本文選題：菊粉類果聚糖　切入點(diǎn)：動(dòng)脈粥樣硬化　出處：《重慶醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：采用Meta分析的方法,系統(tǒng)評(píng)價(jià)所有關(guān)于菊粉類果聚糖對(duì)人體脂、糖代謝的影響的隨機(jī)對(duì)照試驗(yàn)結(jié)果,為動(dòng)脈粥樣硬化性心血管疾病和糖尿病防治飲食策略的制定提供依據(jù)。具體內(nèi)容包括：①菊粉類果聚糖對(duì)動(dòng)脈粥樣硬化相關(guān)血脂(HDL-C、TG、LDL-C)的影響的Meta分析；②菊粉類果聚糖對(duì)人體糖代謝主要指標(biāo)(FPG、HbA1c)的影響的Meta分析。方法：兩個(gè)部分的Meta分析都主要經(jīng)過(guò)以下步驟：全面檢索數(shù)據(jù)庫(kù)中的相關(guān)文獻(xiàn)(第一部分檢索的數(shù)據(jù)庫(kù)有PubMed、Embase、中國(guó)知網(wǎng)、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)、中文科技期刊數(shù)據(jù)庫(kù)和萬(wàn)方數(shù)據(jù)知識(shí)服務(wù)平臺(tái),第二部分檢索的數(shù)據(jù)庫(kù)有PubMed、Embase、Medline、 Cochrane),按照預(yù)先制定的納入和排除標(biāo)準(zhǔn)篩選文獻(xiàn),之后進(jìn)行質(zhì)量評(píng)價(jià)(JADAD量表)和數(shù)據(jù)提取,最終采用Cochrane協(xié)作網(wǎng)提供的Review Manager5.1軟件和Statal1.0軟件進(jìn)行Meta分析和發(fā)表偏倚的檢測(cè)。結(jié)果：①菊粉類果聚糖對(duì)動(dòng)脈粥樣硬化相關(guān)血脂的影響的Meta分析：最終納入22篇文獻(xiàn),總樣本數(shù)為822例,實(shí)驗(yàn)組413例,對(duì)照組409例。分析結(jié)果顯示,菊粉類果聚糖對(duì)HDL-C、TG和LDL-C水平影響的合并加權(quán)均數(shù)差(Weighted mean difference, WMD)值及95%可信區(qū)間(Confidence interval, CI)分別為0.05 mmol/L (0.01,0.08)、-0.08 mmol/L(-0.14,-0.01)和-0.16 mmol/L (-0.25,-0.06),即HDL-C水平顯著升高,TG、LDL-C水平顯著降低。亞組分析結(jié)果顯示：血脂異常組TG水平顯著降低0.17 mmol/L;糖尿病組HDL-C水平顯著升高0.15 mmol/L,TG水平顯著降低0.30 mmol/L,其他結(jié)果的改變均無(wú)統(tǒng)計(jì)學(xué)意義。②菊粉類果聚糖對(duì)人體糖代謝主要指標(biāo)的影響的Meta分析：共納入16篇文獻(xiàn),總樣本數(shù)為536例,實(shí)驗(yàn)組271例,對(duì)照組265例。分析結(jié)果顯示,菊粉類果聚糖對(duì)FPG和HbA1c水平影響的合并WMD值及95%C1分別為-0.11 mmol/L(-0.21,-0.01)和-0.36%(-0.76,0.04)。亞組分析結(jié)果顯示：糖尿病組FPG水平顯著降低0.72 mmol/L,95%CI為(-1.01,-0.42)；HbAlc水平顯著降低0.59%,95%CI為(-0.92,-0.25)。非糖尿病組結(jié)果的改變無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論：①在脂代謝調(diào)節(jié)方面,菊粉類果聚糖補(bǔ)充可使人體血清HDL-C水平增高,TG和LDL-C水平降低。其中血脂異常人群、糖尿病人群獲益更多,前者TG水平降低更明顯,后者不僅TG水平降低更明顯,同時(shí)HDL-C水平增高也更明顯。每日攝食菊粉類果聚糖14g左右可能起到防治動(dòng)脈粥樣硬化性心血管疾病的作用。②在糖代謝調(diào)節(jié)方面,膳食補(bǔ)充菊粉類果聚糖,FPG水平降低,HbAlc水平的改變無(wú)統(tǒng)計(jì)學(xué)意義。但是對(duì)于糖尿病人群,FPG和HbAlc水平的降低均有統(tǒng)計(jì)學(xué)意義,并且降低幅度比總?cè)巳好黠@大。每日攝食菊粉類果聚糖13g左右可能在糖尿病及其并發(fā)癥的防治中發(fā)揮有益的作用。
[Abstract]:Objective: to evaluate the results of all randomized controlled trials on the effects of inulin fructan on human lipid and glucose metabolism by Meta analysis. To provide the basis for the formulation of dietary strategies for the prevention and treatment of atherosclerotic cardiovascular diseases and diabetes mellitus. The specific contents include the Meta analysis of the effect of 1% inulin fructan on atherosclerotic related lipids (HDL-C). Meta analysis on the effect of HbA1c on human glucose metabolism. Methods: the two parts of Meta analysis mainly go through the following steps: search the relevant documents in the database (the first part of the database is PubMeden Embase, China knowledge Network, the first part of the database, China Biomedical Literature Database, Chinese Sci-tech Journals Database and Wanfang data knowledge Service platform. The second part of the search database includes PubMeden Embase Medline, Cochranegne, according to the pre-established inclusion and exclusion criteria for the screening of literature, Then the quality evaluation and data extraction were carried out with JADAD scale. Finally, Meta analysis and publication bias detection were performed with Review Manager5.1 and Statal1.0 software provided by Cochrane Cooperative Network. Results the Meta analysis of the effect of fructan on atherosclerotic blood lipid was carried out. The total number of samples was 822, 413 in the experimental group and 409 in the control group. The combined weighted mean difference (WMD) and confidence interval (CI) of inulin fructosans on HDL-Cn TG and LDL-C levels were 0. 05 mmol / L (0. 01 ~ 0. 08 mmol / L -0. 08 mmol / L ~ 0. 014 -0. 01) and -0. 16 mmol / L ~ 0. 25 ~ 0. 06 mmol-0. 06, respectively. The results of subgroup analysis showed that the level of HDL-C increased significantly. The results showed that TG level in dyslipidemia group was significantly decreased by 0.17 mmol / L, HDL-C level in diabetes group was significantly increased by 0.15 mmol / L and decreased significantly by 0.30 mmol / L, and no significant change in other results was found. 2. 2 effect of inulin on the main indexes of glucose metabolism in human body. Meta analysis: a total of 16 articles, The total number of samples was 536, 271 in the experimental group and 265 in the control group. The combined WMD value and 95 of inulin fructan on FPG and HbA1c levels were -0.11 mmol / L ~ (-1) -0.21 ~ (-1) and -0.36 ~ (-6) ~ 0.04 ~ (0.04), respectively. The results of subgroup analysis showed that the FPG level of diabetic group was significantly lower than that of non-diabetic group by -1.01-0.42HbAlc (-0.59mmol / L ~ (95) CI = -0.92- 0.25) respectively. The subgroup analysis showed that the level of FPG was significantly decreased by -0.72 mmol / L ~ (95) CI, -1.01-0.42HbAlc level in diabetes mellitus group. The changes were not statistically significant. Conclusion: 1 is involved in lipid metabolism regulation. Inulin fructan supplementation increased serum HDL-C levels and decreased TG and LDL-C levels, especially in patients with dyslipidemia and diabetes mellitus, the former had a more significant decrease in TG level, and the latter had more significant decrease in TG level. At the same time, the increase of HDL-C level was also more obvious. Ingesting about 14g of inulin fructan per day might play a role in preventing and treating atherosclerotic cardiovascular diseases. 2. In the regulation of glucose metabolism, There was no significant change in FPG and HbAlc levels in diabetic patients after dietary supplementation of FPG and FPG, but there was no significant difference in the level of HbAlc in diabetic patients, but there was no significant difference in the levels of FPG and HbAlc in diabetic patients. The rate of decrease was obviously larger than that of the total population, and about 13g of fructan intake per day might play a beneficial role in the prevention and treatment of diabetes mellitus and its complications.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R151.3

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