Ebada Mahmoud Ahmed, Fayed Notila, Fayed Laila, Alkanj Souad, Abdelkarim Ahmed, Farwati Haya, Hanafy Aya, Negida Ahmed, Ebada Mohamed, Noser Yousef
Faculty of Medicine, Zagazig University, Zagazig, El-Sharkia, Egypt.
Al-Ahrar Teaching Hospital, Zagazig, El-Sharkia, Egypt.
Iran J Pharm Res. 2019 Fall;18(4):2144-2156. doi: 10.22037/ijpr.2019.1100842.
Alpha-lipoic acid (ALA) is a naturally-occurring compound that has shown promising antioxidant and anti-inflammatory effects in experimental and human studies. The aim of this study was to assess the efficacy of ALA in the management of patients with diabetes mellitus (DM). We searched Medline (via PubMed), EBSCO, Scopus, and Web of Science for relevant randomized controlled trials. Data on glycated hemoglobin (HbA1c), blood glucose levels, lipid profile components, HOMA, and glutathione peroxidase (GPx) were extracted and pooled as the standardized mean difference (SMD) in a random effect model meta-analysis using RevMan version 5.3. Ten studies (n = 553 patients) were included. In the term of HBA1C, the overall SMD did not favor either of the two groups (SMD = 0.01, 95% CI [-0.32,0.35]; = 0.94) in uncomplicated T2DM patients. Moreover, there was no statistically significant difference between the two groups in terms of FBG (SMD = -0.06, 95% CI [-0.44,0.33]; = 0.78), PPBG (SMD = 0.04, 95% CI [-0.27,0.34]; = 0.82), HDL (SMD = -0.05, 95% CI [-0.35,0.25]; = 0.75), LDL (SMD = -0.05, 95% CI [-0.33,0.23]; = 0.75). In terms of GPx, ALA was superior to placebo (SMD = 0.43, 95% CI [0.07,0.8]; = 0.02). Our analysis showed that ALA was not superior to placebo in terms of HBA1C, LDL, HDL, TC, TG reduction in uncomplicated T2DM. However, in terms of GPx, ALA was significantly superior to the placebo. Further studies with larger sample sizes should investigate different doses of ALA in DM patients.
α-硫辛酸（ALA）是一种天然存在的化合物，在实验研究和人体研究中已显示出有前景的抗氧化和抗炎作用。本研究的目的是评估ALA在糖尿病（DM）患者管理中的疗效。我们在医学文献数据库（通过PubMed）、EBSCO、Scopus和科学网中检索了相关的随机对照试验。提取糖化血红蛋白（HbA1c）、血糖水平、血脂谱成分、稳态模型评估（HOMA）和谷胱甘肽过氧化物酶（GPx）的数据，并在使用RevMan 5.3版本的随机效应模型荟萃分析中汇总为标准化均数差（SMD）。纳入了10项研究（n = 553例患者）。在未合并并发症的2型糖尿病患者中，就HbA1c而言，总体SMD对两组均无显著倾向（SMD = 0.01，95%置信区间[-0.32,0.35]；P = 0.94）。此外，两组在空腹血糖（FBG，SMD = -0.06，95%置信区间[-0.44,0.33]；P = 0.78）、餐后血糖（PPBG，SMD = 0.04，95%置信区间[-0.27,0.34]；P = 0.82）、高密度脂蛋白（HDL，SMD = -0.05，95%置信区间[-0.35,0.25]；P = 0.75）、低密度脂蛋白（LDL，SMD = -0.05，95%置信区间[-0.33,0.23]；P = 0.75）方面均无统计学显著差异。就GPx而言，ALA优于安慰剂（SMD = 0.43，95%置信区间[0.07,0.8]；P = 0.02）。我们的分析表明，在未合并并发症的2型糖尿病患者中，ALA在降低HbA1c、LDL、HDL、总胆固醇（TC）、甘油三酯（TG）方面并不优于安慰剂。然而，就GPx而言，ALA显著优于安慰剂。应进行更大样本量的进一步研究，以调查不同剂量的ALA在糖尿病患者中的作用。
