坚果对血糖控制标志物的影响：随机对照试验的系统评价和荟萃分析。
The effect of nuts on markers of glycemic control: a systematic review and meta-analysis of randomized controlled trials.
机构信息
Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA.
出版信息
Am J Clin Nutr. 2019 Feb 1;109(2):297-314. doi: 10.1093/ajcn/nqy236.
BACKGROUND
Observational evidence suggests higher nut consumption is associated with better glycemic control; however, it is unclear if this association is causal.
OBJECTIVES
We aimed to conduct a systematic review and meta-analysis of randomized controlled trials to examine the effect of tree nuts and peanuts on markers of glycemic control in adults.
METHODS
A systematic review and meta-analysis of randomized controlled trials was conducted. A total of 1063 potentially eligible articles were screened in duplicate. From these articles, 40 were eligible for inclusion and data from these articles were extracted in duplicate. The weighted mean difference (WMD) between the nut intervention and control arms was determined for fasting glucose, fasting insulin, glycated hemoglobin (HbA1c), and homeostasis model assessment of insulin resistance (HOMA-IR) using the DerSimonian and Laird random-effects method. For outcomes where a limited number of studies were published, a qualitative synthesis was presented.
RESULTS
A total of 40 randomized controlled trials including 2832 unique participants, with a median duration of 3 mo (range: 1-12 mo), were included. Overall consumption of tree nuts or peanuts had a favorable effect on HOMA-IR (WMD: -0.23; 95% CI: -0.40, -0.06; I2 = 51.7%) and fasting insulin (WMD: -0.40 μIU/mL; 95% CI: -0.73, -0.07 μIU/mL; I2 = 49.4%). There was no significant effect of nut consumption on fasting blood glucose (WMD: -0.52 mg/dL; 95% CI: -1.43, 0.38 mg/dL; I2 = 53.4%) or HbA1c (WMD: 0.02%; 95% CI: -0.01%, 0.04%; I2 = 51.0%).
CONCLUSIONS
Consumption of peanuts or tree nuts significantly decreased HOMA-IR and fasting insulin; there was no effect of nut consumption on HbA1c or fasting glucose. The results suggest that nut consumption may improve insulin sensitivity. In the future, well-designed clinical trials are required to elucidate the mechanisms that account for these observed effects.
背景
观察性证据表明，坚果摄入量较高与血糖控制较好有关；然而，目前尚不清楚这种关联是否具有因果关系。
目的
我们旨在进行系统评价和荟萃分析，以检查树坚果和花生对成年人血糖控制标志物的影响。
方法
进行了系统评价和荟萃分析。对 1063 篇可能符合条件的文章进行了重复筛选。从这些文章中，有 40 篇符合纳入标准，并对这些文章的数据进行了重复提取。使用 DerSimonian 和 Laird 随机效应法，确定坚果干预组和对照组之间空腹血糖、空腹胰岛素、糖化血红蛋白 (HbA1c) 和稳态模型评估的胰岛素抵抗 (HOMA-IR) 的加权均数差 (WMD)。对于发表的研究数量有限的结果，进行了定性综合。
结果
共纳入 40 项随机对照试验，包含 2832 名独特参与者，中位随访时间为 3 个月（范围：1-12 个月）。总体上，食用树坚果或花生对 HOMA-IR（WMD：-0.23；95%CI：-0.40，-0.06；I2=51.7%）和空腹胰岛素（WMD：-0.40 μIU/mL；95%CI：-0.73，-0.07 μIU/mL；I2=49.4%）有有利影响。食用坚果对空腹血糖（WMD：-0.52 mg/dL；95%CI：-1.43，0.38 mg/dL；I2=53.4%）或 HbA1c（WMD：0.02%；95%CI：-0.01%，0.04%；I2=51.0%）无显著影响。
结论
食用花生或树坚果可显著降低 HOMA-IR 和空腹胰岛素；坚果的摄入对 HbA1c 或空腹血糖没有影响。这些结果表明，坚果的摄入可能会改善胰岛素敏感性。未来需要进行精心设计的临床试验，以阐明这些观察到的效果的机制。
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