Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran; Department of Epidemiology and Biostatistics, School of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran.
Complement Ther Med. 2021 Jan;56:102597. doi: 10.1016/j.ctim.2020.102597. Epub 2020 Oct 24.
Inflammation is the main cause in the development of chronic diseases. The enhancement of pro-inflammatory factors, such as tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP) is the main risk factor in chronic diseases. Resistant starch type 2 (RS2) is non-gelatinized granules which their enzymatic hydrolysis is very low. RS2 might be able to reduce inflammatory mediators, therefore; our aim for this study was indicating RS2 effects on inflammatory mediators such as IL-6, TNF-a, and CRP among healthy and unhealthy subjects.
Articles which assessed RS2 effect on IL-6, TNF-α, and hs-CRP were found by advanced search methods. Electronic databases including Google scholar, ISI web of science, SCOPUS, and PubMed, were searched up to October 2019. Treatment effect was the mean difference between changes in serum levels of inflammatory biomarkers in each arm of the clinical trials. To pool the effect of resistant starch on inflammatory biomarkers, we used random effects model.
We included eight articles in systematic review and meta-analysis. The overall effect illustrated no significant change in serum levels of hs-CRP, IL-6, and TNF-α in intervention group compared with the control group (WMD: -7.18 pg/mL, 95% CI: -27.80, 13.45; P = 0.495, I = 100.0%, WMD: -0.003 pg/mL, 95% CI: -0.07, 0.06; P = 0.919, I = 98.1%, WMD: -0.003 pg/mL, 95% CI: -0.004, -0.001; P < 0.0001, I = 98.0% respectively).
In conclusion, we found that RS2 could not reduce inflammatory mediators, but we still need more RCTs with longer intervention duration, higher dose, and studies in different countries.
炎症是慢性疾病发展的主要原因。促炎因子（如肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和高敏 C 反应蛋白（hs-CRP））的增强是慢性疾病的主要危险因素。类型 2 抗性淀粉（RS2）是未胶凝的颗粒，其酶解非常低。RS2 可能能够降低炎症介质，因此；我们的目的是研究 RS2 对健康和不健康受试者的 IL-6、TNF-a 和 CRP 等炎症介质的影响。
通过高级搜索方法查找评估 RS2 对 IL-6、TNF-α 和 hs-CRP 影响的文章。电子数据库包括 Google Scholar、ISI Web of Science、SCOPUS 和 PubMed，搜索截至 2019 年 10 月。治疗效果是临床试验中每个手臂血清炎症生物标志物变化的均数差值。为了汇总抗性淀粉对炎症生物标志物的影响，我们使用了随机效应模型。
我们对系统评价和荟萃分析纳入了 8 篇文章。总体效果表明，与对照组相比，干预组血清 hs-CRP、IL-6 和 TNF-α 水平无显著变化（WMD：-7.18pg/mL，95%CI：-27.80，13.45；P=0.495，I=100.0%，WMD：-0.003pg/mL，95%CI：-0.07，0.06；P=0.919，I=98.1%，WMD：-0.003pg/mL，95%CI：-0.004，-0.001；P<0.0001，I=98.0%）。
总之，我们发现 RS2 不能降低炎症介质，但我们仍需要更多具有更长干预时间、更高剂量和在不同国家进行的 RCT 研究。
