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首页> 外文期刊>World Journal of Gastroenterology >Insulin sensitizers in treatment of nonalcoholic fatty liver disease: Systematic review.
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Insulin sensitizers in treatment of nonalcoholic fatty liver disease: Systematic review.

机译：胰岛素增敏剂治疗非酒精性脂肪性肝病：系统评价。

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AIM: To summarize the evidence available for the clinical effectiveness of insulin sensitizers in the treatment of nonalcoholic fatty liver disease (NAFLD) systematically. METHODS: Relevant articles were located using computer-assisted searches of Medline (1966-March 2006), EMBASE (1988-March 2006), CINAHL (1982-March 2003), Educational Resource Information Center (1966-March 2006), Library, Information Science and Technology Abstracts (1967-March 2006), Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (1994-2006), dissertations in ProQuest and FirstSearch databases. Manual searches were made in the abstracts from meetings of the American Gastroenterological Association (1999-2006), and the American Association for the Study of Liver Diseases (2003-2005). Studies were retrieved using the following selection criteria: (1) clinical trials using insulin sensitizers in subjects with NAFLD, (2) adult patients, (3) published as full manuscripts or abstracts, and (4) English, Spanish, German, and French languages only. Data were abstracted independently by two reviewers following standardized procedures. A face-to-face comparison of data was conducted to ensure the completeness and reliability of the abstraction process. RESULTS: Nine studies were included, six using metformin and three using thiazolidinediones. Only two studies were placebo-controlled trials. The median sample size for all studies was 18 subjects. In the placebo-controlled trials, metformin improved insulin resistance markers and liver function tests, but not histological scores. In the single-arm trials, metformin and thiazolidinediones improved insulin resistance markers and liver function tests, and beneficial histological changes were reported. There is limited high-quality information available from which to draw categorical conclusions about the clinical use of insulin sensitizers in NAFLD. CONCLUSION: Current information indicates that the use of insulin sensitizers in NAFLD improves insulin resistance and liver function. Histological changes must be corroborated in randomized controlled trials.
机译：目的：总结胰岛素敏化剂在系统治疗非酒精性脂肪性肝病（NAFLD）中的临床有效性的可用证据。方法：使用计算机辅助搜索Medline（1966-2006年3月），EMBASE（1988-2006年3月），CINAHL（1982-2003年3月），教育资源信息中心（1966-2006年3月），图书馆，信息库来查找相关文章。科学和技术摘要（1967年至2006年3月），Cochrane系统评价数据库，效果评价摘要数据库（1994-2006年），ProQuest和FirstSearch数据库中的论文。在美国胃肠病学协会（1999-2006）和美国肝病研究协会（2003-2005）的会议摘要中进行了人工搜索。使用以下选择标准对研究进行检索：（1）在患有NAFLD的受试者中使用胰岛素敏化剂进行临床试验，（2）成年患者，（3）以完整的手稿或摘要出版，以及（4）英语，西班牙语，德语和法语仅语言。数据由两名审核员按照标准化程序独立提取。对数据进行了面对面的比较，以确保抽象过程的完整性和可靠性。结果：包括九项研究，六项使用二甲双胍，三项使用噻唑烷二酮。只有两项研究是安慰剂对照试验。所有研究的中位样本量为18名受试者。在安慰剂对照试验中，二甲双胍改善了胰岛素抵抗标志物和肝功能测试，但未改善组织学评分。在单臂试验中，二甲双胍和噻唑烷二酮改善了胰岛素抵抗标志物和肝功能试验，并报道了有益的组织学改变。可获得的高质量信息有限，无法从中得出关于NAFLD中胰岛素敏化剂临床使用的明确结论。结论：当前信息表明在NAFLD中使用胰岛素增敏剂可改善胰岛素抵抗和肝功能。在随机对照试验中必须证实组织学变化。

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