Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia.
Am J Clin Nutr. 2017 Sep 1;106(3):930-945. doi: 10.3945/ajcn.117.156265.
Prebiotic soluble fibers are fermented by beneficial bacteria in the colon to produce short-chain fatty acids (SCFAs), which are proposed to have systemic anti-inflammatory effects.
This review examines the effect of SCFAs, prebiotics, and pre- and probiotic combinations (synbiotics) on systemic inflammation.
Relevant English language studies from 1947 to May 2017 were identified with the use of online databases. Studies were considered eligible if they examined the effects of SCFAs, prebiotics, or synbiotics; were delivered orally, intravenously, or per rectum; were on biomarkers of systemic inflammation in humans; and performed meta-analysis where possible.
Sixty-eight studies were included. Fourteen of 29 prebiotic studies and 13 of 26 synbiotic studies reported a significant decrease in ≥1 marker of systemic inflammation. Eight studies compared prebiotic and synbiotic supplementation, 2 of which reported a decrease in inflammation with synbiotics only, with 1 reporting a greater anti-inflammatory effect with synbiotics than with prebiotics alone. Meta-analyses indicated that prebiotics reduce C-reactive protein (CRP) [standardized mean difference (SMD): -0.60; 95% CI: -0.98, -0.23], and synbiotics reduce CRP (SMD: -0.40; 95% CI: -0.73, -0.06) and tumor necrosis factor-α (SMD -0.90; 95% CI: -1.50, -0.30).
There is significant heterogeneity of outcomes in studies examining the effect of prebiotics and synbiotics on systemic inflammation. Approximately 50% of included studies reported a decrease in ≥1 inflammatory biomarker. The inconsistency in reported outcomes may be due to heterogeneity in study design, supplement formulation, dosage, duration, and subject population. Nonetheless, meta-analyses provide evidence to support the systemic anti-inflammatory effects of prebiotic and synbiotic supplementation.
益生元可溶解纤维在结肠中被有益细菌发酵产生短链脂肪酸（SCFAs），据推测这些脂肪酸具有全身抗炎作用。
本综述考察了 SCFAs、益生元以及预生元和益生菌的组合（合生剂）对全身炎症的影响。
使用在线数据库，从 1947 年到 2017 年 5 月检索了相关的英文文献。如果研究考察了 SCFAs、益生元或合生剂的影响、通过口服、静脉内或直肠内给予、对人体全身炎症的生物标志物进行了分析、且可能进行了荟萃分析，则认为该研究符合纳入标准。
共纳入 68 项研究。29 项益生元研究中有 14 项、26 项合生剂研究中有 13 项报告了至少 1 项全身炎症标志物的显著降低。8 项研究比较了益生元和合生剂的补充，其中 2 项研究报告合生剂仅能降低炎症，1 项研究报告合生剂比单独使用益生元具有更强的抗炎作用。荟萃分析表明，益生元可降低 C 反应蛋白（CRP）[标准化均数差（SMD）：-0.60；95%可信区间（CI）：-0.98，-0.23]，合生剂可降低 CRP（SMD：-0.40；95%CI：-0.73，-0.06）和肿瘤坏死因子-α（SMD：-0.90；95%CI：-1.50，-0.30）。
研究益生元和合生剂对全身炎症影响的结果存在显著的异质性。大约 50%的纳入研究报告了至少 1 项炎症生物标志物的降低。报告结果的不一致可能是由于研究设计、补充剂配方、剂量、持续时间和研究人群的异质性所致。尽管如此，荟萃分析仍为益生元和合生剂补充的全身抗炎作用提供了证据。
