益生菌能帮助控制2型糖尿病患者的血糖吗?
创作:szx 审核:szx 2020年11月05日
  • 纳入28项RCT(共1947名前驱糖尿病或2型糖尿病患者)进行荟萃分析;
  • 相比于安慰剂或无干预,短期(<12周)或长期(≥12周)益生菌干预均可显著降低患者的空腹血糖;
  • 短期或长期益生菌干预均可降低患者的糖化血红蛋白,但由于相关研究数量较少,差异未到达显著水平;
  • 亚组分析显示,益生菌降低糖化血红蛋白或空腹血糖的效果在未接受胰岛素治疗的患者中更为明显;
  • 另外,短期或长期益生菌干预可有效降低血清胆固醇水平。
主编推荐语
szx
Advances in Nutrition上发表的一项荟萃分析结果,总结了28项RCT(共包含近2000名前驱糖尿病或2型糖尿病患者)的数据后发现,益生菌可显著降低患者的空腹血糖,且效果在血糖控制较差或未接受胰岛素治疗的患者中更好。
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Probiotics Contribute to Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

益生菌促进2型糖尿病患者的血糖控制:系统性综述与荟萃分析

10.1093/advances/nmaa133

2020-10-30, Article

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This systematic review aimed to evaluate the effectiveness and safety of probiotics for glycemic control in adults with impaired glucose control, including prediabetes and type 2 diabetes mellitus (T2DM). We searched PubMed, Embase, and Cochrane databases, and trial registries up to February 2019. We included randomized controlled trials (RCTs) of participants with prediabetes or T2DM. Eligible trials compared probiotics versus either placebo, no intervention, or comparison probiotics, or compared synbiotics versus prebiotics. Primary outcomes were mean change in fasting blood glucose (FBG) and glycated hemoglobin (HbA1c) from baseline to short term (<12 wk) and long term (≥12 wk). We performed meta-analyses using the random-effects model. We included 28 RCTs (1947 participants). Overall, probiotics reduced FBG more than the placebo/no intervention group with a mean difference (MD) of –12.99 mg/dL (95% CI: –23.55, –2.42; P value: 0.016) over the short term; and –2.99 mg/dL (95% CI: –5.84, –0.13; P value: 0.040) over the long term. There was also some evidence for reduced HbA1c in the probiotics group at both short term (MD: –0.17; 95% CI: –0.37, 0.02; P value: 0.084) and long term (MD: –0.14; 95% CI: –0.34, 0.06; P value: 0.172), however, these did not reach statistical significance possibly because only a few trials reported HbA1c as an outcome. Subgroup analyses showed a greater reduction in HbA1c in participants not receiving insulin therapy than those receiving insulin therapy. Furthermore, the effect of probiotics on the reduction of FBG was more pronounced in participants with FBG >130 mg/dL and those not receiving insulin therapy than their counterparts. Probiotics were also effective in lowering serum cholesterol over the short and long term. In conclusion, we found that probiotics may have a glucose-lowering effect in T2DM participants. The effect appeared to be stronger in participants with poorly controlled diabetes and those not on insulin therapy.

First Authors:
Thanitsara Rittiphairoj

Correspondence Authors:
Krit Pongpirul

All Authors:
Thanitsara Rittiphairoj,Krit Pongpirul,Kantima Janchot,Noel T Mueller,Tianjing Li

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