雌激素替代治疗影响绝经后女性2型糖尿病患者代谢情况的Meta分析

摘要

Objective This meta-analysis aimed at assessing the metabolic effects of estrogen replacement therapy (ERT) on postmenopausal women with type 2 diabetes mellitus (T2DM). MethodsA literature search performed using the PubMed,Cochrane Library,CBM,CNKI,Wanfang Data and VIP Database. Only randomized controlled trials (RCTs) were included in the metaanalysis. Cochrane Collaboration''s Review Manager 5.2 software was used for statistical analysis. Data were pooled using a random effects model or a fixed effects model after testing for heterogeneity. Results Total 12 RCTs including 1246 participants met our eligibility criteria. A meta analysis of the extractable data showed that ERT reduced fasting plasma glucose levels(MD-1.00,95%CI-1.59~-0.41,P<0.00001),fasting serum insulin levels (MD-2.83,95%CI-3.58~-2.08,P<0.00001),HbA1c (MD-0.62%,95%CI-0.89~-0.34,P<0.00001) and total cholesterol levels(MD-0.32,95%CI-0.52~-0.11,P=0.002). The ERT and control groups demonstrated no significant difference on triglyceride levels (MD 0.06,95%CI-0.22~0.34,P=0.65). Conclusion ERT may improve glucose and lipid metabolism in postmenopausal women with T2DM.%目的 评价雌激素替代治疗对绝经后女性T2DM患者代谢情况的影响. 方法 在Pubmed,Cochran library,CBM,中国知网,万方和维普数据库进行检索,纳入评价雌激素替代治疗影响绝经后女性糖尿病患者代谢情况的随机对照试验,使用Review Manager 5.2对纳入的研究进行数据分析,根据异质性检验的结果选择随机效应模型或固定效应模型进行数据的合并. 结果 共纳入12项研究,1246例患者.Meta分析结果显示,与对照组比较,试验组FPG水平(MD-1.00,95%CI-1.59~-0.41,P<0.00001)、FIns水平(MD-2.83,95%CI-3.58~-2.08,P<0.00001)、HbA1c(MD-0.62,95%CI-0.89~-0.34,P<0.00001) 和TC水平(MD-0.32,95%CI-0.52~-0.11,P=0.002)降低,TG水平(MD 0.06,95%CI-0.22~0.34,P=0.65)差异无统计学意义. 结论 雌激素替代治疗可在一定程度上改善绝经后女性T2DM患者糖代谢和脂代谢情况.