Nguzogide insulin na-arụ ọrụ dị mkpa na pathogenesis nke ọrịa imeju na-adịghị egbu egbu (NAFLD) .Ọtụtụ ọmụmụ enyochala njikọ nkevitamin DMgbakwunye na nguzogide insulin n'ime ndị ọrịa nwere NAFLD. Nsonaazụ enwetara ka na-abịa na nsonaazụ ndị na-emegiderịta onwe ya. Ebumnuche nke ọmụmụ a bụ iji nyochaa mmetụta ọgwụgwọ vitamin D ọzọ na-eme ka insulin na-eguzogide ndị ọrịa nwere NAFLD. E nwetara akwụkwọ ndị dị mkpa site na PubMed, Google Ọkà mmụta, COCHRANE na Sayensị Direct databases. A na-enyocha ihe ọmụmụ ndị a nwetara site na iji ihe ndị na-edozi ma ọ bụ ihe ndị na-emepụta ihe.Vitamin DMgbakwunye kwalitere nguzogide insulin n'ime ndị ọrịa nwere NAFLD, akara site na mbelata na Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), yana ọdịiche pụtara -1.06 (p = 0.0006; 95% CI -1.66 ruo -0.45). Mgbakwunye vitamin D mụbara ọkwa vitamin D serum na ihe dị iche nke 17.45 (p = 0.0002; 95% CI 8.33 ruo 26.56).Vitamin DMgbakwunye na-ebelata ọkwa ALT na ọnụ ọgụgụ a na-ejikọta ọnụ -4.44 (p = 0.02; 95% CI -8.24 to -0.65) .Ọ dịghị mmetụta ọ bụla a hụrụ na ọkwa AST. Vitamin D supplementation nwere mmetụta bara uru na ịkwalite nkwụsị insulin na ndị ọrịa NAFLD. Nke a Mgbakwunye nwere ike ibelata HOMA-IR na ndị ọrịa dị otú ahụ. Enwere ike iji ya dị ka ọgwụgwọ adjuvant maka ndị ọrịa NAFLD.
Ọrịa imeju abụba na-adịghị egbu egbu (NAFLD) bụ otu ọrịa imeju metụtara abụba1. A na-egosipụta ya site na nnukwu mkpokọta triglycerides na hepatocytes, na-enwekarị ọrụ necroinflammatory na fibrosis (steatohepatitis) 2. Ọ nwere ike ịga n'ihu na steatohepatitis na-abụghị mmanya (NASH), fibrosis na cirrhosis.NAFLD a na-ewere dị ka isi ihe na-akpata ọrịa imeju na-adịghị ala ala na ọnụ ọgụgụ ya na-arịwanye elu, na-eme atụmatụ na 25% ruo 30% nke ndị okenye na mba ndị mepere emepe3,4.A na-eche na nkwụsị insulin, mbufụt, na nrụgide oxidative bụ isi ihe na-akpata. mmepe nke NAFLD1.
Ngwọta nke NAFLD nwere njikọ chiri anya na nguzogide insulin. Dabere na ụdị "okwu abụọ-hit" kachasị ewu ewu, nguzogide insulin na-etinye aka na usoro "mbụ nke mbụ". hepatocytes, ebe a na-eche na nguzogide insulin bụ isi ihe na-akpata mmepe nke steatosis imeju. "Nke mbụ kụrụ" na-eme ka ọ ghara imeju imeju ihe ndị na-eme ka ọ bụrụ "ihe ọkụkụ nke abụọ". mbufụt na fibrosis.Mmepụta nke cytokines proinflammatory, mitochondrial dysfunction, oxidative stress, na lipid peroxidation bụkwa ihe ndị nwere ike itinye aka na mmepe nke imeju imeju, nke adipokines mejupụtara.
Vitamin D bụ vitamin na-agbaze abụba nke na-achịkwa homeostasis ọkpụkpụ. Achọpụtala ọrụ ya n'ọtụtụ ọnọdụ ahụike na-abụghị nke ọkpụkpụ dịka ọrịa metabolic syndrome, nguzogide insulin, oke ibu, ụdị ọrịa shuga 2 na ọrịa ndị metụtara obi. N'oge na-adịbeghị anya, a nnukwu ihe akaebe sayensị enyochala mmekọrịta dị n'etiti vitamin D na NAFLD. A maara vitamin D na-achịkwa nguzogide insulin, mbufụt na-adịghị ala ala na fibrosis. Ya mere, vitamin D nwere ike inye aka gbochie ọganihu nke NAFLD6.
Ọtụtụ ule a na-achịkwa nke a na-achịkwa (RCT) enyochala mmetụta nke vitamin D supplementation na insulin resistance. Otú ọ dị, nsonaazụ enwetara ka dị iche iche;ma ọ bụ na-egosi mmetụta bara uru na nkwụsị insulin ma ọ bụ na-egosighị uru ọ bụla7,8,9,10,11,12,13. N'agbanyeghị ihe ndị na-emegiderịta onwe ha, a chọrọ nyocha-meta iji chọpụta mmetụta zuru ezu nke vitamin D supplementation. Ọtụtụ meta-analyses. Emeela ya na mbụ14,15,16.A meta-analysis site Guo et al.Gụnyere ọmụmụ isii na-enyocha mmetụta vitamin D na nguzogide insulin na-enye nnukwu ihe akaebe na vitamin D nwere ike inwe mmetụta bara uru na mmetụta insulin14. Otú ọ dị, meta- ọzọ. nyocha nyere nsonaazụ dị iche iche. Pramono et al15 chọpụtara na ọgwụgwọ vitamin D ọzọ enweghị mmetụta na insulin sensitivity. Ndị bi n'ime ọmụmụ ihe ahụ bụ ndị nwere ma ọ bụ n'ihe ize ndụ nke nguzogide insulin, ọ bụghị ndị ezubere iche maka NAFLD. Nnyocha ọzọ Wei et al. ., gụnyere ọmụmụ anọ, mere nchọpụta yiri nke ahụ. Mgbakwunye vitamin D ebelataghị HOMA IR16. N'ịtụle nyocha niile gara aga na iji vitamin D emeju maka insulin resistance, updated meta-analysis dị mkpa yana akwụkwọ ndị ọzọ emelitere. Ebumnuche nke ọmụmụ a bụ iji nyochaa mmetụta ntinye vitamin D na nguzogide insulin.
Site n'iji usoro nchọta kachasị elu, anyị chọtara ngụkọta nke ọmụmụ 207, na mgbe a gụchara akwụkwọ, anyị nwetara isiokwu 199. Anyị wepụrụ isiokwu 182 site na nyocha aha na ihe odide, na-ahapụ ngụkọta nke ọmụmụ 17 dị mkpa. Ọmụmụ ihe na-enyeghị ozi niile. achọrọ maka meta-analysis ma ọ bụ nke ederede zuru ezu na-adịghị adị ka ewepụrụ. Mgbe nyochachara na nyocha nke qualitative, anyị nwetara isiokwu asaa maka nyocha usoro nke ugbu a na meta-analysis. A na-egosi eserese ngosi nke ọmụmụ PRISMA na Figure 1. .
Anyị gụnyere isiokwu ederede zuru oke nke ule asaa a na-achịkwa (RCT) .Afọ mbipụta nke isiokwu ndị a sitere na 2012 ruo 2020, na ngụkọta nke 423 samples na ntinye aka na 312 na placebo otu. doses na ogologo oge nke ihe mgbakwunye vitamin D, ebe ndị na-ahụ maka njikwa natara placebo. A na-egosipụta nchịkọta ọmụmụ ihe ọmụmụ na njirimara ọmụmụ na Table 1.
A na-enyocha ihe ize ndụ nke nhụsianya site na iji ihe ize ndụ nke Cochrane Collaboration nke usoro ihe egwu. Isiokwu asaa niile gụnyere n'ime ọmụmụ ihe a gafere nleba anya nke ọma. Nsonaazụ zuru oke nke ihe ize ndụ nke enweghị mmasị maka isiokwu niile gụnyere na-egosipụta na Figure 2.
Ihe mgbakwunye vitamin D na-eme ka insulin na-eguzogide ndị ọrịa nwere NAFLD, nke a na-eji HOMA-IR na-ebelata. Dabere na ụdị mmetụta na-enweghị usoro (I2 = 67%; χ2 = 18.46; p = 0.005), ọnụ ọgụgụ ahụ pụtara ọdịiche dị n'etiti vitamin D supplementation na enweghị vitamin. D mgbakwunye bụ -1.06 (p = 0.0006; 95% CI -1.66 ruo -0.45) (foto 3).
Dabere na ihe atụ nke mmetụta na-enweghị usoro (Nyocha 4), ọnụ ọgụgụ dị iche iche nke vitamin D serum mgbe vitamin D supplementation bụ 17.45 (p = 0.0002; 95% CI 8.33 ruo 26.56) .Dịka nyocha ahụ, vitamin D supplementation nwere ike ịbawanye ụba nke vitamin D. Serum vitamin D larịị site na 17.5 ng / mL. Ka ọ dị ugbu a, mmetụta nke vitamin D supplementation na imeju enzymes ALT na AST gosipụtara dị iche iche. CI -8.24 ruo -0.65) (Nyocha 5) . Otú ọ dị, ọ dịghị mmetụta ọ bụla a hụrụ maka ọkwa AST, na-ejikọta ọnụ -5.28 (p = 0.14; 95% CI - 12.34 ka 1.79) dabere na ụdị mmetụta na-enweghị atụ ( Onyonyo 6).
Mgbanwe na HOMA-IR mgbe mgbakwunye vitamin D gosipụtara nnukwu heterogeneity (I2 = 67%). Meta-regression analysis of ụzọ nchịkwa (ọnụ ma ọ bụ intramuscular), oriri (kwa ụbọchị ma ọ bụ na-abụghị kwa ụbọchị), ma ọ bụ ogologo oge nke vitamin D supplementation (≤ 12 izu na> 12 izu) na-atụ aro na oriri ugboro nwere ike ịkọwa heterogeneity (Table 2) .Ihe niile ma otu nnyocha e mere site Sakpal et al.11 na-eji ụzọ ọnụ ụzọ nchịkwa ọnụ. Nri vitamin D kwa ụbọchị na-eji na nyocha atọ7,8,13.Ntụgharị uche nke ọzọ site n'ịhapụ nyocha nke mgbanwe na HOMA-IR mgbe vitamin D gachara gosiri na ọ dịghị ọmụmụ ihe kpatara ya. mgbanwe dị iche iche nke mgbanwe na HOMA-IR (Fig 7).
Nsonaazụ a gbakọtara nke meta-analysis nke ugbu a chọpụtara na ọgwụgwọ vitamin D ọzọ nwere ike imeziwanye nguzogide insulin, akara ngosi ya na-ebelata HOMA-IR na ndị ọrịa nwere NAFLD. Ụzọ nchịkwa vitamin D nwere ike ịdịgasị iche, site na ntụtụ intramuscular ma ọ bụ ọnụ. .Ntụle ọzọ nke mmetụta ya na-emeziwanye nguzogide insulin iji ghọta mgbanwe nke serum ALT na ọkwa AST. A na-ahụ mbelata na ọkwa ALT, ma ọ bụghị ọkwa AST, n'ihi mgbakwunye vitamin D ọzọ.
Ihe omume NAFLD nwere njikọ chiri anya na nguzogide insulin. Mmụba acid fatty free (FFA), mbufụt anụ ahụ adipose, na adiponectin mbelata bụ maka mmepe nke insulin resistance na NAFLD17. Serum FFA na-ebuli elu nke ukwuu na ndị ọrịa NAFLD, nke emesịa gbanwee. na triacylglycerol site na ụzọ glycerol-3-phosphate. Ngwaahịa ọzọ nke ụzọ a bụ ceramide na diacylglycerol (DAG) .A maara DAG na-etinye aka na ntinye nke protein kinase C (PKC), nke nwere ike igbochi onye na-anabata insulin threonine 1160. nke ejikọtara ya na nguzogide insulin belatara.Mbufụt nke adipose anụ ahụ ma na-abawanye na cytokines proinflammatory dị ka interleukin-6 (IL-6) na tumor necrosis factor alpha (TNF-alpha) na-enyekwa aka na nkwụsị insulin. Dị ka adiponectin, ọ nwere ike ịkwalite. Mgbochi nke fatty acid beta-oxidation (FAO), ojiji glucose na fatty acid synthesis. A na-ebelata ọkwa ya na ndị ọrịa NAFLD, si otú ahụ na-akwalite deve.N'ihe metụtara vitamin D, onye na-anabata vitamin D (VDR) dị na mkpụrụ ndụ imeju ma tinye ya n'ọrụ n'ịbelata usoro mkpali na ọrịa imeju na-adịghị ala ala.Ọrụ VDR na-eme ka mmetụta insulin dịkwuo elu site n'ịgbanwe FFA. Na mgbakwunye, vitamin. D nwere ihe mgbochi mkpali na mgbochi fibrotic n'ime imeju19.
Ihe akaebe dị ugbu a na-egosi na ụkọ vitamin D nwere ike itinye aka na pathogenesis nke ọrịa dị iche iche. Echiche a bụ eziokwu maka njikọ dị n'etiti ụkọ vitamin D na insulin resistance20,21.Vitamin D na-arụ ọrụ ya site na mmekorita ya na VDR na vitamin D metabolizing enzymes. Ndị a nwere ike ịdị n'ụdị sel dị iche iche, gụnyere mkpụrụ ndụ beta pancreatic na sel ndị na-anabata insulin dị ka adipocytes. Ọ bụ ezie na kpọmkwem usoro dị n'etiti vitamin D na insulin resistance nọgidere na-ejighị n'aka, a na-atụ aro na anụ ahụ adipose nwere ike itinye aka na usoro ya. isi ụlọ ahịa vitamin D n'ime ahụ bụ adipose tissue.Ọ na-arụkwa ọrụ dị ka isi iyi dị mkpa nke adipokines na cytokines ma na-etinye aka na mmepụta nke mbufụt nke sistem.
N'inye ihe akaebe a, ntinye vitamin D iji meziwanye nguzogide insulin na ndị ọrịa NAFLD bụ ihe ezi uche dị na ya. Akụkọ ndị na-adịbeghị anya na-egosi mmetụta bara uru nke vitamin D na-eme ka ọ dịkwuo mma n'ịkwalite insulin resistance. Ọtụtụ RCT enyela nsonaazụ ndị na-emegiderịta onwe ha, na-eme ka nyocha ọzọ site na meta-analyses. meta-analysis site Guo et al. Ịtụle mmetụta vitamin D na nguzogide insulin na-enye nnukwu ihe akaebe na vitamin D nwere ike inwe mmetụta bara uru na mmetụta insulin. Ha hụrụ mbelata na HOMA-IR nke -1.32;95%. mmetụta insulin na ndị ọrịa nwere nguzogide insulin ma ọ bụ ihe ize ndụ nke nguzogide insulin gosipụtara na vitamin D mgbakwunye insulin enweghị mmetụta ọ bụla, ọdịiche pụtara ìhè ọkọlọtọ -0.01, 95% CI-0.12, 0.10;p = 0.87, I2 = 0% 15. Otú ọ dị, ekwesịrị ịmara na ọnụ ọgụgụ ndị a na-enyocha na meta-analysis bụ ndị nwere ma ọ bụ n'ihe ize ndụ nke nkwụsị insulin (oke ibu, oke ibu, ọrịa shuga, ọrịa polycystic ovary syndrome [PCOS) na ụdị enweghị mgbagwoju anya. 2 ọrịa shuga), karịa ndị ọrịa NAFLD15. Meta-analysis ọzọ site na Wei et al. A na-enwetakwa nchọpụta yiri nke ahụ. Na nyocha nke vitamin D supplementation na HOMA-IR, gụnyere ọmụmụ anọ, vitamin D emeghị ka HOMA IR (WMD) belata. = 0.380, 95% CI - 0.162, 0.923; p = 0.169) 16. N'ịtụle data niile dịnụ, nyochaa usoro nhazi ugbu a na meta-analysis na-enyekwu akụkọ banyere vitamin D supplementation na-eme ka insulin na-eguzogide ndị ọrịa NAFLD, dị ka meta-analysis. Site na Guo et al. Ọ bụ ezie na a na-eme nyocha meta-nyocha ndị yiri ya, meta-nyocha nke ugbu a na-enye akwụkwọ ọhụrụ emelitere gụnyere ule ndị ọzọ a na-achịkwa ma si otú a na-enye ihe akaebe siri ike maka mmetụta nke vitamin D supplementation na insulin r.echiche.
Enwere ike ịkọwa mmetụta vitamin D na nguzogide insulin site na ọrụ ya dị ka onye nwere ike ịhazi insulin secretion na ọkwa Ca2 +. Calcitriol nwere ike ịkpalite insulin insulin ozugbo n'ihi na vitamin D nzaghachi element (VDRE) dị na onye na-akwalite insulin gene dị na pancreatic. mkpụrụ ndụ beta.Ọ bụghị naanị nsụgharị nke mkpụrụ ndụ insulin, kamakwa VDRE maara na ọ na-akpali mkpụrụ ndụ ihe nketa dị iche iche metụtara nhazi cytoskeleton, njikọ intracellular, na uto cell nke mkpụrụ ndụ cβ pancreatic. E gosikwara na vitamin D na-emetụta nguzogide insulin site n'ịgbanwe Ca2+ flux.Ebe ọ bụ na calcium dị mkpa maka ọtụtụ usoro intracellular mediated insulin na akwara na anụ ahụ adipose, vitamin D nwere ike itinye aka na mmetụta ya na insulin resistance.Ezigbo intracellular Ca2 + ọkwa dị mkpa maka ọrụ insulin. Nnyocha achọpụtala na vitamin D erughi eru na-eduga. mụbara mkpokọta Ca2 +, na-ebute mbelata ọrụ GLUT-4, nke na-emetụta nguzogide insulin26,27.
A na-enyochakwa mmetụta nke vitamin D supplementation na imeziwanye nguzogide insulin iji gosipụta mmetụta ya na ọrụ imeju, nke gosipụtara na mgbanwe na ọkwa ALT na AST. A hụrụ mbelata nke ọkwa ALT, ma ọ bụghị ọkwa AST, n'ihi vitamin D ọzọ. supplementation.A meta-analysis site Guo et al.gosiri mbelata oke ala na ọkwa ALT, na-enweghị mmetụta na ọkwa AST, yiri nke a. yana ọkwa aspartate aminotransferase n'etiti mgbakwunye vitamin D na otu placebo.
Nyocha usoro nke ugbu a na meta-analyses na-arụkwa ụka megide njedebe. Ihe dị iche iche nke meta-analysis ugbu a nwere ike imetụta nsonaazụ a na-enweta n'ọmụmụ ihe a. Echiche ga-eme n'ọdịnihu kwesịrị ileba anya n'ọtụtụ ọmụmụ na isiokwu ndị na-etinye aka n'ịtụle mgbakwunye vitamin D maka nkwụsị insulin, kpọmkwem na-elekwasị anya na ọnụ ọgụgụ NAFLD, na ịdị n'otu nke ọmụmụ ihe. Akụkụ ọzọ ị ga-atụle bụ ịmụ ihe ndị ọzọ na NAFLD, dị ka mmetụta nke vitamin D supplementation na NAFLD ndị ọrịa na-egbuke egbuke, NAFLD ọrụ akara (NAS) na imeju imeju. N'ikpeazụ, vitamin D supplementation kwalitere nguzogide insulin na ndị ọrịa nwere NAFLD, akara ngosi nke belatara HOMA-IR. Enwere ike iji ya mee ihe dị ka ọgwụgwọ adjuvant maka ndị ọrịa NAFLD.
A na-ekpebi njirisi ntozu site na imejuputa echiche PICO. Usoro a kọwara na Tebụl 3.
Nyocha usoro nke ugbu a na meta-analysis na-agụnye ọmụmụ ihe niile ruo March 28, 2021, ma na-enye ederede zuru ezu, na-enyocha nlekọta vitamin D ọzọ na ndị ọrịa nwere NAFLD. Isiokwu nwere akụkọ ikpe, qualitative na Economic Studies, reviews, cadavers and anatomy type. ewepụrụ na ọmụmụ ihe ugbu a. A na-ewepụkwa isiokwu niile na-enyeghị data achọrọ iji mee nchọpụta meta-analysis ugbu a. Iji gbochie mbiputegharị ihe atụ, a na-enyocha ihe nlele maka isiokwu nke otu onye edemede dere n'ime otu ụlọ ọrụ ahụ.
Nyochaa gụnyere ọmụmụ nke ndị okenye NAFLD ndị okenye na-anata nchịkwa vitamin D. A na-enyocha nguzogide insulin site na iji Homeostasis Model Assessment of Insulin Resistance (HOMA-IR).
Ntinye aka a na-enyocha bụ nchịkwa nke vitamin D. Anyị gụnyere ọmụmụ ihe nke vitamin D na-enye na dose ọ bụla, site na usoro nchịkwa ọ bụla, na oge ọ bụla. Otú ọ dị, anyị dekọrọ dose na oge vitamin D na-eduzi na ọmụmụ ọ bụla. .
Isi ihe a nyochara na nyocha usoro nke ugbu a na meta-analysis bụ nguzogide insulin. N'akụkụ a, anyị na-eji HOMA-IR chọpụta nkwụsị insulin na ndị ọrịa. Nsonaazụ nke abụọ gụnyere serum vitamin D ọkwa (ng/mL), alanine aminotransferase (ALT). (IU / l) na aspartate aminotransferase (AST) (IU / l).
Wepụ criteria ntozu (PICO) n'ime mkpụrụokwu site na iji ndị na-arụ ọrụ Boolean (dịka ọmụmaatụ OR, AND, NOT) na mpaghara niile ma ọ bụ okwu MeSH (Isi isiokwu ahụike). igwe iji chọta akwụkwọ akụkọ tozuru oke.
Ndị edemede atọ (DAS, IKM, GS) mere usoro nhọpụta ọmụmụ ihe iji belata ohere nke iwepụ ihe ọmụmụ ndị nwere ike ime. Mgbe esemokwu bilitere, a na-atụle mkpebi nke ndị edemede mbụ, nke abụọ na nke atọ. Nhọrọ ọmụmụ na-amalite site na ijikwa ihe abụọ. Ihe ndekọ. A na-eme nyocha isiokwu na abstract iji wepụ ihe ọmụmụ ndị na-adịghị mkpa. N'ikpeazụ, a na-enyocha ọmụmụ ihe ndị gafere nyocha mbụ iji chọpụta ma ha zutere njedebe nsonye na nkwụsị maka nyocha a. Ihe ọmụmụ niile gụnyere nyocha nke ọma tupu nsonye ikpeazụ.
Ndị ode akwụkwọ niile jiri mpempe akwụkwọ nnakọta data eletrọnịkị wee nakọta data achọrọ site na edemede ọ bụla. A na-achịkọta data ahụ wee jikwaa ya site na iji Onye njikwa nyocha ngwanrọ 5.4.
Ihe data bụ aha onye odee, afọ e bipụtara, ụdị ọmụmụ, ọnụ ọgụgụ mmadụ, vitamin D dose, ogologo oge nchịkwa vitamin D, nha nlele, afọ, HOMA-IR ntọala, na ọkwa vitamin D nke ntọala. Meta-analysis nke pụtara ọdịiche dị na ya. A na-eme HOMA-IR tupu na mgbe nchịkwa vitamin D dị n'etiti otu ọgwụgwọ na njikwa.
Iji hụ na ịdị mma nke isiokwu niile na-ezute ntozu ntozu maka nyocha a, a na-eji ngwá ọrụ nyocha dị oke mkpa mee ihe. Usoro a, nke e mere iji belata ikike nke enweghị mmasị na nhọrọ ọmụmụ, mere onwe ya site n'aka ndị edemede abụọ (DAS na IKM).
Ngwá ọrụ ntule isi eji na nyocha a bụ ihe egwu Cochrane Collaboration nke usoro nhụsianya.
Ịgba mmiri na nyocha nke pụtara ọdịiche dị na HOMA-IR na na-enweghị vitamin D na ndị ọrịa nwere NAFLD. Dị ka Luo et al., Ọ bụrụ na e gosipụtara data ahụ dị ka etiti ma ọ bụ nso nke Q1 na Q3, jiri ihe mgbako gbakọọ ihe pụtara. na Wan et al.A na-akọ 28,29 mmetụta dị iche iche dị ka ihe dị iche iche na 95% ntụkwasị obi (CI) .A na-eme nyocha site na iji ụdị edozi ma ọ bụ nke na-enweghị usoro. n'ihi mgbanwe dị na ezi mmetụta, na ụkpụrụ> 60% na-egosi dị ịrịba ama heterogeneity. Ọ bụrụ na heterogeneity bụ> 60%, a na-eme nyocha ndị ọzọ site na iji meta-regression na sensitivity analysis. (a na-ehichapụ otu ọmụmụ n'otu oge ma nyochaa nyocha ahụ ugboro ugboro) .p-values <0.05 bụ ihe dị ịrịba ama. A na-eme nyocha-meta-analyses site na iji Software Review Manager 5.4, a na-eme nyocha nke uche site na iji ngwugwu ngwanrọ nchịkọta akụkọ (Stata 17.0). maka Windows), na meta-regressions ka emere site na iji Ngwa Ngwa Ngwa Meta-Analysis Integrated 3.
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Khan, RS, Bril, F., Cusi, K. & Newsome, PN.Mgbanwe nke nguzogide insulin na ọrịa imeju abụba na-adịghị egbu egbu. Hepatology 70 (2), 711-724.https://doi.org/10.1002/hep.30429 (2019).
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Oge nzipu: Mee-30-2022