A Meta-analysis Of The Clinical Effect Of Inositol Supplementation In High Risk Population During Pregnancy For The Prevention Of Gestational Diabetes Mellitus

Objective:A systematic review was conducted by evidence-based medicine in order to evaluate the clinical efficacy of inositol supplementation on preventing gestational diabetes mellitus(GDM)in high risk population.Methods:The databases of Pubmed,Embase,Cochrane library,Ovid,Google Scholar,Springer,Wan Fang,Da Yi,China national knowledge internet and National Library were searched.Strict inclusion and exclusion criteria were established to collect clinical randomized controlled trials about inositol supplementation during pregnancy to prevent GDM and related complications.This meta-analysis was analyzed by Review Manager 5.3 software.Results:Eight randomized controlled trials were included in the meta-analysis,containing a total of 1200 patients at high risks of GDM.1.There was a significant reduction in GDM incidence among high risk population supplemented with inositol[OR=0.34,95%CI(0.17,0.67)];2.The incidence of GDM was reduced when the inositol supplementation started at the first trimester[OR=0.34,95%CI(0.17,0.67)],while there was no significant difference when beginning at the second trimester;3.The incidence of GDM was reduced in both doses of myo-inositol(MI)for2gtwiceadayand4gperdayamonghigh-risk groups[OR=0.34,95%CI(0.23,0.50)],[OR=0.02,95%CI(0.01,0.12)].However,when the daily doses of MI was less than 4g,there was no significant difference between the two groups[OR=1.36,95%CI(0.72,2.54)];4.The incidence of GDM was reduced in women with BMI?30kg/m~2 or25kg/m~2?BMI<30kg/m~2whensupplementedwithinsitol[OR=0.33,95%CI(0.19,0.56)],[OR=0.35,95%CI(0.16,0.74)],andthe prevention was more notable when BMI?30kg/m~2.Conclusion:1.Inositol supplementation for high-risk patients during pregnancy can significantly reduce the incidence of GDM;2.Compared with inositol supplementation started at the second trimester,inositol supplementation beginning at the first trimester among high-risk populations can effectively prevent GDM;3.Either doses of myo-inositol for 2g twice a day or 4g per day in high-risk groups can reduce the incidence of GDM.Compared with myo-inositol supplementation for 2g twice a day,the method of myo-inositol supplementation for 4g per day was more effective in preventing GDM,while there was no significant preventive effect when the daily dose of MI supplementation was less than 4g;4.The effect of prevention for GDM with inositol supplementation may be more obvious with the increase of BMI.