（多）酚类物质与抗糖尿病药物联合干预对 2 型糖尿病管理的效果：随机对照人体临床试验的荟萃分析。

Combined effect of interventions with pure or enriched mixtures of (poly)phenols and anti-diabetic medication in type 2 diabetes management: a meta-analysis of randomized controlled human trials.

机构信息

iBET, Instituto de Biologia Experimental e Tecnológica, Apartado 12, 2781-901, Oeiras, Portugal.

CEDOC, Chronic Diseases Research Centre, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056, Lisbon, Portugal.

出版信息

Eur J Nutr. 2020 Jun;59(4):1329-1343. doi: 10.1007/s00394-020-02189-1. Epub 2020 Feb 12.

DOI:10.1007/s00394-020-02189-1

PMID:32052147

Abstract

PURPOSE

(Poly)phenols have been reported to confer protective effects against type 2 diabetes but the precise association remains elusive. This meta-analysis aimed to assess the effects of (poly)phenol intake on well-established biomarkers in people with type 2 diabetes or at risk of developing diabetes.

METHODS

A systematic search was conducted using the following selection criteria: (1) human randomized controlled trials involving individuals with prediabetes and type 2 diabetes; (2) one or more of the following biomarkers: glucose, glycated haemoglobin (HbA1c), insulin, pro-insulin, homeostatic model assessment of insulin resistance (HOMA-IR), islet amyloid polypeptide (IAPP)/amylin, pro-IAPP/pro-amylin, glucagon, C-peptide; (3) chronic intervention with pure or enriched mixtures of (poly)phenols. From 488 references, 88 were assessed for eligibility; data were extracted from 27 studies and 20 were used for meta-analysis. The groups included in the meta-analysis were: (poly)phenol mixtures, isoflavones, flavanols, anthocyanins and resveratrol.

RESULTS

Estimated intervention/control mean differences evidenced that, overall, the consumption of (poly)phenols contributed to reduced fasting glucose levels (- 3.32 mg/dL; 95% CI - 5.86, - 0.77; P = 0.011). Hb1Ac was only slightly reduced (- 0.24%; 95% CI - 0.43, - 0.044; P = 0.016) whereas the levels of insulin and HOMA-IR were not altered. Subgroup comparative analyses indicated a stronger effect on blood glucose in individuals with diabetes (- 5.86 mg/dL, 95% CI - 11.34, - 0.39; P = 0.036) and this effect was even stronger in individuals taking anti-diabetic medication (- 10.17 mg/dL, 95% CI - 16.59, - 3.75; P = 0.002).

CONCLUSIONS

Our results support that the consumption of (poly)phenols may contribute to lower glucose levels in individuals with type 2 diabetes or at risk of diabetes and that these compounds may also act in combination with anti-diabetic drugs.

摘要

目的

（多）酚类已被报道具有预防 2 型糖尿病的保护作用，但确切的关联仍不清楚。本荟萃分析旨在评估（多）酚类摄入对 2 型糖尿病或糖尿病前期人群中已建立的生物标志物的影响。

方法

使用以下选择标准进行系统搜索：（1）涉及糖尿病前期和 2 型糖尿病个体的人类随机对照试验；（2）以下一种或多种生物标志物：葡萄糖、糖化血红蛋白（HbA1c）、胰岛素、前胰岛素、胰岛素抵抗稳态模型评估（HOMA-IR）、胰岛淀粉样多肽（IAPP）/胰岛素原、前胰岛素原/胰岛素原、胰高血糖素、C 肽；（3）用纯（多）酚或富含（多）酚的混合物进行慢性干预。从 488 篇参考文献中，有 88 篇被评估为符合条件；从 27 项研究中提取数据，其中 20 项用于荟萃分析。荟萃分析纳入的组包括：（多）酚混合物、异黄酮、黄烷醇、花青素和白藜芦醇。

结果

总体而言，干预/对照估计均值差异表明，（多）酚类物质的摄入有助于降低空腹血糖水平（-3.32mg/dL；95%置信区间-5.86，-0.77；P=0.011）。Hb1Ac 仅略有降低（-0.24%；95%置信区间-0.43，-0.044；P=0.016），而胰岛素和 HOMA-IR 水平没有改变。亚组比较分析表明，在糖尿病患者中对血糖的影响更强（-5.86mg/dL，95%置信区间-11.34，-0.39；P=0.036），而在服用抗糖尿病药物的患者中，这种作用更强（-10.17mg/dL，95%置信区间-16.59，-3.75；P=0.002）。