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石器时代饮食对代谢紊乱患者葡萄糖代谢和血脂谱的影响:系统评价和随机对照试验的荟萃分析。

The effect of paleolithic diet on glucose metabolism and lipid profile among patients with metabolic disorders: a systematic review and meta-analysis of randomized controlled trials.

机构信息

Faculty of Public Health Branch, Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.

Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Crit Rev Food Sci Nutr. 2022;62(17):4551-4562. doi: 10.1080/10408398.2021.1876625. Epub 2021 Jan 25.

Abstract

OBJECTIVE

Several randomized clinical trials (RCTs) have investigated the effects of the Paleolithic diet (PD) in adult patients suffering from metabolic disorders. However, the results of these RCTs are conflicting. Therefore, we conducted a systematic review and meta-analysis to assess the effects of the PD in patients with metabolic disorders.

METHODS

We searched the PubMed/Medline, Scopus, Cochrane Databases, Google Scholar, Web of Science, and Embase databases up to June, 2020. The data were pooled using a random-effects model. From the eligible publications, 10 articles were selected for inclusion in this systematic review and meta-analysis. The meta-analysis was performed using a random-effects model. The heterogeneity was determined using the I statistics and the Cochrane Q test.

RESULTS

The pooled results from the random-effects model showed a significant reduction of the homeostatic model assessment of insulin resistance (HOMA-IR) (weighted mean difference, WMD: -0.39, 95% CI: -0.70, -0.08), fasting insulin (WMD: -12.17 μU/mL, 95% CI: -24.26, -0.08), total cholesterol (WMD: -0.32 mmol/l, 95% CI: -0.49, -0.15), triglycerides (WMD: -0.29 mmol/L, 95% CI: -0.42, -0.16), low-density lipoprotein cholesterol (WMD: -0.35 mmol/L, 95% CI: -0.67, -0.03), blood pressure (BP)(WMD - 5.89 mmHg; 95% CI - 9.973 to - 1.86 for the systolic BP and WMD - 4.01 mmHg; 95% CI - 6.21 to - 1.80 for the diastolic BP values) and C-reactive protein (CRP) levels (WMD: -0.84, mg/L, 95% CI: -1.62, -0.06) in the PD group control group.

CONCLUSIONS

Our findings provide better insights into the effect of the PD on the modulation of the glucose and lipid metabolism factors in patients with metabolic disorders, providing comprehensive information for the development of future RCTs with a high quality design.

摘要

目的

几项随机临床试验(RCT)已经研究了旧石器饮食(PD)对患有代谢紊乱的成年患者的影响。然而,这些 RCT 的结果存在冲突。因此,我们进行了系统评价和荟萃分析,以评估 PD 对代谢紊乱患者的影响。

方法

我们检索了 PubMed/Medline、Scopus、Cochrane 数据库、Google Scholar、Web of Science 和 Embase 数据库,截至 2020 年 6 月。使用随机效应模型对数据进行汇总。从合格的出版物中,选择了 10 篇文章纳入本系统评价和荟萃分析。使用随机效应模型进行荟萃分析。使用 I 统计量和 Cochrane Q 检验确定异质性。

结果

随机效应模型的汇总结果显示,胰岛素抵抗的稳态模型评估(HOMA-IR)(加权均数差,WMD:-0.39,95%CI:-0.70,-0.08)、空腹胰岛素(WMD:-12.17μU/mL,95%CI:-24.26,-0.08)、总胆固醇(WMD:-0.32mmol/l,95%CI:-0.49,-0.15)、甘油三酯(WMD:-0.29mmol/L,95%CI:-0.42,-0.16)、低密度脂蛋白胆固醇(WMD:-0.35mmol/L,95%CI:-0.67,-0.03)、血压(BP)(WMD-5.89mmHg;95%CI-9.973 至-1.86,收缩压 WMD-4.01mmHg;95%CI-6.21 至-1.80,舒张压值)和 C 反应蛋白(CRP)水平(WMD:-0.84mg/L,95%CI:-1.62,-0.06)在 PD 组与对照组之间存在差异。

结论

我们的研究结果提供了对 PD 调节代谢紊乱患者糖脂代谢因子影响的更深入了解,为高质量设计的未来 RCT 提供了全面的信息。

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