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2型糖尿病病程對(duì)患者骨骼肌肌量影響的Meta分析

發(fā)布時(shí)間:2018-05-17 01:13

  本文選題:肌少癥 + 骨骼肌肌量 ; 參考:《山西醫(yī)科大學(xué)》2017年碩士論文


【摘要】:目的:采用Meta分析系統(tǒng)評(píng)價(jià)2型糖尿病(T2DM)病程對(duì)骨骼肌肌量的影響,為肌少癥的防治提供證據(jù)。方法:檢索檢索Pub Med、EMBASE、Cochrane圖書館、萬方數(shù)據(jù)庫(kù)、維普數(shù)據(jù)庫(kù)、Sinomed數(shù)據(jù)庫(kù)及Clinial Trials注冊(cè)網(wǎng)站。利用百度等搜索引擎查找相關(guān)文獻(xiàn),追溯參考文獻(xiàn),收集截至2017年2月公開發(fā)表的有關(guān)2型糖尿病合并肌少癥的隨機(jī)對(duì)照研究。有2名評(píng)價(jià)員分別篩選文獻(xiàn),用Revman5.3軟件進(jìn)行Meta分析,選擇合適模型進(jìn)行質(zhì)量評(píng)價(jià)、合并統(tǒng)計(jì)量、敏感性分析及發(fā)表性偏倚。結(jié)果:符合納入及排除標(biāo)準(zhǔn)的文獻(xiàn)共5篇,均為隨機(jī)對(duì)照試驗(yàn)。共3054例受試者納入研究。質(zhì)量評(píng)價(jià)4篇為C級(jí),1篇為B級(jí)。Meta分析結(jié)果:1.T2DM短病程(病程5年)患者骨骼肌肌量多于長(zhǎng)病程(病程5年)患者,差異有統(tǒng)計(jì)學(xué)意義[SMD=0.93,95%CI(0.50,1.35),p0.1]。2.與非T2DM組相比,T2DM組患者骨骼肌肌量更少[SMD=0.61,95%CI(0.23,1.00),p0.1],差異有統(tǒng)計(jì)學(xué)意義。亞組分析結(jié)果顯示:與非T2DM組相比,T2DM長(zhǎng)病程組骨骼肌肌量低于非T2DM組,差異有統(tǒng)計(jì)學(xué)意義[SMD=0.98,95%CI(0.23,1.00),p0.1]。T2DM短病程組骨骼肌肌量與非T2DM組相近,二者差異無統(tǒng)計(jì)學(xué)意義(p=0.85)。敏感性分析顯示:結(jié)果較穩(wěn)定。漏斗圖提示發(fā)表偏倚對(duì)研究的影響較小。結(jié)論:T2DM病程可對(duì)骨骼肌肌量產(chǎn)生不良影響。短病程T2DM患者骨骼肌肌量多于長(zhǎng)病程患者,提示T2DM患者隨著病程的延長(zhǎng),對(duì)骨骼肌肌量產(chǎn)生的不良影響更為顯著,進(jìn)一步增加肌少癥發(fā)生發(fā)展的風(fēng)險(xiǎn)。該結(jié)論可為肌少癥的防治提供新思路,但尚需大量臨床研究加以驗(yàn)證。
[Abstract]:Objective: to evaluate the effect of the course of type 2 diabetes mellitus (T2DM) on skeletal muscle volume by Meta analysis system, and to provide evidence for the prevention and treatment of hypomyopathy. Methods: Pub Medmella Cochrane Library, Wanfang database, Weip database and Clinial Trials registration website were searched. Search engine Baidu and other search engines were used to search the relevant literature, retrospective reference literature, to collect published in February 2017 about type 2 diabetes mellitus with hypometriosis randomized controlled study. Two evaluators sifted the literature, analyzed Meta with Revman5.3 software, selected suitable models for quality evaluation, combined statistics, sensitivity analysis and publication bias. Results: there were 5 articles in accordance with the inclusion and exclusion criteria, all of which were randomized controlled trials. A total of 3054 subjects were included in the study. Results: 1. The quantity of skeletal muscle in patients with short course of T2DM (5 years course) was more than that in patients with long course of disease (5 years course). The amount of skeletal muscle in T2DM group was less than that in non-T2DM group. The results of subgroup analysis showed that the amount of skeletal muscle in T2DM long course group was lower than that in non T2DM group, and the difference was statistically significant. The skeletal muscle quantity in T2DM short course group was similar to that in non T2DM group, and there was no significant difference between them (p 0. 85). Sensitivity analysis showed that the results were stable. Funnel graphs suggest that publication bias has little effect on the study. Conclusion the disease course of W T 2 DM may have a bad effect on skeletal muscle volume. The quantity of skeletal muscle in patients with short course of T2DM was more than that in patients with long course of disease, which suggested that the adverse effects of T2DM on skeletal muscle volume were more significant with the prolongation of the course of disease, and further increased the risk of occurrence and development of oligosacter disease. This conclusion can provide a new idea for the prevention and treatment of hypomuscular disease, but it still needs a lot of clinical research to verify.
【學(xué)位授予單位】:山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2017
【分類號(hào)】:R587.1

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