Aim: To systematically review the effectiveness of vinegar consumption in improving glycaemic control in adults with type 2 diabetes mellitus.
Design: A systematic review and meta-analysis.
Review sources: The CINAHL, Excerpta Medica database (EMBASE), Medline, PubMed, Scopus and Cochrane databases were searched in April 2019. Interventional studies published in the English language, from inception to 15 April 2019, were included.
Review methods: Two investigators independently assessed the quality of the studies, discussed their findings to reach consensus and complied with the standards of the Cochrane Handbook for Systematic Reviews of Interventions. Random-effects meta-analysis was conducted in Review Manager 5.3.5 to assess the effect size. A series of subgroup and sensitivity analyses were conducted to explore the causes of heterogeneity. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
Results: A total of six relevant studies, including 317 patients with type 2 diabetes mellitus, were selected from 356 studies identified through electronic searches and reference lists. The meta-analysis showed significantly better fasting blood glucose and haemoglobin A1c (HbA1c) level. In secondary analyses, there was a remarkable reduction in total cholesterol and low-density lipoprotein postintervention.
Conclusion: Vinegar content varied across the studies, and the sample sizes in the included studies were relatively small. Therefore, caution should be exercised when trying to extrapolate the results to a larger population.
Impact: Existing reviews are limited to narrative synthesis, lacking critical appraisal, heterogenous outcomes, nor any report of fasting blood glucose and HbA1c. This meta-analysis review extends the evidence on the beneficial effects of vinegar on glycaemic control as measured by HbA1c and fasting blood glucose. Clinicians could incorporate vinegar consumption as part of their dietary advice for patients with diabetes.
目的: 针对食醋在改善2型糖尿病成人患者血糖控制方面的有效性展开系统性评估。 设计: 系统评估与荟萃分析 评估数据来源: 2019年4月通过CINAHL、医学文摘数据库(EMBASE)、Medline、PubMed、Scopus和Cochrane数据库进行搜索。从数据库建立之初到2019年4月15日以英语发表的干预性研究文献应包括在内。 评估方法: 两名研究人员各自针对研究质量进行评估,讨论研究结果达成一致,同时遵守《Cochrane干预措施系统评估操作手册》的标准。在系统评估管理软件(Review Manager 5.3.5)中进行随机效应荟萃分析,以评估影响程度。还进行了一系列子组和敏感性分析,以便探讨出现异质性的原因。采用推荐分级、评估、制定与评价(GRADE)方法对证据质量进行评估。 结果: 从356项通过电子检索和参考文献确定的研究中,共选出6项相关研究,其中包括317例2型糖尿病患者。荟萃分析结果显示,空腹状态下血糖和血红蛋白A1c(HbA1c)水平明显改善。在二次分析中,总胆固醇和低密度脂蛋白在干预后显著减少。 结论: 不同研究中的食醋含量各不相同,且纳入研究的样本量相对较小。因此,在试图将结果外推到较大人群时需谨慎。 影响: 现有评估工作仅限于采用叙述性综合法,缺乏关键性评价和异质性结果,并且尚无任何有关空腹状态下血糖和HbA1c情况的报告。本项荟萃分析评估拓展了醋对血糖控制(通过测量HbA1c和空腹状态下血糖得出)的有益作用的证据。因此,临床医师可将食醋囊括在糖尿病患者饮食建议之中。.
Keywords: blood sugar; diabetes mellitus; fasting blood glucose; glacial acetic acid; glycated haemoglobin a; meta-analysis; nurse; nursing; systematic review; type 2; vinegar.
© 2019 John Wiley & Sons Ltd.