益生菌、益生元及合生制剂改善糖尿病患者的部分代谢指标
创作:szx 审核:szx 2020年10月22日
  • 纳入38项研究进行荟萃分析,评估益生菌、益生元或合生制剂对糖尿病患者的血糖、胰岛素及血脂的影响;
  • 益生菌(乳杆菌属、双歧杆菌属、链球菌属等)、益生元(菊粉、低聚半乳糖等)或合生制剂可降低糖化血红蛋白水平(差异接近显著),对LDL胆固醇水平无显著作用;
  • 显著降低空腹血糖(−0.58 mmol/L)、总胆固醇(−0.14 mmol/L)、甘油三酯(−0.11 mmol/L)及胰岛素(−10.51 pmol/L)水平,显著增加HDL胆固醇(0.04 mmol/L)水平。
主编推荐语
szx
来自Diabetologia上发表的一项荟萃分析结果,总结了38项研究的数据后发现,补充益生菌、益生元或合生制剂,可显著降低糖尿病患者的空腹血糖、总胆固醇、甘油三酯及胰岛素水平,并显著增加HDL胆固醇水平,但对糖化血红蛋白及LDL胆固醇无显著影响。
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Diabetologia [IF:7.518]

The effect of probiotics, prebiotics or synbiotics on metabolic outcomes in individuals with diabetes: a systematic review and meta-analysis

益生菌、益生元或合生制剂对于糖尿病患者的代谢结局的影响:系统性综述与荟萃分析

10.1007/s00125-020-05295-1

2020-10-13, Article

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Aims/hypothesis: The aim was to conduct a systematic review and meta-analysis of randomised controlled clinical trials assessing the effect of probiotic, prebiotic or synbiotic supplementation on gut microbiota and glucose control and lipid levels in individuals with diabetes.
Methods: MEDLINE, EMBASE and the Cochrane Library were searched. The eligibility criteria for the studies was involvement of participants with a diagnosis of type 1 or type 2 diabetes. Metabolic outcomes (glucose control, insulinaemia, and lipid profile) of any probiotic, prebiotic or synbiotic supplementation related to modification of gut microbiota (prebiotics, probiotics and synbiotics) were analysed. We provided a narrative synthesis and meta-analysis of the findings on metabolic outcomes from the studies. Metabolic outcomes were extracted post-intervention and expressed as mean differences (MDs) and 95% CIs between treatment and comparator groups. We pooled the results using a random-effects meta-analysis. The meta-analysis was conducted using Review Manager (RevMan) software.
Results: After the removal of duplicates and ineligible studies, 5219 studies were retained for review of titles and abstracts. The number of articles was reduced to 130 by review, for which the full-text articles were obtained and reassessed, 38 of which were included in the final meta-analysis. Overall, the use of prebiotics, probiotics or synbiotics reduced HbA1c levels, but did not reach the threshold for significance (−2.17 mmol/mol, 95% CI −4.37, 0.03; p = 0.05, [−0.20%, 95% CI −0.40 to 0.00; p = 0.05, I2 = 66%]) and had no effect on LDL-cholesterol levels (−0.05 mmol/l; 95% CI −0.14, 0.05, p = 0.35, I2 = 37%). However, their consumption decreased levels of fasting blood glucose (−0.58 mmol/l; 95% CI −0.86, −0.30; p < 0.01, I2 = 60%), total cholesterol (−0.14 mmol/l; 95% CI −0.26, −0.02, p = 0.02, I2 = 39%), triacylglycerols (−0.11 mmol/l; 95% CI −0.20, −0.02, p = 0.01, I2= 21%) and insulinaemia (−10.51 pmol/l; 95% CI −16.68,−4.33, p < 0.01, I2 = 74%), and increased HDL-cholesterol levels (0.04 mmol/l; 95% CI 0.01, 0.07, p < 0.01, I2= 24%).
Conclusions/interpretation: In individuals with diabetes mellitus, supplementation with probiotics, prebiotics or synbiotics improved metabolic variables, although the magnitude of this effect is low. Our results suggest that consumption of probiotics, prebiotics or synbiotics may be a potential adjuvant treatment for improving metabolic outcomes.

First Authors:
Patricia M Bock

Correspondence Authors:
Patricia M Bock

All Authors:
Patricia M Bock,Gabriela H Telo,Rafaela Ramalho,Mariana Sbaraini,Gabriel Leivas,Andreza F Martins,Beatriz D Schaan

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