Wang Xia, Juan Qi-Fang, He Yu-Wei, Zhuang Li, Fang Yuan-Yuan, Wang Yong-Hong
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J Pediatr Endocrinol Metab. 2017 May 24;30(6):611-622. doi: 10.1515/jpem-2016-0230.
A systematic review and meta-analysis was designed to evaluate the effect of probiotics on diabetes and its associated risk factors.
We systematically searched the Cochrane Library, PubMed, EMBASE and Web of Science to June 2016. We also hand-searched the citation lists of included studies and previously identified systematic reviews to identify further relevant trials. Our primary outcome variables included glucose, glycated hemoglobin (HbA1c) and insulin. The pooled standardized mean difference was used to compare the effect between the probiotics and controlled groups, and the pooled standardized mean difference effect size with a 95% confidence interval (CI) was estimated using a random-effect model. Heterogeneity was assessed with Cochran's Q and Higgins I2 tests. Two reviewers assessed trial quality and extracted data independently. The analysis and bias for each included study was performed and assessed using Review Manager 5.2.
Eighteen randomized, placebo-controlled studies (n=1056 participants, 527 consuming probiotics, 529 not consuming probiotics) were included for analysis. Comparing the probiotics groups with the control groups, there were statistically significant pooled standardized mean differences on the reduction of glucose (-0.61, 95% CI -0.98, -0.24; p=0.001), insulin (-0.49, 95% CI -0.93, -0.04; p=0.03) and HbA1c (-0.39, 95% CI -0.60, -0.19%; p=0.0001). Subgroup analysis also indicated statistical significance on the reduction of low-density lipoprotein cholesterol (LDL-C) in non-type 2 diabetes (non-T2DM) mellitus patients with diabetes, for the pooled standardized mean difference was -0.29 (95% CI -0.54, -0.04; p=0.02).
Probiotics may have beneficial effects on the reduction of glucose, insulin and HbA1c for diabetes, especially for T2DM mellitus patients.
本系统评价和荟萃分析旨在评估益生菌对糖尿病及其相关危险因素的影响。
我们系统检索了截至2016年6月的Cochrane图书馆、PubMed、EMBASE和科学网。我们还手工检索了纳入研究的参考文献列表以及先前确定的系统评价，以识别更多相关试验。我们的主要结局变量包括血糖、糖化血红蛋白（HbA1c）和胰岛素。采用合并标准化均数差值比较益生菌组和对照组的效果，并使用随机效应模型估计合并标准化均数差值效应大小及95%置信区间（CI）。采用Cochran's Q检验和Higgins I2检验评估异质性。两名评价者独立评估试验质量并提取数据。使用Review Manager 5.2对每项纳入研究进行分析和偏倚评估。
纳入18项随机、安慰剂对照研究（n = 1056名参与者，527名服用益生菌，529名未服用益生菌）进行分析。将益生菌组与对照组比较，在降低血糖（-0.61，95%CI -0.98，-0.24；p = 0.001）、胰岛素（-0.49，95%CI -0.93，-0.04；p = 0.03）和HbA1c（-0.39，95%CI -0.60，-0.19%；p = 0.0001）方面，合并标准化均数差值有统计学意义。亚组分析还表明，在非2型糖尿病（非T2DM）糖尿病患者中，降低低密度脂蛋白胆固醇（LDL-C）方面有统计学意义，合并标准化均数差值为-0.29（95%CI -0.54，-0.04；p = 0.02）。
益生菌可能对降低糖尿病患者的血糖、胰岛素和HbA1c有有益作用，尤其是对T2DM患者。
