098～0.855）、甘油三酯（SMD=0.721,95%CI: 0.227～1.214）,均低于对照组,差异均有统计学意义（均P＜005）。结论社区干预对2型糖尿病病情控制效果显著,建议对2型糖尿病患者采取积极的社区干预措施。     

有氧运动与营养教育对高总胆固醇男生血脂健康体适能及运动行为影响

目的探讨有氧运动与营养教育对高总胆固醇男生血脂、健康体适能及运动行为的影响,为培养大学生正确的营养与健康观念,养成良好的运动习惯提供参考。方法以河南省4所高校总胆固醇高于200 mg/d L的140名男大学生依随机方式分为骑自行车+营养教育(BE)组和控制(C)组。BE组进行6周的有氧运动干预,每周3次,每次60 min,运动强度为50%～70%心跳率储备量(HRR)及每周60 min营养教育课程。受试者分别于干预前后检测血脂、健康体适能、每日食物摄入量及运动行为。结果 BE组体质量指数(body mass index,BMI)、腰臀比均低于C组[(25. 57±1. 77)(28. 88±2. 10) kg/m²,(0. 81±0. 03)(0. 87±0. 06)]; BE组心肺适能优于C组[(54. 45±5. 31)(50. 00±5. 29)](t值分别为5. 89,6. 11,4. 74,P值均<0. 01)。C组总胆固醇(TC)高于BE组[(229. 90±25. 63)(195. 90±34. 79) mg/d L],BE组高密度脂蛋白胆固醇...     

运动对儿童青少年1型糖尿病患者骨骼的影响

1型糖尿病发病高峰期与骨量积累关键期重合。1型糖尿病会引发患者生长激素/胰岛素样生长因子-1轴改变,导致成年后峰值骨量偏低,增加未来发生骨质疏松和脆性骨折的风险。本研究通过查阅国内外文献,对儿童和青少年阶段1型糖尿病患者骨密度、骨代谢、骨结构、骨材料性特征、运动改善该阶段患者骨量的主要机制以及不同运动方式的干预特点进行综述。