■肌醇已成为高危人群中妊娠糖尿病发展的预防疗法之一。进行了系统评价和荟萃分析,以确定肌醇在降低超重和肥胖孕妇妊娠糖尿病发生率方面的有效性和安全性。
■此荟萃分析使用标准Cochrane方法进行,并根据系统审查和荟萃分析(PRISMA)2020指南的首选报告项目进行报告。纳入标准是纳入超重和肥胖孕妇并使用肌醇补充剂的随机对照试验(RCT)。主要结果是24-28周时妊娠期糖尿病的发生率。次要结果包括剖宫产率,妊娠高血压的发病率,巨大儿和早产。风险比(RR)和95%置信区间(CI)用于二分数据。
■包括六个RCT。与标准微量营养素补充剂相比,标准剂量的肌醇(4g)可以降低GDM的发病率(RR0.54;CI[0.30,0.96];n=887名妇女),但是证据的确定性很低到很低。然而,低剂量肌醇,对于RR为0.71;CI[0.14,3.50]的超重和肥胖女性,其对妊娠期糖尿病发病率的益处尚不确定.没有注意到不良反应。对于次要结果,标准剂量肌醇似乎可以降低妊娠高血压和早产的发生率,但是证据的确定性很低到很低。
目前的证据不确定补充肌醇对超重和肥胖孕妇的潜在益处。虽然研究表明每天4g肌醇可以降低GDM的发病率,妊娠高血压和早产,没有严重不良事件的相关风险,证据的确定性低至非常低。未来的高质量试验可能会提供更有说服力的证据来支持实践建议。
UNASSIGNED: Myo-inositol has emerged as one of the preventive therapies for the development of gestational diabetes mellitus in at-risk populations. This systematic
review and meta-analysis was conducted to determine the efficacy and safety of myo-inositol in decreasing the incidence of gestational diabetes in overweight and obese pregnant women.
UNASSIGNED: This meta-analysis was conducted using the standard Cochrane methodology and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 guidelines. Inclusion criteria were randomized controlled trials (RCTs) that enrolled overweight and obese pregnant women and used myo-inositol supplementation. The primary outcome was the incidence of gestational diabetes mellitus at 24-28 weeks. Secondary outcomes included cesarean section rate, the incidence of pregnancy-induced hypertension, macrosomia and preterm delivery. Risk ratios (RRs) and 95% confidence intervals (CIs) were used for dichotomous data.
UNASSIGNED: Six RCTs were included. Compared to standard micronutrient supplementation, standard dose of myo-inositol (4 g) may reduce the incidence of GDM (RR 0.54; CI [0.30, 0.96]; n = 887 women), but the certainty of evidence is low to very low. With low-dose myo-inositol however, evidence is uncertain about its benefit on the incidence of gestational diabetes mellitus in overweight and obese women with RR 0.71; CI [0.14, 3.50]. No adverse effects were noted. For the secondary outcomes, standard dose myo-inositol appears to reduce the incidence of pregnancy-induced hypertension and preterm delivery, but the certainty of evidence is low to very low.
UNASSIGNED: Current evidence is uncertain on the potential benefit of myo-inositol supplementation in overweight and obese pregnant women. While studies show that 4 g myo-inositol per day may decrease the incidence of GDM, pregnancy-induced hypertension and pre-term birth with no associated risk of serious adverse events, the certainty of evidence is low to very low. Future high-quality trials may provide more compelling evidence to support practice recommendations.