国内团队:菌群疗法用于慢性肾病效果如何?
创作:楸楸 审核:兵兵 2020年05月17日
  • 纳入包括671名慢性肾病(CKD)患者的13项随机对照试验进行分析;
  • 补充益生菌、益生元和合生元可减少C反应蛋白(CRP)、丙二醛(MDA)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-c)水平,增加谷胱甘肽(GSH)、总抗氧化能力(TAC)和高密度脂蛋白胆固醇(HDL-c)水平,但对总甘油三酯(TG)的影响无统计学意义;
  • 干预持续时间、体质指数BMI、干预种类及年龄等均影响干预结果;
  • 该研究结果支持CKD患者服用益生菌、益生元及合生元产品。
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兵兵
北京中医药大学东直门医院团队近期在《Critical Reviews in Food Science and Nutrition》发表研究,纳入2000.1-2019.5报道的13项随机对照试验研究,进行系统综述和荟萃分析,表明补充益生菌、益生元和合生制剂可以改善慢性肾病相关炎性症状、氧化压力以及患者体内的脂质组成。菌群疗法的长期干预是进一步研究的方向。
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Probiotics, prebiotics, and synbiotics for the improvement of metabolic profiles in patients with chronic kidney disease: A systematic review and meta-analysis of 

益生菌,益生元和合生元改善慢性肾脏疾病患者的代谢状况:随机对照试验的系统综述和荟萃分析

10.1080/10408398.2020.1740645

2020-04-24, Review

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This systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to quantify the effects of probiotic, prebiotic, and synbiotic supplementation on biomarkers of inflammation and oxidative stress, as well as lipid profiles among patients with chronic kidney disease (CKD). Electronic databases, including PubMed, the Cochrane Database, and the Web of Science were searched from January 1, 2000, to May 15, 2019. All RCTs that investigated the effect of prebiotics, probiotics, and synbiotics on a circulating (serum and plasma) inflammatory marker (C-reactive protein [CRP]), oxidative stress indicators (malondialdehyde [MDA], glutathione [GSH], and total anti-oxidant capacity [TAC]); and lipid profiles (total cholesterol [TC], triglycerides [TG], low-density lipoprotein cholesterol [LDL-c], and high-density lipoprotein cholesterol [HDL-c]) among patients with CKD were included. Data were pooled and expressed as a standardized mean difference (SMD) with a 95% confidence interval (CI). The protocol for this meta-analysis is registered with PROSPERO; No. CRD42019139090. Thirteen trials that included 671 patients were identified for analysis. The methodological quality varied across studies. Meta-analysis indicated that microbial therapies significantly reduced CRP (SMD, −0.75; 95% CI, −1.03 to −0.47; p = 0.000), MDA (SMD, −1.06; 95% CI, −1.59 to −0.52; p = 0.000), TC (SMD, −0.33; 95% CI, −0.52 to −0.13; p = 0.000), and LDL-c (SMD, −0.44; 95% CI, −0.86 to −0.02; p = 0.000) levels; they also increased the GSH (SMD, 0.44; 95% CI, 0.25 to 0.65; p = 0.000), TAC (SMD, 0.61; 95% CI, 0.07 to 1.15; p = 0.000), and HDL-c (SMD, 0.45; 95% CI, 0.03 to 0.87; p = 0.000) levels in CKD patients, as compared to the placebo groups; however, there was no statistically significant TG concentration among patients with CKD. Subgroup analyses showed that other key factors, such as the duration of intervention, participants’ baseline body mass index (BMI), type of intervention, and age, had an effect of microbial therapies on outcomes. This meta-analysis supports the potential use of probiotic, prebiotic, and synbiotic supplements in the improvement of established biomarkers of inflammation and oxidative stress, as well as lipid profiles among patients with CKD, which are well-known cardiovascular risk factors. Further research into these interventions should consider the limitations of our study to explore the effect of long-term administration of these supplements in the CKD population.

First Authors:
Hui Juan Zheng,Jing Guo,Qiuhong Wang

Correspondence Authors:
Wei Jing Liu,Yaoxian Wang

All Authors:
Hui Juan Zheng,Jing Guo,Qiuhong Wang,Liansheng Wang,Yahui Wang,Fan Zhang,Wei-Jun Huang,Wenting Zhang,Wei Jing Liu,Yaoxian Wang

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