Inner Mongolia Autonomous Region Academy of Traditional Medicine, No. 11 Jian Kang Street, Hohhot, 010020, Inner Mongolia, China.
Inner Mongolia Hospital of traditional Chinese Medicine, Hohhot, 010020, China.
Nutr J. 2020 Dec 1;19(1):130. doi: 10.1186/s12937-020-00647-4.
Chitosan supplementation has been shown to modulate glycemic levels; however, studies have reported conflicting results. The present meta-analysis with trial sequential analysis was conducted to verify the overall influence of chitosan on glycemic levels in patients with metabolic syndrome.
The PubMed, Cochrane library, and EMBASE databases were systematically searched for randomized controlled studies of chitosan intake and glycemic levels.
A total of ten clinical trials including 1473 subjects were included in this meta-analysis. Pooled effect sizes were determined by random-effects meta-analysis. Subgroup analysis was performed to analyze the sources of heterogeneity and their influence on the overall results. The results revealed a significant reduction in fasting glucose levels (SMD: - 0.39 mmol/L, 95% CI: - 0.62 to - 0.16) and hemoglobin A1c (HbA1c) levels (SMD: -1.10; 95% CI: - 2.15 to - 0.06) following chitosan supplementation but no effect on insulin levels (SMD: - 0.20 pmol/L, 95% CI: - 0.64 to 0.24). Subgroup analyses further demonstrated significant reductions in fasting glucose levels in subjects administered 1.6-3 g of chitosan per day and in studies longer than 13 weeks. Trial sequential analysis of the pooled results of the hypoglycemic effect demonstrated that the cumulative Z-curve crossed both the conventional boundary and trial sequential monitoring boundary for glucose and HbA1c.
The glucose level of patients who are diabetic and obese/overweight can be improved by supplementation with chitosan for at least 13 weeks at 1.6-3 g per day. Additional clinical research data are needed to confirm the role of chitosan, particularly in regulating glycosylated hemoglobin and insulin.
壳聚糖补充剂已被证明可调节血糖水平；然而，研究结果却存在差异。本项荟萃分析结合试验序贯分析旨在验证壳聚糖对代谢综合征患者血糖水平的总体影响。
系统检索了 PubMed、Cochrane 图书馆和 EMBASE 数据库中关于壳聚糖摄入和血糖水平的随机对照研究。
共有 10 项临床试验（共 1473 名受试者）纳入本项荟萃分析。采用随机效应荟萃分析确定汇总效应量。进行亚组分析以分析异质性来源及其对总体结果的影响。结果表明，壳聚糖补充后空腹血糖水平（SMD：-0.39 mmol/L，95%CI：-0.62 至-0.16）和糖化血红蛋白（HbA1c）水平（SMD：-1.10；95%CI：-2.15 至-0.06）显著降低，但对胰岛素水平无影响（SMD：-0.20 pmol/L，95%CI：-0.64 至 0.24）。亚组分析进一步表明，每天给予 1.6-3 g 壳聚糖的受试者以及试验持续时间超过 13 周的受试者，空腹血糖水平显著降低。对低血糖作用的汇总结果进行试验序贯分析表明，累积 Z 曲线穿过了血糖和 HbA1c 的常规边界和试验序贯监测边界。
对于肥胖/超重的糖尿病患者，每天补充 1.6-3 g 壳聚糖至少 13 周，可以改善血糖水平。需要更多的临床研究数据来证实壳聚糖的作用，特别是在调节糖化血红蛋白和胰岛素方面。
