Ho hanyetsa insulin ho phetha karolo ea bohlokoa ho pathogenesis ea lefu la sebete le se nang tahi (NAFLD) .Liphuputso tse ngata li hlahlobile mokhatlo oavithamine Dtlatsetso ka ho hanyetsa insulin ho bakuli ba NAFLD.Liphetho tse fumanoeng li ntse li tla le liphello tse hanyetsanang.Sepheo sa thuto ena e ne e le ho hlahloba phello ea phekolo e eketsehileng ea vithamine D ho ntlafatsa ho hanyetsa insulin ho bakuli ba NAFLD.Lingoliloeng tse sebetsang li fumanoe ho PubMed, Google Li-database tsa Scholar, COCHRANE le Science Direct.Lithuto tse fumanoeng li ile tsa hlahlobjoa ho sebelisoa mefuta e sa fetoheng kapa e sa fetoheng.Lithuto tse supileng tse tšoanelehang tse nang le kakaretso ea barupeluoa ba 735 li kenyelelitsoe.Vithamine Dtlatsetso e ntlafalitse ho hanyetsa insulin ho bakuli ba NAFLD, e bontšitsoeng ka ho fokotseha ha Homeostatic Model Assessment ea Insulin Resistance (HOMA-IR), e nang le phapang e kopanetsoeng ea -1.06 (p = 0.0006; 95% CI -1.66 ho -0.45). Tlatsetso ea vithamine D e ekelitse maemo a serum vithamine D ka phapang e bolelang ea 17.45 (p = 0.0002; 95% CI 8.33 ho 26.56).Vithamine Dtlatsetso e fokolitse maemo a ALT ka phapang e kopanetsoeng ea -4.44 (p = 0.02; 95% CI -8.24 ho -0.65) .Ha ho phello e ileng ea hlokomeloa maemong a AST. Vitamin D supplementation e na le liphello tse molemo ho ntlafatsa ho hanyetsa insulin ho bakuli ba NAFLD. tlatsetso e ka fokotsa HOMA-IR ho bakuli ba joalo.E ka sebelisoa e le pheko e ka thusang bakuli ba NAFLD.
Lefu la sebete sa mafura a Nonalcoholic (NAFLD) ke sehlopha sa mafu a sebete a amanang le mafura1. E khetholloa ke ho bokellana ho phahameng ha triglycerides ho hepatocytes, hangata ka ts'ebetso ea necroinflammatory le fibrosis (steatohepatitis) 2. E ka tsoela pele ho ea ho nonalcoholic steatohepatitis (NASH), fibrosis le cirrhosis.NAFLD e nkoa e le sesosa se ka sehloohong sa lefu la sebete le sa foleng 'me ho ata ha eona ho ntse ho eketseha, ho hakanngoa ho 25% ho 30% ea batho ba baholo linaheng tse tsoetseng pele3,4. Ho hanyetsa insulin, ho ruruha le khatello ea oxidative ho nahanoa hore ke lintlha tse ka sehloohong. ntshetsopele ya NAFLD1.
Pathogenesis ea NAFLD e amana haufi-ufi le ho hanyetsa insulin.Ho itšetlehile ka mokhoa o atileng ka ho fetisisa oa "li-hit-hit hypothesis" tse peli, ho hanyetsa insulin ho ameha ts'ebetsong ea "first hit". hepatocytes, moo ho hanyetsa insulin ho nahanoang hore ke sesosa se ka sehloohong se bakang ho nts'etsopele ea hepatic steatosis "Ho otla ha pele" ho eketsa ts'oaetso ea sebete ho lintlha tse etsang "ho otla ha bobeli". ho ruruha le fibrosis.Ho hlahisa li-cytokine tsa proinflammatory, ho se sebetse ha mitochondrial, khatello ea oxidative, le lipid peroxidation le tsona ke lintlha tse ka tlatsetsang ho nts'etsopele ea kotsi ea sebete, e entsoeng ke adipokines.
Vithamine D ke vithamine e qhibilihang ka mafura e laolang masapo a homeostasis.Karolo ea eona e 'nile ea hlahlojoa ka ho pharaletseng maemong a sa tšoaneng a bophelo bo botle ba masapo a kang lefu la metabolism, insulin resistance, botenya, mofuta oa 2 lefu la tsoekere le mafu a amanang le pelo. 'mele o moholo oa bopaki ba saense o hlahlobile kamano pakeng tsa vithamine D le NAFLD.Vitamin D e tsejoa ho laola insulin ho hanyetsa, ho ruruha ho sa foleng le fibrosis.Ka lebaka leo, vithamine D e ka thusa ho thibela tsoelo-pele ea NAFLD6.
Liteko tse 'maloa tse laoloang ka nako e telele (RCTs) li hlahlobile phello ea tlatsetso ea vithamine D ka insulin ho hanyetsa.Leha ho le joalo, liphello tse fumanoeng li ntse li fapana;ebang e bontša phello e molemo ho insulin ho hanyetsa kapa ho se bontše molemo leha e le ofe7,8,9,10,11,12,13.Ho sa tsotellehe liphello tse hanyetsanang, tlhahlobo ea meta e hlokahalang ho hlahloba phello e akaretsang ea tlatsetso ea vithamine D. Litlhahlobo tse ngata tsa meta li entsoe nakong e fetileng14,15,16.A meta-analysis by Guo et al.Ho kenyeletsoa le lithuto tse tšeletseng tse hlahlobang phello ea vithamine D ka insulin ho hanyetsa ho fana ka bopaki bo bongata ba hore vithamine D e ka ba le phello e molemo ho insulin sensitivity14. Leha ho le joalo, meta e 'ngoe- tlhahlobo e ile ea fana ka liphello tse fapaneng.Pramono et al15 e fumane hore phekolo e eketsehileng ea vithamine D e ne e se na phello ho insulin sensitivity.Baahi ba kenyelletsoeng thutong e ne e le lihlooho tse nang le kapa tse kotsing ea ho hanyetsa insulin, eseng tse lebisitsoeng ka ho khetheha bakeng sa NAFLD.Phuputso e 'ngoe ke Wei et al. ., ho kopanyelletsa le lithuto tse 'nè, tse entsoeng liphuputso tse tšoanang.Bithamine D supplementation ha ea ka ea fokotsa HOMA IR16. Ho nahanoa ka litlhahlobo tsohle tsa nakong e fetileng mabapi le tšebeliso ea li-supplement tsa vithamine D bakeng sa insulin resistance, upda.ted meta-analysis e hlokahalang hammoho le lingoliloeng tse ling tse nchafalitsoeng.Morero oa thuto ena e ne e le ho hlahloba phello ea tlatsetso ea vithamine D ho hanyetsa insulin.
Ka ho sebelisa leano le holimo la ho batla, re fumane kakaretso ea lithuto tsa 207, 'me ka mor'a ho qhekella, re ile ra fumana lihlooho tse 199. Re ile ra qhelela ka thōko lihlooho tsa 182 ka ho hlahloba lihlooho le li-abstracts, ra siea kakaretso ea lithuto tse nepahetseng tsa 17. Lithuto tse sa kang tsa fana ka boitsebiso bohle. e hlokahalang bakeng sa tlhahlobo ena ea meta kapa eo mongolo o feletseng o neng o sa fumanehe o ne o sa kenyelletsoa.Ka mor'a ho hlahloba le ho hlahloba boleng, re ile ra fumana lihlooho tse supileng bakeng sa tlhahlobo ea hona joale e hlophisitsoeng le tlhahlobo ea meta.Chate ea phallo ea thuto ea PRISMA e bontšoa ho Setšoantšo sa 1 .
Re kenyelelitse lihlooho tse ngotsoeng ka botlalo tsa liteko tse supileng tse laoloang ka nako e sa lekanyetsoang (RCTs) .Lilemo tsa khatiso ea lihlooho tsena li tloha 2012 ho ea ho 2020, ka kakaretso ea sampuli ea 423 sehlopheng sa ho kenella le 312 sehlopheng sa placebo. litekanyetso le nako ea li-supplement tsa vithamine D, ha sehlopha sa taolo se fumane sebaka sa placebo. Kakaretso ea liphetho tsa thuto le litšobotsi tsa thuto li hlahisoa ho Lethathamo la 1.
Kotsi ea leeme e ile ea hlahlobjoa ho sebelisoa kotsi ea Cochrane Collaboration ea mokhoa oa leeme.Lingoliloeng tsohle tse supileng tse kenyellelitsoeng thutong ena li fetisitse tlhahlobo ea boleng.Liphetho tse felletseng tsa kotsi ea leeme bakeng sa lihlooho tsohle tse kenyellelitsoeng li bonts'itsoe ho Figure 2.
Tlatsetso ea vithamine D e ntlafatsa ho hanyetsa insulin ho bakuli ba NAFLD, e khetholloang ke ho fokotseha ha HOMA-IR.Ho itšetlehile ka mohlala oa liphello tse sa reroang (I2 = 67%; χ2 = 18.46; p = 0.005), phapang e kopanetsoeng e bolela phapang pakeng tsa tlatsetso ea vithamine D le ho se na vithamine. Tlatsetso ea D e ne e le -1.06 (p = 0.0006; 95% CI -1.66 ho -0.45) (setšoantšo sa 3).
Ho ipapisitsoe le mohlala oa litlamorao tse sa reroang (Setšoantšo sa 4), phapang e kopaneng ea serum ea vithamine D ka mor'a tlatsetso ea vithamine D e ne e le 17.45 (p = 0.0002; 95% CI 8.33 ho 26.56) . Ho ea ka tlhahlobo, tlatsetso ea vithamine D e ka eketsa Khabareng, phello ea tlatsetso ea vithamine D ho li-enzyme tsa sebete ALT le AST e bontšitse liphello tse sa tšoaneng.Tlhaloso ea vithamine D e fokolitse maemo a ALT ka phapang e kopanetsoeng ea -4.44 (p = 0.02; 95% CI -8.24 ho -0.65) (Setšoantšo sa 5) . Leha ho le joalo, ha ho na phello e ileng ea hlokomeloa bakeng sa maemo a AST, ka phapang e kopanetsoeng ea -5.28 (p = 0.14; 95% CI - 12.34 ho 1.79) e thehiloeng ho mohlala oa liphello tse sa tloaelehang ( Setšoantšo sa 6).
Liphetoho tsa HOMA-IR ka mor'a ho tlatsetsa ha vithamine D li bontšitse ho fapana ho hoholo (I2 = 67%). Meta-regression analysis ea tsela ea tsamaiso (molomo kapa intramuscular), ho noa (letsatsi le letsatsi kapa e seng letsatsi le leng le le leng), kapa nako ea vithamine D supplementation (≤ Libeke tsa 12 le libeke tse> 12) li fana ka maikutlo a hore makhetlo a mangata a sebelisoang a ka hlalosa heterogeneity (Letlapa la 2) .Bohle empa boithuto bo le bong ka Sakpal et al.11 e sebelisitse tsela ea tsamaiso ea molomo. Ho ja letsatsi le leng le le leng la li-supplement tsa vithamine D tse sebelisoang lithutong tse tharo7,8,13. Tlhahlobo e eketsehileng ea kutloisiso ka tlhahlobo e le 'ngoe ea liphetoho tsa HOMA-IR ka mor'a tlatsetso ea vithamine D e bontšitse hore ha ho thuto e ikarabellang bakeng sa ho fapana ha liphetoho ho HOMA-IR (setšoantšo sa 7).
Liphetho tse kopantsoeng tsa tlhahlobo ea morao-rao ea meta li fumane hore phekolo e eketsehileng ea vithamine D e ka ntlafatsa ho hanyetsa insulin, e leng letšoao le fokolitsoeng HOMA-IR ho bakuli ba NAFLD. Tsela ea tsamaiso ea vithamine D e ka 'na ea fapana, ka ente ea intramuscular kapa ka molomo. .Tlhahlobo e eketsehileng ea phello ea eona ho ntlafatsa ho hanyetsa insulin ho utloisisa liphetoho tsa serum ALT le maemo a AST. Ho fokotseha ha maemo a ALT, empa eseng AST, ho ile ha hlokomeloa ka lebaka la tlatsetso e eketsehileng ea vithamine D.
Ketsahalo ea NAFLD e amana haufi-ufi le insulin ho hanyetsa.Ho eketseha ha mafura a mafura a mahala (FFA), ho ruruha ha lisele tsa adipose, le ho fokotseha ha adiponectin ho ikarabella bakeng sa tsoelo-pele ea insulin ho hanyetsa NAFLD17.Serum FFA e phahame haholo ho bakuli ba NAFLD, e leng ka mor'a moo e fetoloang. ho triacylglycerol ka tsela ea glycerol-3-phosphate.Sehlahisoa se seng sa tsela ena ke ceramide le diacylglycerol (DAG) .DAG e tsejoa e kentse letsoho ts'ebetsong ea protheine kinase C (PKC), e ka thibelang insulin receptor threonine 1160, e amanang le ho fokotseha ha insulin ho hanyetsa.Ho ruruha ha lisele tsa adipose le ho eketseha ha li-cytokine tsa proinflammatory tse kang interleukin-6 (IL-6) le tumor necrosis factor alpha (TNF-alpha) le tsona li tlatsetsa ho insulin ho hanyetsa.Ha e le adiponectin, e ka khothalletsa Thibelo ea mafura a mafura a beta-oxidation (FAO), tšebeliso ea tsoekere le synthesis ea mafura a mafura.lopment of insulin resistance.E amanang le vithamine D, vithamine D receptor (VDR) e teng liseleng tsa sebete 'me e' nile ea ameha ho fokotsa mekhoa ea ho ruruha ho mafu a sa foleng a sebete.Mosebetsi oa VDR o eketsa kutloisiso ea insulin ka ho fetola FFA.Ho phaella moo, vithamine D e na le thepa ea anti-inflammatory le anti-fibrotic sebeteng19.
Bopaki ba hona joale bo bontša hore ho haelloa ke vithamine D ho ka 'na ha ameha ho bakoang ke mafu a' maloa. Khopolo ena e na le 'nete bakeng sa kamano pakeng tsa ho haelloa ke vithamine D le insulin resistance20,21.Vitamin D e fana ka karolo ea eona e ka bang teng ka ho sebelisana le VDR le vithamine D metabolizing enzymes. Tsena li ka 'na tsa e-ba teng ka mefuta e mengata ea lisele, ho akarelletsa le lisele tsa pancreatic beta le lisele tse arabelang insulin tse kang adipocytes.Le hoja mokhoa o nepahetseng pakeng tsa vithamine D le insulin ho hanyetsa o ntse o sa tsejoe hantle, ho 'nile ha boleloa hore lisele tsa adipose li ka ameha ka mokhoa oa eona. lebenkele le ka sehloohong la vithamine D 'meleng ke lisele tsa adipose.E boetse e sebetsa e le mohloli oa bohlokoa oa li-adipokine le li-cytokine 'me e ameha tlhahisong ea ho ruruha ha tsamaiso.Bopaki ba morao-rao bo bontša hore vithamine D e laola liketsahalo tse amanang le insulin secretion ho tloha lisele tsa beta tsa pancreatic.
Ho fanoe ka bopaki bona, tlatsetso ea vithamine D ho ntlafatsa ho hanyetsa insulin ho bakuli ba NAFLD hoa utloahala.Litlaleho tsa morao-rao li bontša phello e molemo ea tlatsetso ea vithamine D ho ntlafatsa ho hanyetsa insulin.Li-RCT tse ngata li fane ka liphello tse hanyetsanang, tse hlokang ho hlahlojoa ho eketsehileng ka litlhahlobo tsa meta.A morao tjena. meta-analysis by Guo et al.Ho hlahloba phello ea vithamine D ho insulin ho hanyetsa ho fana ka bopaki bo bongata ba hore vithamine D e ka ba le phello e molemo ho insulin sensitivity.Ba fumane phokotseho ea HOMA-IR ea - 1.32;95% CI - 2.30, - 0.34.Lithuto tse kenyelletsoeng ho hlahloba HOMA-IR e ne e le lithuto tse tšeletseng14. Leha ho le joalo, ho na le bopaki bo hanyetsanang.Tlhahlobo e hlophisitsoeng le tlhahlobo ea meta e amanang le 18 RCTs ka Pramono et al ho hlahloba phello ea tlatsetso ea vithamine D ho kutloisiso ea insulin ho batho ba nang le insulin ho hanyetsa kapa kotsi ea ho hanyetsa insulin e bontšitse hore vithamine D e eketsehileng kutloisiso ea insulin ha e na phello, phapang e tloaelehileng ea moelelo -0.01, 95% CI -0.12, 0.10;p = 0.87, I2 = 0% 15. Leha ho le joalo, hoa lokela ho hlokomeloa hore baahi ba hlahlobiloeng tlhahlobo ea meta e ne e le lihlooho tse nang le kapa tse kotsing ea ho hanyetsa insulin (boima bo feteletseng, botenya, prediabetes, polycystic ovary syndrome [PCOS] le mofuta o sa rarahanang. 2 lefu la tsoekere), ho e-na le bakuli ba NAFLD15. Tlhahlobo e 'ngoe ea meta ka Wei et al. Liphuputso tse tšoanang li ile tsa boela tsa fumanoa.Ha ho hlahlojoa vithamine D supplementation ho HOMA-IR, ho kenyelletsa le lithuto tse' nè, vithamine D supplementation ha ea ka ea fokotsa HOMA IR (WMD). = 0.380, 95% CI - 0.162, 0.923; p = 0.169) 16. Ho bapisa lintlha tsohle tse fumanehang, tlhahlobo ea morao-rao e hlophisitsoeng le tlhahlobo ea meta e fana ka litlaleho tse ngata tsa tlatsetso ea vithamine D ho ntlafatsa ho hanyetsa insulin ho bakuli ba NAFLD, ho tšoana le tlhahlobo ea meta. ka Guo et al. Le hoja ho 'nile ha etsoa litlhahlobo tse tšoanang tsa meta, tlhahlobo ea morao-rao ea meta e fana ka lingoliloeng tse nchafalitsoeng tse amanang le liteko tse laoloang ka nako e telele' me kahoo li fana ka bopaki bo matla ba phello ea vithamine D supplementation ka insulin r.sistance.
Phello ea vithamine D ho hanyetsa insulin e ka hlalosoa ka karolo ea eona e le molaoli ea ka khonang ho laola insulin secretion le maemo a Ca2 +. Calcitriol e ka 'na ea etsa hore ka ho toba tlhahiso ea insulin e be teng hobane karolo ea karabo ea vithamine D (VDRE) e teng mofuteng oa liphatsa tsa lefutso tsa insulin tse fumanehang pancreatic. lisele tsa beta.Hase feela ho ngoloa ha liphatsa tsa lefutso tsa insulin, empa hape VDRE e tsejoa ho susumetsa liphatsa tsa lefutso tse sa tšoaneng tse amanang le ho thehoa ha cytoskeleton, li-junctions tsa intracellular, le ho hōla ha lisele tsa pancreatic cβ cell.Vitamin D e boetse e bontšitsoe hore e ama insulin ho hanyetsa ka ho fetola Ca2 + flux.Kaha khalsiamo e bohlokoa bakeng sa mekhoa e mengata ea insulin-mediated intracellular meleng ea mesifa le adipose, vithamine D e ka 'na ea ameha phello ea eona ho insulin ho hanyetsa.Maemo a nepahetseng a intracellular Ca2 + a hlokahala bakeng sa ts'ebetso ea insulin.Liphuputso li fumane hore ho haella ha vithamine D ho lebisa ho e eketsehile likhahla tsa Ca2 +, tse fellang ka ho fokotseha ha mosebetsi oa GLUT-4, o amang insulin ho hanyetsa26,27.
Phello ea tlatsetso ea vithamine D ho ntlafatsa ho hanyetsa insulin e ile ea hlahlojoa ka ho eketsehileng ho bonahatsa phello ea eona mosebetsing oa sebete, e ileng ea bontšoa liphetohong tsa ALT le AST. tlatsetso.Tlhahlobo ea meta e entsoeng ke Guo et al.e bonts'itse ho fokotseha ha moeli oa maemo a ALT, ho se na phello ho maemo a AST, a tšoanang le thuto ena14.Phuputso e 'ngoe ea tlhahlobo ea meta ea Wei et al.2020 e boetse e fumane hore ha ho na phapang ho serum alanine aminotransferase. le maemo a aspartate aminotransferase pakeng tsa tlatsetso ea vithamine D le lihlopha tsa placebo.
Litlhahlobo tsa morao-rao tse hlophisitsoeng le litlhahlobo tsa meta li boetse li hanyetsana le mefokolo.Ho fapana ha meta-analysis hona joale ho ka 'na ha susumetsa liphello tse fumanoeng thutong ena.Maikutlo a nakong e tlang a lokela ho sebetsana le palo ea lithuto le lihlooho tse amehang ho hlahloba tlatsetso ea vithamine D bakeng sa ho hanyetsa insulin, ka ho khetheha ho lebisa tlhokomelo ho batho ba NAFLD, le homogeneity ea lithuto.Ntho e 'ngoe e lokelang ho nahanoa ke ho ithuta litekanyo tse ling ho NAFLD, tse kang phello ea tlatsetso ea vithamine D ho bakuli ba NAFLD ka mekhahlelo ea ho ruruha, lintlha tsa mosebetsi oa NAFLD (NAS) le ho satalla sebete. Qetellong, tlatsetso ea vithamine D e ntlafalitse ho hanyetsa insulin ho bakuli ba NAFLD, e leng letšoao le ileng la fokotseha HOMA-IR.E ka sebelisoa e le phekolo e ka sebelisoang bakeng sa bakuli ba NAFLD.
Mekhoa ea ho tšoaneleha e khethoa ka ho kenya ts'ebetsong mohopolo oa PICO. Moralo o hlalositsoeng ho Lethathamo la 3.
Tlhahlobo ea hona joale e hlophisitsoeng le tlhahlobo ea meta e kenyelletsa lithuto tsohle ho fihlela ka March 28, 2021, 'me e fana ka mongolo o feletseng, ho hlahloba tsamaiso e eketsehileng ea vithamine D ho bakuli ba NAFLD.Lingoliloeng tse nang le litlaleho tsa linyeoe, lithuto tsa boleng le moruo, litlhahlobo, li-cadavers le mefuta ea anatomy. li ne li sa kenyelletsoa thutong ea morao-rao.Lihlooho tsohle tse neng li sa fane ka lintlha tse hlokahalang ho etsa tlhahlobo ea meta ea morao-rao le tsona li ne li sa kenyelletsoa.Ho thibela ho pheta-pheta mohlala, mehlala e ile ea hlahlojoa bakeng sa lihlooho tse ngotsoeng ke mongoli a le mong ka har'a setsi se le seng.
Tlhahlobo e kenyelletsa lithuto tsa bakuli ba baholo ba NAFLD ba fumanang tsamaiso ea vithamine D. Ho hanyetsa insulin ho ile ha hlahlojoa ho sebelisoa Tlhahlobo ea Homeostasis Model ea Insulin Resistance (HOMA-IR).
Ts'ebetso e ntseng e hlahlojoa e ne e le tsamaiso ea vithamine D. Re kenyelelitse lithuto tseo ho tsona vithamine D e neng e tsamaisoa ka tekanyo leha e le efe, ka mokhoa leha e le ofe oa tsamaiso, le ka nako leha e le efe. Leha ho le joalo, re ile ra tlaleha tekanyo le nako ea vithamine D e tsamaisoang thutong ka 'ngoe .
Sephetho se ka sehloohong se ileng sa batlisisoa tlhahlobisong ea hona joale e hlophisitsoeng le tlhahlobo ea meta e ne e le ho hanyetsa insulin.Ntlheng ena, re sebelisitse HOMA-IR ho fumana hore insulin e hanyetsanoa ho bakuli.Liphetho tsa bobeli li ne li kenyelletsa maemo a serum vithamine D (ng / mL), alanine aminotransferase (ALT). ) (IU / l) le maemo a aspartate aminotransferase (AST) (IU / l).
Ntša Melao-motheo ea ho Tšoaneleha (PICO) ka mantsoe a bohlokoa ka ho sebelisa li-opereishene tsa Boolean (mohlala OR, LE, HONA) le likarolo tsohle kapa mantsoe a MeSH (Medical Subject Heading). Thutong ena, re sebelisitse database ea PubMed, Google Scholar, COCHRANE le Science Direct ha re batla. enjine ho fumana likoranta tse tšoanelehang.
Ts'ebetso ea khetho ea boithuto e entsoe ke bangoli ba bararo (DAS, IKM, GS) ho fokotsa monyetla oa ho tlosa lithuto tse ka bang teng. direkoto.Ho ile ha etsoa tlhahlobo ea sehlooho le e sa bonahaleng e le hore e se ke ea kenyelletsa lithuto tse se nang thuso.Ka mor'a moo, liphuputso tse fetisitseng tlhahlobo ea pele li ile tsa hlahlojoa ka ho eketsehileng ho hlahloba hore na li kopane le mekhoa ea ho kenyelletsa le ho qheleloa ka thōko bakeng sa tlhahlobo ena.Lithuto tsohle tse kenyellelitsoeng li ile tsa hlahlojoa ka ho feletseng boleng ba boleng pele ho kenyelletsoa ho qetela.
Bangoli bohle ba ile ba sebelisa liforomo tsa pokello ea lintlha tsa elektronike ho bokella lintlha tse hlokahalang ho tsoa sehloohong se seng le se seng.Lintlha li ile tsa bokelloa 'me tsa laoloa ho sebelisoa Software Review Manager 5.4.
Lintlha tsa lintlha e ne e le lebitso la mongoli, selemo sa khatiso, mofuta oa thuto, palo ea baahi, tekanyo ea vithamine D, nako ea tsamaiso ea vithamine D, boholo ba sampuli, lilemo, lintlha tsa motheo tsa HOMA-IR, le litekanyetso tsa motheo tsa vithamine D. Meta-analysis ea phapang e bolelang ho HOMA-IR pele le ka morao tsamaiso ea vithamine D e ne e etsoa pakeng tsa lihlopha tsa phekolo le taolo.
Ho netefatsa boleng ba lihlooho tsohle tse finyellang litekanyetso tsa ho tšoaneleha bakeng sa tlhahlobo ena, ho ile ha sebelisoa sesebelisoa se tloaelehileng sa tlhahlobo ea bohlokoa.Ts'ebetso ena, e etselitsoeng ho fokotsa monyetla oa ho ba le leeme khethong ea boithuto, e entsoe ka boikemelo ke bangoli ba babeli (DAS le IKM).
Sesebelisoa sa bohlokoa sa tlhahlobo se sebelisitsoeng tlhahlobisong ena e ne e le kotsi ea Cochrane Collaboration ea mokhoa oa leeme.
Ho kopanya le ho hlahloba phapang e bolelang ho HOMA-IR e nang le vithamine D le ntle le eona ho bakuli ba NAFLD. Ho ea ka Luo et al., Haeba boitsebiso bo hlahisoa e le bo-median kapa mefuta e mengata ea Q1 le Q3, sebelisa mochine oa ho bala ho bala moelelo. le Wan et al.Likarolo tsa 28,29 tsa phello li tlalehoa e le phapang e bolelang le linako tsa 95% tsa kholiseho (CI) .Litlhahlobo li ne li etsoa ka mekhoa e tsitsitseng kapa e sa tloaelehang ea liphello.Heterogeneity e ile ea hlahlojoa ho sebelisoa lipalo-palo tsa I2, tse bontšang hore karolo ea ho fapana ha phello e hlokometsoeng ho pholletsa le lithuto e ne e le. ka lebaka la ho fapana ha phello ea 'nete, ka boleng> 60% e bontšang heterogeneity ea bohlokoa. (phuputso e le 'ngoe ka nako e ile ea hlakoloa' me tlhahlobo e phetoa) p-litekanyetso <0.05 li ne li nkoa e le tsa bohlokoa. Litlhahlobo tsa Meta li ile tsa etsoa ho sebelisoa Software Review Manager 5.4, litlhahlobo tsa kutloisiso li ile tsa etsoa ho sebelisoa sephutheloana sa lipalo-palo (Stata 17.0). bakeng sa Windows), 'me meta-regressions e entsoe ho sebelisoa Integrated Meta-Analysis Software Version 3.
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Nako ea poso: May-30-2022