O le tetee atu o le inisalini e taua tele i le faʻamaʻiina o le maʻi gaʻo gaʻo e le o le ava (NAFLD). E tele suʻesuʻega ua iloiloina le mafutaga avaitamini Dsupplementation with insulin resistance i tagata mamaʻi ma le NAFLD.O taunuʻuga na maua e oʻo mai pea ma faʻalavelave faʻalavelave. Scholar, COCHRANE ma Science Direct databases. O suʻesuʻega na maua na suʻesuʻeina e faʻaaoga ai faʻataʻitaʻiga tumau-aʻafiaga poʻo faʻalavelave faʻafuaseʻi. E fitu suʻesuʻega agavaa ma le aofaʻi o tagata 735 na aofia ai.Vitamini Dfaʻaopoopoga faʻaleleia le faʻamalosia o le inisalini i tagata mamaʻi ma le NAFLD, faʻailogaina i le faʻaitiitia o le Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), faʻatasi ai ma le faʻaputuina o le eseesega o le -1.06 (p = 0.0006; 95% CI -1.66 i le -0.45). Vitamin D supplementation faateleina le maualuga o le vitamini D i le toto ma se eseesega o le 17.45 (p = 0.0002; 95% CI 8.33 i le 26.56).Vitamini Dfaʻaopoopoga faʻaititia le maualuga o le ALT faʻatasi ai ma le eseesega o le aofaʻi o le -4.44 (p = 0.02; 95% CI -8.24 i le -0.65). Leai se aʻafiaga na matauina i luga o le AST maualuga. Vitamin D supplementation ei ai aʻafiaga aoga i le faʻaleleia o le inisalini tetee i tagata gasegase NAFLD. faʻaopoopoga e mafai ona faʻaititia le HOMA-IR i ia maʻi. E mafai ona faʻaaogaina e avea o se togafitiga faʻapitoa mo tagata NAFLD.
Faʻamaʻi gaʻo gaʻo e le faʻaogaina (NAFLD) o se vaega o faʻamaʻi gaʻo e fesoʻotaʻi ma le gaʻo 1. E faʻaalia i le maualuga o le faʻaputuina o triglycerides i le hepatocytes, e masani ona i ai le gaioiga o le necroinflammatory ma le fibrosis (steatohepatitis) 2. E mafai ona alualu i luma i le steatohepatitis e le ava malosi (NASH), fibrosis ma le cirrhosis.NAFLD ua manatu o se mafuaʻaga tele o faʻamaʻi faʻamaʻi o le ate ma o lona faʻateleina o loʻo faʻateleina, faʻatatau i le 25% i le 30% o tagata matutua i atunuʻu atinaʻe3,4. Insulin resistance, mumū, ma le faʻamaʻiina o le oxidative e manatu e avea ma mea taua i totonu. atinae ole NAFLD1.
O le pathogenesis o le NAFLD e fesoʻotaʻi vavalalata ma le faʻamalosia o le inisalini. E faʻavae i luga o le faʻataʻitaʻiga sili ona taatele o le "two-hit hypothesis", o le faʻamalosia o le inisalini e aʻafia i le "first-hit" process. I lenei faiga muamua, e aofia ai le faʻaputuina o lipids o loʻo i totonu. hepatocytes, lea e manatu ai le faʻamalosia o le inisalini o se mafuaʻaga autu i le atinaʻeina o steatosis o le ate. O le "muamua lavea" e faʻateleina ai le vaivai o le ate i mea e fai ai le "lua lona lua". E mafai ona oʻo atu ai i le faʻaleagaina o le ate, fulafula ma fibrosis.O le gaosiga o cytokines proinflammatory, mitochondrial dysfunction, faʻamaʻi faʻamaʻi, ma le lipid peroxidation o mea ia e mafai ona fesoasoani i le atinaʻeina o manuʻa ate, faʻavaeina e adipokines.
Vitamini D o se vaitamini ga'o e mafai ona fa'atonutonuina le homeostasis o ponaivi. O lona matafaioi na su'esu'eina lautele i le tele o tulaga fa'alesoifua maloloina e le o se skeletal e pei o le metabolic syndrome, insulin resistance, obesity, type 2 diabetes and cardiovascular-related ma'i. le tele o faʻamaoniga faʻasaienisi ua suʻesuʻeina le sootaga i le va o le vaitamini D ma le NAFLD. Vitamin D e iloa e faʻatonutonu ai le faʻamalosia o le inisalini, faʻamaʻi tumau ma fibrosis.
O nisi o suʻesuʻega faʻatonutonu faʻafuaseʻi (RCTs) ua iloiloina le aʻafiaga o le vailaʻau D supplementation i luga ole insulin resistance.pe faʻaalia se aoga aoga ile faʻamalosia o le inisalini poʻo le le faʻaalia o soʻo se manuia7,8,9,10,11,12,13. E ui lava i taunuuga feteʻenaʻi, e manaʻomia se faʻataʻitaʻiga faʻataʻitaʻiga e iloilo ai le aʻafiaga atoa o le vitamini D supplementation. Tele meta-analyses na faia muamua14,15,16.A meta-suʻesuʻega a Guo et al.E aofia ai suʻesuʻega e ono e iloiloina ai le aʻafiaga o le vaitamini D i le faʻamalosia o le inisalini e maua ai le tele o faʻamaoniga e mafai e le vaitamini D ona i ai se aoga aoga i le insulin sensitivity14. Ae ui i lea, o le isi meta- suʻesuʻega na maua ai iʻuga eseese.Pramono et al15 na maua ai o togafitiga faʻaopoopo vitamini D e leai se aʻafiaga i le faʻaogaina o le inisalini. ., e aofia ai suʻesuʻega e fa, na faia ai suʻesuʻega tutusa. Ole faʻaopoopoga ole Vitamin D e leʻi faʻaitiitia ai le HOMA IR16. Mafaufau i faʻataʻitaʻiga uma na muamua atu i le faʻaogaina o vailaʻau D supplements mo le faʻamalosia o le inisalini, o se faʻafouinae mana'omia le su'esu'ega fa'ata'ita'iga fa'atasi ai ma tusitusiga fa'afou fa'aopoopo. O le fa'amoemoe o lenei su'esu'ega o le iloilo lea o le a'afiaga o le fa'aopoopoina o le vaitamini D i le fa'amalosia o le inisalini.
I le faʻaaogaina o le suʻesuʻega pito i luga, na matou maua ai le aofaʻi o suʻesuʻega 207, ma ina ua maeʻa le toe faʻaaogaina, matou maua tala 199. Matou te le aofia ai 182 tusiga e ala i le suʻeina o ulutala ma faʻamatalaga, ma tuʻu ai le aofaʻi o suʻesuʻega talafeagai 17. Suesuega e leʻi tuʻuina atu faʻamatalaga uma. e manaʻomia mo lenei faʻataʻitaʻiga faʻataʻitaʻiga poʻo le mea na le maua ai le tusitusiga atoa na le aofia ai. Ina ua maeʻa suʻesuʻega ma iloiloga faʻapitoa, na matou mauaina ni tala se fitu mo le iloiloga faʻatulagaina o loʻo i ai nei ma faʻataʻitaʻiga meta. .
Matou te aofia ai tusitusiga atoa o faʻataʻitaʻiga faʻataʻitaʻiga e fitu (RCTs) . O tausaga faʻasalalau o nei tusiga na amata mai le 2012 i le 2020, faʻatasi ai ma le aofaʻi o 423 faʻataʻitaʻiga i le vaega faʻalavelave ma le 312 i le placebo group. O le vaega faʻataʻitaʻi na maua eseese tui ma umi ole vaitamini D supplements, a'o maua e le vaega fa'atonutonu se placebo. O se aotelega o fa'ai'uga o su'esu'ega ma uiga o su'esu'ega o lo'o tu'uina atu ile Laulau 1.
Sa su'esu'eina le tulaga lamatia o le fa'aituau e fa'aaoga ai le Cochrane Collaboration's risk of bias method. O mataupu uma e fitu na aofia i lenei su'esu'ega na pasia le iloiloga lelei. O fa'ai'uga atoa o le fa'aituau mo tala uma e aofia ai o lo'o fa'aalia i le Ata 2.
Vitamin D supplementation faʻaleleia le faʻamalosia o le inisalini i tagata mamaʻi ma le NAFLD, faʻaalia i le faʻaitiitia o HOMA-IR. Faʻavae i luga o se faʻataʻitaʻiga faʻataʻitaʻiga faʻafuaseʻi (I2 = 67%; χ2 = 18.46; p = 0.005), o le eseesega o le eseesega i le va o vitamini D supplementation ma leai se vaitamini D faʻaopoopoga o le -1.06 (p = 0.0006; 95% CI -1.66 i le -0.45) (ata 3).
Faʻavae i luga o se faʻataʻitaʻiga faʻataʻitaʻiga (Ata 4), o le eseesega o le aofaʻi o le vailaʻau D serum ina ua maeʻa le vailaʻau D supplementation o le 17.45 (p = 0.0002; 95% CI 8.33 i le 26.56). E tusa ai ma le auiliiliga, vitamini D supplementation e mafai ona faateleina le serum vitamini D maualuga i le 17.5 ng / mL. I le taimi nei, o le aafiaga o le vitamini D supplementation i luga ole ate enzymes ALT ma le AST na faʻaalia ai iʻuga eseese. Vitamin D supplementation faʻaititia ALT maualuga ma le tuʻufaʻatasia o le eseesega o le -4.44 (p = 0.02; 95% CI -8.24 i -0.65) (Ata 5) .Ae ui i lea, e leai se aafiaga na matauina mo tulaga AST, faʻatasi ai ma le faʻaogaina o le eseesega o le -5.28 (p = 0.14; 95% CI - 12.34 i le 1.79) faʻavae i luga o se faʻataʻitaʻiga faʻataʻitaʻiga faʻafuaseʻi ( Ata 6).
Suiga ile HOMA-IR ina ua maeʻa le vailaʻau D supplementation na faʻaalia ai le tele o le heterogeneity (I2 = 67%). Meta-regression iloiloga o le auala o le pulega (tuugutu poʻo le intramuscular), faʻaaogaina (i aso taʻitasi poʻo le le o aso taʻitasi), poʻo le umi ole vitamini D supplementation (≤ 12 vaiaso ma> 12 vaiaso) o loʻo fautua mai ai o le faʻaaogaina o taimi e mafai ona faʻamatalaina ai le heterogeneity (Table 2) .11 faʻaaogaina le auala tautala o le pulega. O le faʻaaogaina o vitamini D supplements i aso uma na faʻaaogaina i suʻesuʻega e tolu. le eseesega o suiga ile HOMA-IR (Fig 7).
O faʻaiʻuga tuʻufaʻatasia o suʻesuʻega faʻataʻitaʻiga o loʻo i ai nei na maua ai o togafitiga faʻaopoopo vitamini D e mafai ona faʻaleleia ai le faʻamalosia o le inisalini, o se faʻailoga e faʻaititia ai le HOMA-IR i tagata mamaʻi ma le NAFLD. Ole auala ole faʻatonuga ole vaitamini D e mafai ona fesuisuiai, e ala ile tui intramuscular poʻo le gutu. .O le su'esu'ega atili o lona a'afiaga i le fa'aleleia atili o le inisalini e tete'e ina ia malamalama ai i suiga o le toto ALT ma le AST maualuga. O le fa'aitiitia o le maualuga o le ALT, ae le o le AST, na matauina ona o le fa'aopoopoina o vitamini D.
O le tupuga o le NAFLD e fesoʻotaʻi vavalalata ma le faʻamalosia o le inisalini. Faʻateleina gaʻo gaʻo saoloto (FFA), faʻamaʻi o le tino, ma le faʻaitiitia o le adiponectin e nafa ma le atinaʻeina o le inisalini tetee i le NAFLD17. Serum FFA e maualuga tele i tagata gasegase NAFLD, lea e mulimuli ane liua. i triacylglycerols e ala i le glycerol-3-phosphate ala.O le isi oloa o lenei auala o le ceramide ma le diacylglycerol (DAG). Ua iloa le DAG e aafia i le faʻagaoioia o le protein kinase C (PKC), lea e mafai ona faʻalavelaveina le inisalini receptor threonine 1160, lea e fesoʻotaʻi ma le faʻaitiitia o le faʻamalosia o le inisalini. O le fulafula o le adipose tissue ma le faʻateleina o cytokines proinflammatory pei ole interleukin-6 (IL-6) ma le tumor necrosis factor alpha (TNF-alpha) e fesoasoani foi i le faʻamalosia o le inisalini. Ae mo le adiponectin, e mafai ona faʻaleleia. le faʻasaina o le gaʻo gaʻo beta-oxidation (FAO), faʻaogaina o le kulukose ma le faʻaogaina o le gaʻo gaʻo. O ona maualuga e faʻaititia i gasegase NAFLD, ma faʻapupulaina ai le devefaʻaitiitia le faʻamalosia o le inisalini. E fesoʻotaʻi ma vaitamini D, o le vaitamini D receptor (VDR) o loʻo i ai i totonu o sela o le ate ma ua aʻafia i le faʻaitiitia o gaioiga faʻamaʻi i faʻamaʻi faʻamaʻi o le ate. D o lo'o iai mea fa'ama'i fa'ama'i ma fa'ama'i-fibrotic i le ate19.
O faʻamaoniga o loʻo i ai nei o loʻo taʻu mai ai o le le atoatoa o le vitamini D e mafai ona aʻafia i le pathogenesis o le tele o faʻamaʻi. O lenei manatu e faʻamaoni mo le fesoʻotaʻiga i le va o le vitamini D deficiency ma le insulin resistance20,21. Vitamin D faʻaaogaina lona tulaga gafatia e ala i fegalegaleaiga ma VDR ma vitamini D metabolizing enzymes. O nei mea e mafai ona i ai i le tele o ituaiga sela, e aofia ai sela beta pancreatic ma sela e tali atu i le inisalini e pei o adipocytes. faleoloa autu o le vaitamini D i le tino o le adipose tissue. E galue foi o se punavai taua o adipokines ma cytokines ma e aafia i le gaosiga o le mumū o le tino. O faʻamaoniga o loʻo i ai nei e taʻu mai ai o le vailaʻau D e faʻatonutonu mea e fesoʻotaʻi ma le faʻaogaina o le inisalini mai sela beta pancreatic.
Tuuina atu lenei faʻamaoniga, vitamini D supplementation e faʻaleleia ai le faʻamalosia o le inisalini i tagata gasegase NAFLD e talafeagai. O lipoti lata mai o loʻo faʻaalia ai se aoga aoga o le vailaʻau D supplementation i le faʻaleleia atili o le inisalini. meta-suʻesuʻega a Guo et al.—E iloilo e iloilo le suʻesuʻeina o le aʻafiaga o le vaitamini D i luga o le inisalini tetee e maua ai le tele o faʻamaoniga e mafai e le vailaʻau D ona iai se aoga aoga ile faʻaogaina ole insulin.95% CI - 2.30, - 0.34. O suʻesuʻega na aofia ai e iloilo le HOMA-IR e ono suʻesuʻega 14. Peitaʻi, o faʻamaoniga feteʻenaʻi o loʻo i ai. ma'ale'ale inisalini i matā'upu o lo'o i ai le inisalini tete'e po'o le a'afia o le inisalini tete'e na fa'aalia ai le fa'aopoopoina o le vaitamini D ole fa'ainisinia e leai sona a'afiaga, fa'avasegaina le eseesega o lona uiga -0.01, 95% CI -0.12, 0.10;p = 0.87, I2 = 0% 15. Ae ui i lea, e tatau ona maitauina o le faitau aofaʻi o tagata na suʻesuʻeina i le faʻataʻitaʻiga faʻataʻitaʻiga o mataupu ma pe lamatia le faʻamalosia o le inisalini (mamafa tele, oona, prediabetes, polycystic ovary syndrome [PCOS] ma le faʻalavelave faʻalavelave. 2 maʻisuka), nai lo le NAFLD maʻi15.O se isi faʻataʻitaʻiga faʻataʻitaʻiga a Wei et al. Na maua foʻi suʻesuʻega tutusa. I le iloiloga o le vitamini D supplementation i HOMA-IR, e aofia ai suʻesuʻega e fa, vitamini D supplementation e leʻi faʻaitiitia ai HOMA IR (WMD). = 0.380, 95% CI - 0.162, 0.923; p = 0.169) 16. Faʻatusatusaina o faʻamatalaga uma o loʻo maua, o le iloiloga faʻatulagaina o loʻo i ai nei ma faʻataʻitaʻiga faʻataʻitaʻiga o loʻo tuʻuina atu ai le tele o lipoti o le vitamini D supplementation faʻaleleia le faʻamalosia o le inisalini i tagata gasegase NAFLD, tutusa ma le meta-suʻesuʻega. saunia e Guo et al.E ui lava na faia faʻataʻitaʻiga faʻataʻitaʻiga tutusa, o loʻo tuʻuina atu e le meta-suʻesuʻega o loʻo i ai nei se tusitusiga faʻafouina e aofia ai le tele o faʻataʻitaʻiga faʻataʻitaʻiina ma faʻapea ona maua ai se faʻamaoniga malosi mo le aʻafiaga o le vailaʻau D supplementation ile insulin r.esistance.
O le aʻafiaga o le vaitamini D i luga o le inisalini e mafai ona faʻamatalaina e ala i lana matafaioi o se faʻatonuga o le faʻaogaina o le inisalini ma le Ca2 + maualuga. E mafai e le Calcitriol ona faʻaoso tuusaʻo le faʻaogaina o le inisalini ona o le elemene tali vitamini D (VDRE) o loʻo i ai i le faʻalauiloaina o le inisalini o loʻo i totonu o le pancreatic. beta cell. E le gata o le transcription o le inisalini gene, ae o le VDRE foi ua lauiloa e faaosofia ai kenera eseese e fesoʻotaʻi ma le cytoskeleton formation, intracellular junctions, ma le tuputupu aʻe o sela o pancreatic cβ cells. Vitamin D ua faʻaalia foi e aʻafia ai le inisalini tetee e ala i le faʻaogaina o Ca2 + flux.Talu ai o le calcium e taua tele mo le tele o inisalini-mediated intracellular process in muscle and adipose tissue, e mafai ona aʻafia le vaitamini D i lona aʻafiaga i le inisalini tetee.O le maualuga o le intracellular Ca2 + maualuga e manaʻomia mo le gaioiga o le inisalini. Ua maua suʻesuʻega o le le atoatoa o le vitamini D e taʻitaʻia ai. faateleina Ca2 + concentrations, e mafua ai le faʻaitiitia o le GLUT-4 gaioiga, lea e aʻafia ai le insulin resistance26,27.
O le aʻafiaga o le faʻaopoopoga o vitamini D i le faʻaleleia atili o le inisalini na toe suʻesuʻeina e atagia ai lona aʻafiaga i luga o le ate, lea na atagia i suiga i le ALT ma le AST maualuga. O le faʻaitiitia o le maualuga o le ALT, ae le o le AST, na matauina ona o le faʻaopoopoga o vitamini D. supplementation.A meta-suʻesuʻega a Guo et al.faʻaalia ai se faʻaitiitiga tuaoi i tulaga ALT, e aunoa ma se aafiaga i tulaga AST, tutusa ma lenei suʻesuʻega14.O le isi suʻesuʻega faʻataʻitaʻiga a Wei et al.2020 na maua ai foi le leai o se eseesega i le serum alanine aminotransferase ma le aspartate aminotransferase maualuga i le va o vitamini D faʻaopoopoga ma vaega placebo.
O suʻesuʻega faʻatulagaina o loʻo iai nei ma faʻataʻitaʻiga faʻataʻitaʻiga o loʻo finau foi e faasaga i tapulaʻa.O le eseesega o le faʻataʻitaʻiga o loʻo iai nei atonu na aʻafia ai iʻuga na maua i lenei suʻesuʻega. faʻapitoa faʻatatau i le faitau aofaʻi o le NAFLD, ma le homogeneity o suʻesuʻega.O le isi itu e tatau ona mafaufau i ai o le suʻesuʻeina o isi faʻamaufaʻailoga i le NAFLD, e pei o le aʻafiaga o le vitamini D supplementation i le NAFLD maʻi i luga o faʻamaʻi faʻamaʻi, NAFLD sikoa gaoioiga (NAS) ma le stiffness ate. I le faaiuga, o le vitamini D supplementation na faʻaleleia atili ai le faʻamalosia o le inisalini i tagata mamaʻi ma le NAFLD, o se faʻailoga na faʻaitiitia ai HOMA-IR. E mafai ona faʻaaogaina e avea o se togafitiga faʻapitoa mo tagata NAFLD.
Fa'atonuga fa'atatau e fa'atatau ile fa'atinoina ole manatu ole PICO.O le fa'avae o lo'o fa'amatalaina ile Laulau 3.
O le iloiloga faʻatulagaina o loʻo iai nei ma faʻataʻitaʻiga faʻataʻitaʻiga e aofia uma suʻesuʻega e oʻo atu ia Mati 28, 2021, ma tuʻuina atu le tusitusiga atoa, iloilo faʻaopoopo vitamini D pulega i tagata mamaʻi ma NAFLD.Articles ma lipoti mataupu, agavaa ma suʻesuʻega tau tamaoaiga, iloiloga, cadavers ma ituaiga tino. na le aofia ai mai le suʻesuʻega o loʻo iai nei.O tala uma e leʻi tuʻuina atu faʻamatalaga e manaʻomia e faʻatautaia ai le faʻataʻitaʻiga faʻataʻitaʻiga o loʻo iai nei na le aofia ai foi.
O le iloiloga na aofia ai suʻesuʻega o tagata matutua NAFLD o loʻo mauaina le vaitamini D pulega. Na iloiloina le faʻamalosia o le inisalini e faʻaaoga ai le Homeostasis Model Assessment of Insulin Resistance (HOMA-IR).
O le faʻalavelave o loʻo iloiloina o le faʻaogaina lea o le vaitamini D. Matou te aofia ai suʻesuʻega lea na tuʻuina atu ai le vaitamini D i soʻo se tui, i soʻo se auala o le pulega, ma mo soʻo se umi. .
O le taunuʻuga autu na suʻesuʻeina i le iloiloga faʻatulagaina o loʻo i ai nei ma meta-suʻesuʻega o le insulin resistance. I lenei tulaga, na matou faʻaogaina le HOMA-IR e fuafua ai le faʻamalosia o le inisalini i tagata mamaʻi. ) (IU/l) ma aspartate aminotransferase (AST) (IU/l) maualuga.
Ave'ese Tulaga Agava'a (PICO) i upu autu e fa'aaoga ai le Boolean operators (eg OR, AND, NOT) ma vaega uma po'o MeSH (Medical Subject Heading) terms.I lenei su'esu'ega, sa matou fa'aogaina le PubMed database, Google Scholar, COCHRANE ma Science Direct e fai ma su'esu'ega. afi e su'e tusi talaaga talafeagai.
O le filifiliga o suʻesuʻega na faʻatinoina e tusitala e toʻatolu (DAS, IKM, GS) e faʻaitiitia ai le avanoa e aveese ai suʻesuʻega talafeagai. faʻamaumauga. Faʻaulutala ma suʻesuʻega faʻapitoa na faia e le aofia ai suʻesuʻega le talafeagai. Mulimuli ane, o suʻesuʻega na pasia le suʻesuʻega muamua na toe iloiloina e iloilo pe na latou ausia le faʻaogaina ma le faʻaaogaina o faʻamaumauga mo lenei iloiloga.
O tusitala uma na faʻaogaina fomu faʻamaumauga faʻaeletoroni e aoina ai faʻamatalaga manaʻomia mai tusitusiga taʻitasi. Ona faʻapotopotoina lea o faʻamaumauga ma pulea e faʻaaoga ai le software Review Manager 5.4.
O mea fa'amaumauga o le igoa o le tusitala, tausaga o fa'asalalauga, ituaiga su'esu'ega, faitau aofa'i, vaitamini D dose, umi ole fa'atonuga ole vaitamini D, lapo'a fa'ata'ita'iga, tausaga, fa'avae ole HOMA-IR, ma vaega ole vaitamini D. HOMA-IR aʻo leʻi faia ma ina ua maeʻa le faʻatonuga o le vaitamini D i le va o togafitiga ma vaega faʻatonutonu.
Ina ia mautinoa le lelei o tala uma e fetaui ma tulaga agavaa mo lenei iloiloga, na faʻaaogaina ai se meafaigaluega faʻapitoa e iloilo ai.
O le meafaigaluega su'esu'e autu na fa'aogaina i lenei iloiloga o le Cochrane Collaboration's risk of bias method.
O le tuʻufaʻatasia ma le auʻiliʻiliga o eseesega o uiga ile HOMA-IR ma le leai o se vaitamini D i tagata mamaʻi ma le NAFLD. E tusa ai ma Luo et al., pe afai o faʻamatalaga o loʻo tuʻuina atu o le vaeluaga poʻo le laina ole Q1 ma le Q3, faʻaaoga se calculator e faʻatatau ai le uiga. ma Wan et al.28,29 O le tele o aʻafiaga o loʻo lipotia mai e pei o eseesega faʻatasi ma le 95% taimi faʻamaonia (CI) . Na faia suʻesuʻega e faʻaaoga ai faʻataʻitaʻiga faʻamautu poʻo faʻalavelave faʻafuaseʻi. Na suʻesuʻeina le heterogeneity i le faʻaaogaina o le fuainumera I2, e faʻaalia ai o le fua faatatau o fesuiaiga i le vaʻaia o aafiaga i luga o suʻesuʻega na ona o le fesuisuiai o le aafiaga moni, faatasi ai ma tau> 60% o loʻo faʻaalia ai le taua tele. Afai o le heterogeneity e> 60%, o suʻesuʻega faʻaopoopo na faia e faʻaaoga ai le meta-regression ma suʻesuʻega faʻapitoa. (tasi suʻesuʻega i le taimi na faʻaumatia ma toe faia le auʻiliʻiliga).p-values <0.05 na manatu e taua tele.Meta-suʻesuʻega na faia e faʻaaoga ai le software Review Manager 5.4, faʻataʻitaʻiga maaleale na faia e faʻaaoga ai le faʻapipiʻi polokalame faʻafuainumera (Stata 17.0). mo Windows), ma meta-regressions na faia i le faʻaaogaina o le Integrated Meta-Analysis Software Version 3.
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Taimi meli: Me-30-2022