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間歇性禁食對前期糖尿病與2型糖尿病患者的體重與心血管健康的積極影響

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一項綜合分析顯示，間歇性禁食（IF）對前期糖尿病與2型糖尿病患者有顯著的體重減輕效果，並改善若干心血管健康指標。研究發現，IF能有效降低體重、體重指數（BMI）、糖化血紅蛋白（HbA1c）、空腹血糖、總膽固醇和三酸甘油脂，但對脂肪質量、胰島素水平、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）及血壓無顯著影響。與控制飲食（CON）和卡路里限制（CR）相比，IF在體重和BMI上表現更為突出，顯示其在糖尿病預防與治療中的潛力。

The effects of intermittent fasting on body composition and cardiometabolic health in adults with prediabetes or type 2 diabetes: A systematic review and meta-analysis

間歇性禁食對患有前期糖尿病或2型糖尿病的成年人身體組成與心血管代謝健康的影響：系統評價與統合分析

Khalafi M, Habibi Maleki A, Symonds ME, Rosenkranz SK, Rohani H, Ehsanifar M. The effects of intermittent fasting on body composition and cardiometabolic health in adults with prediabetes or type 2 diabetes: A systematic review and meta-analysis. Diabetes Obes Metab. 2024;26(9):3830-3841. doi:10.1111/dom.15730

https://pubmed.ncbi.nlm.nih.gov/38956175/

Abstract

Aim

To perform a meta-analysis to investigate the effects of intermittent fasting (IF), as compared with either a control diet (CON) and/or calorie restriction (CR), on body composition and cardiometabolic health in individuals with prediabetes and type 2 diabetes (T2D).

Methods

PubMed, Web of Science, and Scopus were searched from their inception to March 2024 to identify original randomized trials with parallel or crossover designs that studied the effects of IF on body composition and cardiometabolic health. Weighted mean differences (WMDs) or standardized mean differences with 95% confidence intervals (CIs) were calculated using random-effects models.

Results

Overall, 14 studies involving 1101 adults with prediabetes or T2D were included in the meta-analysis. IF decreased body weight (WMD -4.56 kg [95% CI -6.23 to -2.83]; p = 0.001), body mass index (BMI; WMD -1.99 kg.m2 [95% CI -2.74 to -1.23]; p = 0.001), glycated haemoglobin (HbA1c; WMD -0.81% [95% CI -1.24 to -0.38]; p = 0.001), fasting glucose (WMD -0.36 mmol/L [95% CI -0.63 to -0.09]; p = 0.008), total cholesterol (WMD -0.31 mmol/L [95% CI -0.60 to -0.02]; p = 0.03) and triglycerides (WMD -0.14 mmol/L [95% CI -0.27 to -0.01]; p = 0.02), but did not significantly decrease fat mass, insulin, low-densitiy lipoprotein, high-density lipoprotein, or blood pressure as compared with CON. Furthermore, IF decreased body weight (WMD -1.14 kg [95% CI -1.69 to -0.60]; p = 0.001) and BMI (WMD -0.43 kg.m2 [95% CI -0.58 to -0.27]; p = 0.001), but did not significantly affect fat mass, lean body mass, visceral fat, insulin, HbA1c, lipid profiles or blood pressure.

Conclusion

Intermittent fasting is effective for weight loss and specific cardiometabolic health markers in individuals with prediabetes or T2D. Additionally, IF is associated with a reduction in body weight and BMI compared to CR, without effects on glycaemic markers, lipid profiles or blood pressure.

Keywords: body composition; cardiovascular disease; dietary intervention; dyslipidaemia; insulin resistance; type 2 diabetes.

摘要

目的

進行系統評價與統合分析，探討間歇性禁食（IF）與對照飲食（CON）和/或熱量限制（CR）相比，對患有前期糖尿病和2型糖尿病（T2D）個體的身體組成與心血管代謝健康的影響。

方法

從PubMed、Web of Science和Scopus中檢索，涵蓋其創立至2024年3月的原始隨機對照試驗，研究間歇性禁食對身體組成和心血管代謝健康的影響。使用隨機效應模型計算加權平均差（WMD）或標準化平均差（SMD）及95%置信區間（CI）。

結果

總共有14項研究，涉及1101名患有前期糖尿病或T2D的成年人，納入本次統合分析。結果顯示，間歇性禁食能顯著降低體重（WMD -4.56 kg [95% CI -6.23至-2.83]；p = 0.001）、體重指數（BMI；WMD -1.99 kg/m² [95% CI -2.74至-1.23]；p = 0.001）、糖化血紅蛋白（HbA1c；WMD -0.81% [95% CI -1.24至-0.38]；p = 0.001）、空腹血糖（WMD -0.36 mmol/L [95% CI -0.63至-0.09]；p = 0.008）、總膽固醇（WMD -0.31 mmol/L [95% CI -0.60至-0.02]；p = 0.03）和三酸甘油酯（WMD -0.14 mmol/L [95% CI -0.27至-0.01]；p = 0.02），但與對照飲食相比，並未顯著降低脂肪量、胰島素、低密度脂蛋白、高密度脂蛋白或血壓。此外，間歇性禁食與熱量限制相比，顯著降低體重（WMD -1.14 kg [95% CI -1.69至-0.60]；p = 0.001）和BMI（WMD -0.43 kg/m² [95% CI -0.58至-0.27]；p = 0.001），但對脂肪量、瘦體重、內臟脂肪、胰島素、HbA1c、脂質檢查或血壓無顯著影響。

結論

間歇性禁食對前期糖尿病或2型糖尿病患者的減重及某些心血管代謝健康指標有效。此外，與熱量限制相比，間歇性禁食與體重和BMI的減少相關，但對血糖指標、脂質檢查或血壓未產生顯著影響。

關鍵字：身體組成；心血管疾病；飲食干預；脂質異常；胰島素抗性；2型糖尿病。

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