Liu F, Prabhakar M, Ju J, Long H, Zhou H-W
State Key Laboratory of Organ Failure Research, Department of Environmental Health, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, China.
Shandong University of Traditional Chinese Medicine, Jinan, China.
Eur J Clin Nutr. 2017 Jan;71(1):9-20. doi: 10.1038/ejcn.2016.156. Epub 2016 Sep 14.
BACKGROUND/OBJECTIVES: This systematic review and meta-analysis was performed to assess the effects of inulin-type fructans (ITF) on human blood lipids and glucose homeostasis associated with metabolic abnormalities, including dyslipidemia, overweight or obesity, and type-2 diabetes mellitus (T2DM).
SUBJECTS/METHODS: The MEDLINE, EMBASE and Cochrane Library databases were systematically searched for randomized controlled trials (RCTs) before January 2016. Human trials that investigated the effects of ITF supplementation on the lipid profile, fasting glucose and insulin were included using Review Manager 5.3.
Twenty RCTs with 607 adult participants were included in this systematic review and meta-analysis. In the overall analysis, the supplementation of ITF reduced only the low density lipoprotein-cholesterol (LDL-c) (mean difference (MD): -0.15; 95% confidence interval (CI): -0.29, -0.02; P=0.03) without affecting the other endpoints. Within the T2DM subgroup analysis, ITF supplementation was positively associated with a decreased fasting insulin concentration (MD: -4.01; 95% CI: -5.92, -2.09; P<0.0001) and increased high density lipoprotein-cholesterol (HDL-c) (MD: 0.07; 95% CI: 0, 0.14; P=0.05). Moreover, a reduced fasting glucose tendency was identified only in the T2DM subgroup (MD: -0.42; 95% CI: -0.90, 0.06; P=0.09). There was a potential publication bias, and few trials were available for the T2DM subgroup analysis.
In summary, the use of ITF may have benefits for LDL-c reduction across all study populations, whereas HDL-c improvement and glucose control were demonstrated only in the T2DM subgroup. Thus, additional, well-powered, long-term, randomized clinical trials are required for a definitive conclusion. Overall, ITF supplementation may provide a novel direction for improving the lipid profile and glucose metabolism.
背景/目的：进行本系统评价和荟萃分析，以评估菊粉型果聚糖（ITF）对与代谢异常相关的人体血脂和血糖稳态的影响，这些代谢异常包括血脂异常、超重或肥胖以及2型糖尿病（T2DM）。
受试者/方法：系统检索MEDLINE、EMBASE和Cochrane图书馆数据库中2016年1月之前的随机对照试验（RCT）。使用Review Manager 5.3纳入研究ITF补充剂对血脂谱、空腹血糖和胰岛素影响的人体试验。
本系统评价和荟萃分析纳入了20项随机对照试验，共607名成年参与者。在总体分析中，补充ITF仅降低了低密度脂蛋白胆固醇（LDL-c）（平均差（MD）：-0.15；95%置信区间（CI）：-0.29，-0.02；P=0.03），而未影响其他终点。在T2DM亚组分析中，补充ITF与空腹胰岛素浓度降低（MD：-4.01；95%CI：-5.92，-2.09；P<0.0001）和高密度脂蛋白胆固醇（HDL-c）升高（MD：0.（此处原文有误，应为0.07）；95%CI：0，0.14；P=0.05）呈正相关。此外，仅在T2DM亚组中发现空腹血糖有降低趋势（MD：-0.42；95%CI：-0.90，0.06；P=0.09）。存在潜在的发表偏倚，且T2DM亚组分析可用的试验较少。
总之，在所有研究人群中，使用ITF可能有助于降低LDL-c，而仅在T2DM亚组中显示出HDL-c改善和血糖控制。因此，需要更多有足够效力的长期随机临床试验才能得出明确结论。总体而言，补充ITF可能为改善血脂谱和葡萄糖代谢提供一个新方向。
