{"title":"2型糖尿病患者微量营养素缺乏的负担：系统回顾和荟萃分析","authors":"Daya Krishan Mangal, Nida Shaikh, Himanshu Tolani, Diksha Gautam, Anuj Kumar Pandey, Yeshwanth Sonnathi, Shiv Dutt Gupta, Sanjay Kalra, Kamlesh Chand Sharma, Jagdish Prasad, Rajeev Tewari, Fahmina Anwar","doi":"10.1136/bmjnph-2024-000950","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Micronutrient deficiencies are a significant issue worldwide, particularly in South Asia and sub-Saharan Africa. These deficiencies can impact glucose metabolism and insulin signalling pathways, potentially leading to the beginning and advancement of type 2 diabetes (T2D). This study is a comprehensive assessment of the burden of multiple micronutrient deficiencies among T2D patients. The aim of the study is to resolve conflicting evidence from previous studies that mainly focused on one specific micronutrient.</p><p><strong>Methods: </strong>The systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines and the Cochrane Handbook. This comprehensive literature search explored Embase, ProQuest, PubMed, Scopus, Cochrane Library, Google Scholar, LILACS and the grey literature, and studies that met the inclusion criteria. A pre-piloted data extraction sheet was used to extract data for relevant study outcomes and characteristics. Results were produced by R V.4.3.2 (R Core Team 2023 using general packages such as tidyverse, and specific packages such as meta and metafor.</p><p><strong>Results: </strong>The analysis included 132 studies with 52 501 participants. The pooled prevalence of multiple micronutrient deficiency (vitamins, minerals and electrolytes) was 45.30% (95% CI 40.35% to 50.30%) among T2D patients. The pooled prevalence (48.62%, 95% CI 42.55 to 54.70) was higher in women with T2D than in men. Vitamin D was the most prevalent micronutrient deficiency (60.45%, 95% CI 55% to 65%), followed by magnesium (41.95%, 95% CI 27% to 56%). B12 deficiency (28.72%, 95% CI 21.08% to 36.37%) was higher in the metformin consuming group. The prevalence of micronutrient deficiency varied across WHO regions.</p><p><strong>Conclusions: </strong>Micronutrient deficiencies were common in T2D patients, the most common being vitamin D deficiency. Women were more likely to be affected by micronutrient deficiency than men. These studies were hospital based and the findings of this systematic review may be used with caution due to inherent selection bias. Diversity of foods, lifestyle choices and cultural practices may contribute to geographic variations in micronutrient deficiency.</p><p><strong>Trial registration: </strong>PROSPERO CRD42023439780.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"8 1","pages":"e000950"},"PeriodicalIF":2.5000,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322531/pdf/","citationCount":"0","resultStr":"{\"title\":\"Burden of micronutrient deficiency among patients with type 2 diabetes: systematic review and meta-analysis.\",\"authors\":\"Daya Krishan Mangal, Nida Shaikh, Himanshu Tolani, Diksha Gautam, Anuj Kumar Pandey, Yeshwanth Sonnathi, Shiv Dutt Gupta, Sanjay Kalra, Kamlesh Chand Sharma, Jagdish Prasad, Rajeev Tewari, Fahmina Anwar\",\"doi\":\"10.1136/bmjnph-2024-000950\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Micronutrient deficiencies are a significant issue worldwide, particularly in South Asia and sub-Saharan Africa. These deficiencies can impact glucose metabolism and insulin signalling pathways, potentially leading to the beginning and advancement of type 2 diabetes (T2D). This study is a comprehensive assessment of the burden of multiple micronutrient deficiencies among T2D patients. The aim of the study is to resolve conflicting evidence from previous studies that mainly focused on one specific micronutrient.</p><p><strong>Methods: </strong>The systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines and the Cochrane Handbook. This comprehensive literature search explored Embase, ProQuest, PubMed, Scopus, Cochrane Library, Google Scholar, LILACS and the grey literature, and studies that met the inclusion criteria. A pre-piloted data extraction sheet was used to extract data for relevant study outcomes and characteristics. 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引用次数: 0
摘要
背景：微量营养素缺乏是世界范围内的一个重大问题，特别是在南亚和撒哈拉以南非洲。这些缺陷会影响葡萄糖代谢和胰岛素信号通路，可能导致2型糖尿病（T2D）的发生和发展。本研究是对糖尿病患者多种微量营养素缺乏负担的综合评估。这项研究的目的是解决先前主要集中在一种特定微量营养素的研究中出现的相互矛盾的证据。方法：系统评价遵循系统评价和荟萃分析首选报告项目（PRISMA） 2020指南和Cochrane手册。本综合文献检索检索了Embase、ProQuest、PubMed、Scopus、Cochrane Library、谷歌Scholar、LILACS和灰色文献，以及符合纳入标准的研究。使用预导数据提取表提取相关研究结果和特征的数据。结果是由R V.4.3.2 （R Core Team 2023）使用通用包（如tidyverse）和特定包（如meta和metafor）生成的。结果：分析包括132项研究，52,501名参与者。T2D患者中多种微量营养素缺乏症（维生素、矿物质和电解质）的总患病率为45.30% （95% CI 40.35% ~ 50.30%）。女性T2D患者的总患病率（48.62%,95% CI 42.55 ~ 54.70）高于男性。维生素D是最普遍的微量营养素缺乏症（60.45%，95%可信区间为55%至65%），其次是镁（41.95%，95%可信区间为27%至56%）。B12缺乏症（28.72%,95% CI 21.08%至36.37%）在二甲双胍摄入组中更高。世卫组织各区域微量营养素缺乏症的流行程度各不相同。结论：T2D患者普遍存在微量营养素缺乏，其中以维生素D缺乏最为常见。女性比男性更容易受到微量营养素缺乏的影响。这些研究是基于医院的，由于固有的选择偏倚，本系统评价的结果可能要谨慎使用。食物、生活方式选择和文化习俗的多样性可能导致微量营养素缺乏的地域差异。试验注册：PROSPERO CRD42023439780。
Burden of micronutrient deficiency among patients with type 2 diabetes: systematic review and meta-analysis.
Background: Micronutrient deficiencies are a significant issue worldwide, particularly in South Asia and sub-Saharan Africa. These deficiencies can impact glucose metabolism and insulin signalling pathways, potentially leading to the beginning and advancement of type 2 diabetes (T2D). This study is a comprehensive assessment of the burden of multiple micronutrient deficiencies among T2D patients. The aim of the study is to resolve conflicting evidence from previous studies that mainly focused on one specific micronutrient.
Methods: The systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines and the Cochrane Handbook. This comprehensive literature search explored Embase, ProQuest, PubMed, Scopus, Cochrane Library, Google Scholar, LILACS and the grey literature, and studies that met the inclusion criteria. A pre-piloted data extraction sheet was used to extract data for relevant study outcomes and characteristics. Results were produced by R V.4.3.2 (R Core Team 2023 using general packages such as tidyverse, and specific packages such as meta and metafor.
Results: The analysis included 132 studies with 52 501 participants. The pooled prevalence of multiple micronutrient deficiency (vitamins, minerals and electrolytes) was 45.30% (95% CI 40.35% to 50.30%) among T2D patients. The pooled prevalence (48.62%, 95% CI 42.55 to 54.70) was higher in women with T2D than in men. Vitamin D was the most prevalent micronutrient deficiency (60.45%, 95% CI 55% to 65%), followed by magnesium (41.95%, 95% CI 27% to 56%). B12 deficiency (28.72%, 95% CI 21.08% to 36.37%) was higher in the metformin consuming group. The prevalence of micronutrient deficiency varied across WHO regions.
Conclusions: Micronutrient deficiencies were common in T2D patients, the most common being vitamin D deficiency. Women were more likely to be affected by micronutrient deficiency than men. These studies were hospital based and the findings of this systematic review may be used with caution due to inherent selection bias. Diversity of foods, lifestyle choices and cultural practices may contribute to geographic variations in micronutrient deficiency.
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