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大豆蛋白对慢性肾脏病的影响:一项随机对照试验的荟萃分析

The effects of soy protein on chronic kidney disease: a meta-analysis of randomized controlled trials.

作者信息

Zhang J, Liu J, Su J, Tian F

机构信息

Department of Nutrition, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.

出版信息

Eur J Clin Nutr. 2014 Sep;68(9):987-93. doi: 10.1038/ejcn.2014.112. Epub 2014 Jun 18.

Abstract

BACKGROUND/OBJECTIVES: There is a growing body of evidence to indicate that soy protein consumption may have a beneficial effect on kidney function. We performed a meta-analysis to evaluate the effects of soy protein consumption compared with animal protein consumption in patients with pre-dialysis chronic kidney disease (CKD).

SUBJECTS/METHODS: We conducted a structured electronic search of the databases PubMed, EMBASE, Cochrane Library and Chinese Biological Medicine for randomized controlled trials published up to March 2014. The outcome measures were serum creatinine (SCR), triglyceride (TG), total cholesterol (TC), calcium (Ca) and phosphorus concentrations. Weighted or standard mean differences were calculated for net changes using random-effects models.

RESULTS

The meta-analysis consisted of nine trials, comprising 197 subjects. Soy protein intake significantly reduced SCR and serum phosphorus concentrations. The mean difference was -6.231 μmol/l (95% confidence interval (CI): -11.109, -1.352 μmol/l) for SCR (P=0.012) and -0.804 (95% CI: -1.143, -0.464 μmol/l) for serum phosphorus (P=0.00). It also significantly reduced serum TG, with a pooled estimated change of -0.223 mmol/l (95% CI: -0.396, -0.051 mmol/l; P=0.011) after the exclusion of one trial indicated by sensitivity analyses. No statistically significant effects were observed for TC (-0.135 mmol/l (95% CI: -0.289, 0.019 mmol/l)) or Ca (0.023 mmol/l (95% CI: -0.016, 0.062 mmol/l)).

CONCLUSIONS

The meta-analysis suggested a protective effect of soy protein consumption on SCR and serum phosphorus concentrations in pre-dialysis CKD patients. It may also have a significant effect on lowering serum TG concentrations. However, nonsignificant effects on TC and Ca were observed. Evidence was limited because of the relatively small number of available trials and subjects.

摘要

背景/目的:越来越多的证据表明,食用大豆蛋白可能对肾功能产生有益影响。我们进行了一项荟萃分析,以评估在透析前慢性肾脏病(CKD)患者中,食用大豆蛋白与食用动物蛋白相比的效果。

受试者/方法:我们对PubMed、EMBASE、Cochrane图书馆和中国生物医学数据库进行了结构化电子检索,以查找截至2014年3月发表的随机对照试验。结局指标为血清肌酐(SCR)、甘油三酯(TG)、总胆固醇(TC)、钙(Ca)和磷浓度。使用随机效应模型计算净变化的加权或标准平均差。

结果

该荟萃分析包括9项试验,共197名受试者。摄入大豆蛋白可显著降低SCR和血清磷浓度。SCR的平均差值为-6.231μmol/L(95%置信区间(CI):-11.109,-1.352μmol/L)(P=0.012),血清磷的平均差值为-0.804(95%CI:-1.143,-0.464μmol/L)(P=0.00)。在敏感性分析表明排除一项试验后,它还显著降低了血清TG,汇总估计变化为-0.223mmol/L(95%CI:-0.396,-0.051mmol/L;P=0.011)。未观察到TC(-0.135mmol/L(95%CI:-0.289,0.019mmol/L))或Ca(0.023mmol/L(95%CI:-0.016,0.062mmol/L))有统计学显著影响。

结论

荟萃分析表明,食用大豆蛋白对透析前CKD患者的SCR和血清磷浓度有保护作用。它可能对降低血清TG浓度也有显著影响。然而,未观察到对TC和Ca有显著影响。由于可用试验和受试者数量相对较少,证据有限。

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