Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China.
Healthcare-associated Infection Control Center, Sichuan Academy of Medical Science and Sichuan Provincial People's Hospital, Chengdu, China.
Nutr Diabetes. 2019 Jun 5;9(1):19. doi: 10.1038/s41387-019-0086-9.
The role of resistant starch (RS) in glucose, insulin, insulin resistance or sensitivity, and lipid parameters have been reported in several studies and remained controversial. A pooled analysis which assessed these parameters has not been performed. Thus, we conducted a meta-analysis to sum up existing evidence about the issue.
We searched in MEDLINE and PUBMED for studies that were published before November 2018. Meta-analysis of diabetics and nondiabetics trials were performed by use of a random-effects model.
A total of 13 case-control studies that included 428 subjects with body mass index ≥25 were identified. RS supplementation reduced fasting insulin in overall and stratified (diabetics and nondiabetics trials) analysis (SMD = -0.72; 95% CI: -1.13 to -0.31; SMD = -1.26; 95% CI: -1.66 to -0.86 and SMD = -0.64; 95% CI: -1.10 to -0.18, respectively), and reduced fasting glucose in overall and stratified analysis for diabetic trials (SMD = -0.26; 95% CI: -0.5 to -0.02 and SMD = -0.28; 95% CI: -0.54 to -0.01, respectively). RS supplementation increased HOMA-S% (SMD = 1.19; 95% CI: 0.59-1.78) and reduced HOMA-B (SMD =-1.2; 95% CI: -1.64 to -0.77), LDL-c concentration (SMD =-0.35; 95% CI: -0.61 to -0.09), and HbA1c (SMD = -0.43; 95% CI: -0.74 to -0.13) in overall analysis.
This meta-analysis has provided evidence that RS supplementation can improve fasting glucose, fasting insulin, insulin resistance and sensitivity, especially for diabetic with overweight or obesity. However, owing to potential sophistication, individual difference and composition of intestinal microbiota, this result should be carefully taken into account.
抗性淀粉（RS）在葡萄糖、胰岛素、胰岛素抵抗或敏感性以及血脂参数方面的作用在几项研究中已经得到了报道，但仍然存在争议。目前尚未进行评估这些参数的汇总分析。因此，我们进行了一项荟萃分析，以总结关于这一问题的现有证据。
我们在 MEDLINE 和 PUBMED 中检索了截至 2018 年 11 月发表的研究。使用随机效应模型对糖尿病患者和非糖尿病患者的试验进行荟萃分析。
共确定了 13 项包含 428 名体重指数≥25 的病例对照研究。RS 补充剂可降低总体和分层（糖尿病和非糖尿病试验）分析中的空腹胰岛素（SMD = -0.72；95%CI：-1.13 至-0.31；SMD = -1.26；95%CI：-1.66 至-0.86 和 SMD = -0.64；95%CI：-1.10 至-0.18），并降低糖尿病试验的总体和分层分析中的空腹血糖（SMD = -0.26；95%CI：-0.50 至-0.02 和 SMD = -0.28；95%CI：-0.54 至-0.01）。RS 补充剂可增加 HOMA-S%（SMD = 1.19；95%CI：0.59-1.78）和降低 HOMA-B（SMD =-1.2；95%CI：-1.64 至-0.77）、LDL-c 浓度（SMD =-0.35；95%CI：-0.61 至-0.09）和 HbA1c（SMD =-0.43；95%CI：-0.74 至-0.13）。
本荟萃分析提供的证据表明，RS 补充剂可以改善空腹血糖、空腹胰岛素、胰岛素抵抗和敏感性，特别是对超重或肥胖的糖尿病患者。然而，由于潜在的复杂性、个体差异和肠道微生物群落的组成，应谨慎考虑这一结果。
