Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, No. 32, South Renmin Road, Shiyan, 442000, China.
Department of Histology and Embryology, School of Basic Medical Sciences, Hubei University of Medicine, No. 30, South Renmin Road, Shiyan, 442000, China.
J Transl Med. 2019 Dec 5;17(1):410. doi: 10.1186/s12967-019-02159-0.
Currently, many clinical trials have shown that inulin-type fructans (ITF) supplementation is associated with glycemic control; nevertheless, the results are inconclusive. The aim of this meta-analysis of randomized controlled trials was to assess the effects of ITF supplementation on glycemic control.
PubMed, EMBASE and the Cochrane Library were searched for eligible articles up to March 6, 2019. A random-effects model was used to analyze the pooled results, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was applied to assess the quality of evidence. The dose-response model was used to recommend the daily dose and duration for ITF supplementation.
Thirty-three trials involving 1346 participants were included. Overall, ITF supplementation could significantly reduce concentrations of fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS) and homeostasis model assessment-insulin resistance (HOMA-IR). In the prediabetes and type 2 diabetes (T2DM) population, a more significant reduction in FBG [weighted mean difference (WMD): - 0.60 mmol/l; 95% CI - 0.71, - 0.48 mmol/l; high rate], HbA1c (WMD: - 0.58%; 95% CI - 0.83, - 0.32%; high rate), FINS (WMD: - 1.75 µU/ml; 95% CI - 2.87, - 0.63 µU/ml; low rate), and HOMA-IR (WMD: - 0.69; 95% CI - 1.10, - 0.28; low rate) were observed, and ITF supplementation with a daily dose of 10 g for a duration of 6 weeks and longer was recommended. Moreover, subgroup analyses suggested that the effects of glycemic control were significantly influenced by the sex of the subjects and the type and the method of intake of ITF.
Our analyses confirmed that these four main glycemic indicators were significantly reduced by ITF supplementation, particularly in the prediabetes and T2DM population. Evidence supports that reasonable administration of ITF supplementation may have potential clinical value as an adjuvant therapy for prediabetes and T2DM management. Trial registration The trial was registered at PROSPERO as CRD42018115875 on November 23, 2018.
目前，许多临床试验表明，菊粉型果聚糖（ITF）补充剂与血糖控制有关；然而，结果并不确定。本荟萃分析随机对照试验的目的是评估 ITF 补充剂对血糖控制的影响。
截至 2019 年 3 月 6 日，我们检索了 PubMed、EMBASE 和 Cochrane 图书馆中符合条件的文章。使用随机效应模型分析汇总结果，并应用推荐评估、制定与评估分级系统（GRADE）评估证据质量。采用剂量反应模型推荐 ITF 补充剂的每日剂量和持续时间。
纳入 33 项涉及 1346 名参与者的试验。总体而言，ITF 补充剂可显著降低空腹血糖（FBG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）和稳态模型评估胰岛素抵抗（HOMA-IR）的浓度。在糖尿病前期和 2 型糖尿病（T2DM）人群中，FBG [加权均数差（WMD）：-0.60mmol/L；95%置信区间（CI）：-0.71，-0.48mmol/L；高比例]、HbA1c（WMD：-0.58%；95%CI：-0.83，-0.32%；高比例）、FINS（WMD：-1.75µU/ml；95%CI：-2.87，-0.63µU/ml；低比例）和 HOMA-IR（WMD：-0.69；95%CI：-1.10，-0.28；低比例）的降低更为显著，推荐 ITF 补充剂的每日剂量为 10g，持续时间为 6 周及以上。此外，亚组分析表明，血糖控制的效果受到研究对象的性别以及 ITF 的类型和摄入方式的显著影响。
我们的分析证实，ITF 补充剂可显著降低这四个主要血糖指标，尤其是在糖尿病前期和 T2DM 人群中。有证据表明，合理应用 ITF 补充剂可能具有作为糖尿病前期和 T2DM 管理辅助治疗的潜在临床价值。
该试验于 2018 年 11 月 23 日在 PROSPERO 上以 CRD42018115875 号进行注册。
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