摘要目的 系统评价妊娠期糖尿病患者补充维生素D与糖稳态参数及血脂指标的关系.方法 计算机检索PubMed、Web of Science、 中国知网和万方数据库,搜索补充维生素D相关的随机对照试验,检索时间为建库开始至2018年2月1日.由2位研究者独立筛选文献、 提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3和Stata 15.0软件进行Meta分析.结果 最终纳入6个RCT,共409例患者(试验组204例,对照组205例).Meta分析结果显示,试验组与对照组相比,空腹血糖[MD=-11.43,95％CI=(-15.24-7.61),P=0.00001]、 空腹胰岛素[MD=-4.8,95％CI=(-5.99,3.62),P<0.00001]、 稳态模型评估的胰岛素抵抗指数(HOMA-IR)[MD=-1.48,95％CI=(-1.81,1.16),P<0.00001]、 总胆固醇(TC)[MD=-14.09,95％CI=(-22.09,5.2),P=0.002]、 低密度脂蛋白胆固醇(LDL)水平显著下降[MD=-10.54,95％CI=(-18.18,2.89),P=0.007],高密度脂蛋白胆固醇(HDL)水平较对照组升高[MD=2.11,95％CI=(0.36,3.86),P=0.02],但对于甘油三酯(TG),两组比较差异无统计学意义.结论 妊娠期糖尿患者补充维生素D可降低空腹血糖、 胰岛素、TC、LDL,改善胰岛素抵抗,升高HDL,但对TG无明显影响.

abstractsObjective To systematically evaluate the effects of vitamin D supplementation on glucose homeostasis parameters and lipid profiles in gestational diabetes patients. Methods Four main databases inclu-ding PubMed, Web of Science, CNKI and Wanfang were searched to collect randomized controlled trials ( RCTs) about vitamin D supplementation for gestational diabetes mellitus from inception to February 1, 2018. Two investigators were chosen to search, extract and evaluate the data independently. Software RevMan 5. 3 and Stata 15. 0 were used for meta-analysis. Results Results A total of 6 randomized RCTs were included in-cluding 409 patients totally which were divided into two groups as study group ( n=204 ) and control group ( n=205) . The results showed that compared with the control group, patients in study group had lower fasting plasma glucose (FPG) [MD=-11. 43, 95％ CI= (-15. 24-7. 61), P=0. 00001], fasting insulin ( FIns) [ MD=-4. 8, 95％ CI= (-5. 99, 3. 62) , P<0. 00001] , insulin homeostasis model assessment of insulin resistance ( HOMA-IR) [ MD=-1. 48, 95％ CI= (-1. 81, 1. 16) , P<0. 00001] , total-cholesterol (TC) [MD=-14. 09, 95％ CI= (-22. 09, 5. 2), P=0. 002], low-density lipoprotein (LDL) [MD=-10. 54, 95％ CI= (-18. 18, 2. 89) , P=0. 007] and high-density lipoprotein ( HDL) [ MD=2. 11, 95％CI= (0. 36, 3. 86), P=0. 02]. No significant difference was found in triglycerides level (TG) between the two groups. Conclusion Vitamin D supplementation in patients with gestational diabetes can improve FPG, in-sulin, TC, LDL, insulin resistance and HDL, but has no effect on TG.