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口服镁补充剂对 2 型糖尿病患者血糖控制的影响:系统评价和对照临床试验的剂量反应荟萃分析。

The effects of oral magnesium supplementation on glycaemic control in patients with type 2 diabetes: a systematic review and dose-response meta-analysis of controlled clinical trials.

机构信息

Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Nutritional Sciences Department, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

Br J Nutr. 2022 Dec 28;128(12):2363-2372. doi: 10.1017/S0007114521005201. Epub 2022 Jan 20.

Abstract

The current systematic review and meta-analysis were conducted to evaluate the effects of oral Mg supplementation on glycaemic control in type 2 diabetes mellitus (T2DM) patients. Related articles were found by searching the PubMed, SCOPUS, Embase and Web of Science databases (from inception to 30 February 2020). A one-stage robust error meta-regression model based on inverse variance weighted least squares regression and cluster robust error variances was used for the dose-response analysis between Mg supplementation and duration of intervention and glycaemic control factors. Eighteen eligible randomised clinical trials were included in our final analysis. The dose-response testing indicated that the estimated mean difference in HbA1c at 500 mg/d was -0·73 % (95 % CI: -1·25, -0·22) suggesting modest improvement in HbA1c with strong evidence ( value: 0·004). And in fasting blood sugar (FBS) at 360 mg/d was -7·11 mg/dl (95 % CI: -14·03, -0·19) suggesting minimal amelioration in FBS with weak evidence ( value: 0·092) against the model hypothesis at this sample size. The estimated mean difference in FBS and HbA1c at 24 weeks was -15·58 mg/dl (95 % CI: -24·67, -6·49) and -0·48 (95 % CI: -0·77, -0·19), respectively, suggesting modest improvement in FBS ( value: 0·034) and HbA1c ( value: 0·001) with strong evidence against the model hypothesis at this sample size. Oral Mg supplementation could have an effect on glycaemic control in T2DM patients. However, the clinical trials so far are not sufficient to make guidelines for clinical practice.

摘要

本系统评价和荟萃分析旨在评估口服镁补充剂对 2 型糖尿病(T2DM)患者血糖控制的影响。通过检索 PubMed、SCOPUS、Embase 和 Web of Science 数据库(从建库至 2020 年 2 月 30 日),找到了相关文章。采用基于逆方差加权最小二乘回归和聚类稳健误差方差的单阶段稳健误差荟萃回归模型,对镁补充剂与干预持续时间和血糖控制因素之间的剂量反应关系进行分析。最终分析纳入了 18 项符合条件的随机临床试验。剂量反应测试表明,500mg/d 镁补充剂组的 HbA1c 估计平均差值为-0.73%(95%CI:-1.25,-0.22),提示 HbA1c 有适度改善,且具有较强证据( value:0.004)。而在 360mg/d 组的空腹血糖(FBS)估计平均差值为-7.11mg/dl(95%CI:-14.03,-0.19),提示在该样本量下,FBS 有轻微改善,证据较弱( value:0.092),与模型假设不符。在 24 周时,FBS 和 HbA1c 的估计平均差值分别为-15.58mg/dl(95%CI:-24.67,-6.49)和-0.48(95%CI:-0.77,-0.19),提示在该样本量下,FBS( value:0.034)和 HbA1c( value:0.001)有适度改善,且证据较强,与模型假设不符。口服镁补充剂可能对 T2DM 患者的血糖控制有一定影响。然而,迄今为止的临床试验还不足以制定临床实践指南。

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