低 n-6/n-3 PUFA 比值对血糖的影响：一项荟萃分析。
Effect of low-ratio n-6/n-3 PUFA on blood glucose: a meta-analysis.
机构信息
Institute of Agro-Food Science and Technology, Shandong Academy of Agricultural Sciences/Shandong Provincial Food for Special Medical Purpose Engineering Technology Research Center/Key Laboratory of Agro-Products Processing Technology of Shandong Province/Key Laboratory of Novel Food Resources Processing, Ministry of Agriculture and Rural Affairs, Jinan, China.
出版信息
Food Funct. 2019 Aug 1;10(8):4557-4565. doi: 10.1039/c9fo00323a. Epub 2019 Jul 11.
OBJECTIVE
The aim of this meta-analysis was to investigate the effect of increasing dietary low-ratio n-6/n-3 polyunsaturated fatty acid (PUFA) intake on blood glucose and other related indicators.
METHODS
We systematically searched randomized controlled trials of low-ratio n-6/n-3 PUFA intervention on PubMed, Embase, Cochrane library and related references up to August 2018. The change values were calculated as the weighted mean difference (WMD) by using a random-effect model.
RESULTS
Eleven randomized controlled trials were included. No significant effect of dietary low-ratio n-6/n-3 PUFA supplementation was observed on fasting blood glucose (WMD: 0.057 mmol L; 95% CI: -0.090 to 0.204 mmol L), insulin (WMD: -0.757 mIU L; 95% CI: -2.419 to 0.904 mIU L), insulin resistance index (WMD: -0.201; 95% CI: -0.566 to 0.165), and glycosylated hemoglobin (WMD: -0.063%; 95% CI: -0.061 to 0.186%). Subgroup analysis showed that the effect of low-ratio n-6/n-3 PUFA on the reduction of the plasma insulin level in North America (WMD: -3.473 mIU L; 95% CI: -5.760 to -1.185 mIU L) was more obvious than that in Asian countries (WMD: -0.797 mIU L; 95% CI: -2.497 to 0.902 mIU L) and European countries (WMD: -0.063 mIU L; 95% CI: -0.061 to 0.186 mIU L). In the subgroup of diabetic subjects, low-ratio n-6/n-3 PUFA supplementation can decrease the plasma insulin level (WMD: -3.010 mIU L; 95% CI: -5.371 to -0.648 mIU L) and insulin resistance index (WMD: -0.460; 95% CI: -0.908 to -0.012). When the intervention period was longer than 8 weeks, low-ratio n-6/n-3 PUFA supplementation could also decrease the plasma insulin level (WMD: -2.782 mIU L; 95% CI: -4.946 to -0.618 mIU L). No significant publication bias was observed for all blood glucose and other related indicators as suggested by Begg's test and Egger's test.
CONCLUSION
Our meta-analysis found that low-ratio n-6/n-3 PUFA supplementation could improve the glucose metabolism by reducing the insulin and insulin resistance in the diabetic patients. Low-ratio n-6/n-3 PUFA supplementation could reduce the plasma insulin level when the supplementation duration was longer than 8 weeks.
目的
本荟萃分析旨在研究增加低 n-6/n-3 多不饱和脂肪酸（PUFA）饮食摄入对血糖和其他相关指标的影响。
方法
我们系统地检索了 2018 年 8 月之前在 PubMed、Embase、Cochrane 图书馆和相关参考文献中关于低 n-6/n-3 PUFA 干预的随机对照试验。使用随机效应模型计算加权均数差值（WMD）。
结果
纳入 11 项随机对照试验。饮食中低 n-6/n-3 PUFA 补充对空腹血糖（WMD：0.057mmol/L；95%CI：-0.090 至 0.204mmol/L）、胰岛素（WMD：-0.757mIU/L；95%CI：-2.419 至 0.904mIU/L）、胰岛素抵抗指数（WMD：-0.201；95%CI：-0.566 至 0.165）和糖化血红蛋白（WMD：-0.063%；95%CI：-0.061 至 0.186%）没有显著影响。亚组分析表明，低 n-6/n-3 PUFA 对北美人群血浆胰岛素水平降低的作用（WMD：-3.473mIU/L；95%CI：-5.760 至 -1.185mIU/L）比亚洲国家（WMD：-0.797mIU/L；95%CI：-2.497 至 0.902mIU/L）和欧洲国家（WMD：-0.063mIU/L；95%CI：-0.061 至 0.186mIU/L）更明显。在糖尿病患者亚组中，低 n-6/n-3 PUFA 补充可以降低血浆胰岛素水平（WMD：-3.010mIU/L；95%CI：-5.371 至 -0.648mIU/L）和胰岛素抵抗指数（WMD：-0.460；95%CI：-0.908 至 -0.012）。当干预时间超过 8 周时，低 n-6/n-3 PUFA 补充也可以降低血浆胰岛素水平（WMD：-2.782mIU/L；95%CI：-4.946 至 -0.618mIU/L）。Begg 检验和 Egger 检验均表明，所有血糖和其他相关指标均无明显发表偏倚。
结论
本荟萃分析发现，低 n-6/n-3 PUFA 补充可通过降低糖尿病患者的胰岛素和胰岛素抵抗来改善血糖代谢。当补充时间超过 8 周时，低 n-6/n-3 PUFA 补充可降低血浆胰岛素水平。
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