Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Food Safety Research Center (Salt), Semnan University of Medical Sciences, Semnan, Iran.
Am J Clin Nutr. 2021 Nov 8;114(5):1675-1685. doi: 10.1093/ajcn/nqab250.
Uncertainty remains about the estimates of the effects for resveratrol supplementation, including the certainty of the evidence for each estimate and the magnitude of the observed impact based on the minimal important difference.
We aimed to provide an overview of the effects of resveratrol supplementation, in comparison to control groups, for the management of cardiometabolic risk factors in patients with type 2 diabetes (T2D), metabolic syndrome (MetS), and nonalcoholic fatty liver disease (NAFLD).
PubMed, Scopus, and ISI Web of Science were searched from inception to May 2021. For each meta-analysis, the mean difference and its 95% CI were recalculated using a random-effects model. The certainty of evidence was rated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach.
We identified 11 meta-analyses corresponding to 29 outcomes in 1476 individuals with T2D, 17 meta-analyses reporting 26 outcomes in 727 participants with the MetS, and 10 meta-analyses reporting 24 outcomes in 271 patients with NAFLD. Resveratrol supplementation had beneficial effects on some outcomes such as blood pressure, lipid profile, glycemic control, and insulin resistance in T2D, waist circumference in MetS, and body-weight and inflammation markers in NAFLD; however, for almost all outcomes, the magnitude of the effect was trivial, the certainty of evidence was very low to low, or the number of trials was too few. In the case of glycated hemoglobin (HbA1c), there was evidence that resveratrol can exert favorable and clinically important effects in the short term (<12 wk; mean difference: -1.05%, 95% CI: -2.09%, -0.02%; n = 6; GRADE = moderate).
Current evidence does not support supplementation with resveratrol for the management of cardiometabolic risk factors in patients with T2D, MetS, and NAFLD. In the case of HbA1c, subject to the limitations such as short-term follow-up and small sample size, there was a clinically important effect. The protocol of the present systematic review was registered in Open Science Framework (https://osf.io/ake85; registration doi: 10.17605/OSF.IO/AKE85).
关于白藜芦醇补充剂的效果评估仍存在不确定性，包括每个评估结果的证据确定性以及基于最小有意义差异的观察到的影响程度。
本研究旨在综述白藜芦醇补充剂与对照组相比，在 2 型糖尿病（T2D）、代谢综合征（MetS）和非酒精性脂肪性肝病（NAFLD）患者的心血管代谢风险因素管理方面的效果。
从建库至 2021 年 5 月，我们在 PubMed、Scopus 和 ISI Web of Science 中进行了检索。对于每个荟萃分析，我们使用随机效应模型重新计算了均数差值及其 95%置信区间。证据确定性采用 GRADE（推荐评估、制定与评价）方法进行评级。
我们共鉴定出 11 项荟萃分析，涉及 1476 例 T2D 患者的 29 项结局，17 项荟萃分析报告了 727 例 MetS 患者的 26 项结局，10 项荟萃分析报告了 271 例 NAFLD 患者的 24 项结局。白藜芦醇补充剂对 T2D 患者的某些结局（如血压、血脂谱、血糖控制和胰岛素抵抗）、MetS 患者的腰围以及 NAFLD 患者的体重和炎症标志物有有益影响；然而，对于几乎所有结局，其影响程度都微不足道，证据确定性非常低至低，或者试验数量太少。在糖化血红蛋白（HbA1c）方面，有证据表明白藜芦醇在短期（<12 周；均数差值：-1.05%，95%置信区间：-2.09%，-0.02%；n=6；GRADE=中等）内可以产生有利的、具有临床意义的效果。
目前的证据不支持在 T2D、MetS 和 NAFLD 患者中使用白藜芦醇补充剂来管理心血管代谢风险因素。在 HbA1c 方面，鉴于短期随访和样本量小等局限性，存在具有临床意义的效果。本系统评价的方案已在开放科学框架（https://osf.io/ake85；注册 doi：10.17605/OSF.IO/AKE85）中注册。
