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益生菌补充剂用于管理 2 型糖尿病成人的心血管危险因素:系统评价和荟萃分析。

Probiotic supplementation for management of cardiovascular risk factors in adults with type II diabetes: A systematic review and meta-analysis.

机构信息

Faculty of Pharmacy, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

Department of Pharmaceutical Biotechnology, Isfahan Pharmaceutical Research Center, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Clin Nutr. 2018 Apr;37(2):532-541. doi: 10.1016/j.clnu.2017.02.015. Epub 2017 Feb 24.

Abstract

BACKGROUND & AIMS: The effectiveness of probiotics in control of hypertension and dyslipidemia in diabetic patients remains unclear. Therefore, we systematically reviewed relevant data to elucidate the effects of probiotics on blood pressure and lipid profile of type 2 diabetic patients.

METHODS

We searched PubMed, ISI Web of Knowledge, Scopus, The Cochrane Library, ClinicalTrials.gov, ProQuest Dissertations and Theses databases until May 2016. The primary outcomes were systolic blood pressure (SBP) and diastolic blood pressure (DBP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG). Other biochemical response and adverse effects were considered as secondary outcomes. Data was extracted from included studies and pooled in meta-analysis whenever possible (both standardized mean difference (SMD) analysis and weighted mean difference (WMD) analysis were performed).

RESULTS

Eleven eligible randomized controlled trial (n = 641) were identified. Pooling data from these trials demonstrated probiotic consumption significantly decreased SBP (WMD, -3.28 mmHg; 95% confidence interval [CI], -5.38 to -1.18), DBP (WMD, -2.13 mmHg; 95% CI, -4.5 to 0.24), LDL-C (WMD, 8.32 mg/dl; 95% CI, -15.24 to -1.4), TC (WMD, -12.19 mg/dl; 955 CI -17.62 to -6.75) and TG (WMD, -24.48 mg/dl; 95% CI, -33.77 to -11.18) in type 2 diabetic patients compared with placebo. The methodological quality varied across trials included in this study.

CONCLUSION

This systematic review suggests probiotics supplementation may be helpful for control of dyslipidemia and hypertension in type 2 diabetic patients. Conducting more trails with large sample size and long follow-up time still is necessary to develop clinical practice guidelines for management of cardiovascular risk factors in patient with type 2 diabetes.

摘要

背景与目的

益生菌在控制糖尿病患者高血压和血脂异常方面的有效性尚不清楚。因此,我们系统地回顾了相关数据,以阐明益生菌对 2 型糖尿病患者血压和血脂谱的影响。

方法

我们检索了 PubMed、ISI Web of Knowledge、Scopus、The Cochrane Library、ClinicalTrials.gov、ProQuest Dissertations and Theses 数据库,检索时间截至 2016 年 5 月。主要结局指标为收缩压(SBP)和舒张压(DBP)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和甘油三酯(TG)。其他生化反应和不良反应被视为次要结局。只要有可能,就从纳入的研究中提取数据并进行荟萃分析(同时进行标准化均数差(SMD)分析和加权均数差(WMD)分析)。

结果

确定了 11 项符合条件的随机对照试验(n=641)。对这些试验的数据进行汇总表明,益生菌的摄入显著降低了 SBP(WMD,-3.28mmHg;95%置信区间[CI],-5.38 至-1.18)、DBP(WMD,-2.13mmHg;95%CI,-4.5 至 0.24)、LDL-C(WMD,8.32mg/dl;95%CI,-15.24 至-1.4)、TC(WMD,-12.19mg/dl;955 CI-17.62 至-6.75)和 TG(WMD,-24.48mg/dl;95%CI,-33.77 至-11.18)与安慰剂相比,2 型糖尿病患者。本研究纳入的试验方法学质量存在差异。

结论

本系统评价提示益生菌补充剂可能有助于控制 2 型糖尿病患者的血脂异常和高血压。仍需要进行更多具有大样本量和长期随访时间的试验,以便为 2 型糖尿病患者心血管危险因素的管理制定临床实践指南。

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