杏仁对 2 型糖尿病患者肠道微生物群、糖代谢和炎症标志物的影响：系统评价和随机对照试验的荟萃分析。

The Effects of Almonds on Gut Microbiota, Glycometabolism, and Inflammatory Markers in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

机构信息

Faculty of Education, Health and Human Sciences, School of Health Sciences, University of Greenwich, Avery Hill Campus, Avery Hill Road, London SE9 2UG, UK.

The School of Nursing, Soochow University, Suzhou 215006, China.

出版信息

Nutrients. 2021 Sep 26;13(10):3377. doi: 10.3390/nu13103377.

UNLABELLED

The use of nutritional interventions for managing diabetes is one of the effective strategies aimed at reducing the global prevalence of the condition, which is on the rise. Almonds are the most consumed tree nut and they are known to be rich sources of protein, monounsaturated fatty acids, essential minerals, and dietary fibre. Therefore, the aim of this review was to evaluate the effects of almonds on gut microbiota, glycometabolism, and inflammatory parameters in patients with type 2 diabetes.

METHODS

This systematic review and meta-analysis was carried out according to the preferred reporting items for systematic review and meta-analysis (PRISMA). EBSCOhost, which encompasses the Health Sciences Research Databases; Google Scholar; EMBASE; and the reference lists of articles were searched based on population, intervention, control, outcome, and study (PICOS) framework. Searches were carried out from database inception until 1 August 2021 based on medical subject headings (MesH) and synonyms. The meta-analysis was carried out with the Review Manager (RevMan) 5.3 software.

RESULTS

Nine randomised studies were included in the systematic review and eight were used for the meta-analysis. The results would suggest that almond-based diets have significant effects in promoting the growth of short-chain fatty acid (SCFA)-producing gut microbiota. Furthermore, the meta-analysis showed that almond-based diets were effective in significantly lowering ( < 0.05) glycated haemoglobin (HbA1c) levels and body mass index (BMI) in patients with type 2 diabetes. However, it was also found that the effects of almonds were not significant ( > 0.05) in relation to fasting blood glucose, 2 h postprandial blood glucose, inflammatory markers (C-reactive protein and Tumour necrosis factor α, TNF-α), glucagon-like peptide-1 (GLP-1), homeostatic model assessment of insulin resistance (HOMA-IR), and fasting insulin. The biological mechanisms responsible for the outcomes observed in this review in relation to reduction in HbA1c and BMI may be based on the nutrient composition of almonds and the biological effects, including the high fibre content and the low glycaemic index profile.

CONCLUSION

The findings of this systematic review and meta-analysis have shown that almond-based diets may be effective in promoting short-chain fatty acid-producing bacteria and lowering glycated haemoglobin and body mass index in patients with type 2 diabetes compared with control. However, the effects of almonds were not significant ( > 0.05) with respect to fasting blood glucose, 2 h postprandial blood glucose, inflammatory markers (C-reactive protein and TNF-α), GLP-1, HOMA-IR, and fasting insulin.

目的

评估杏仁对 2 型糖尿病患者肠道微生物群、糖代谢和炎症参数的影响。

方法

本系统评价和荟萃分析根据系统评价和荟萃分析的首选报告项目（PRISMA）进行。根据人群、干预、对照、结局和研究（PICOS）框架，检索 EBSCOhost 涵盖的健康科学研究数据库；Google Scholar；EMBASE；和文章的参考文献列表。基于医学主题词（MesH）和同义词，从数据库开始搜索到 2021 年 8 月 1 日。荟萃分析使用 Review Manager（RevMan）5.3 软件进行。

结果

共纳入 9 项随机研究进行系统评价，8 项用于荟萃分析。结果表明，杏仁饮食对促进短链脂肪酸（SCFA）产生肠道微生物群的生长有显著影响。此外，荟萃分析显示，杏仁饮食在降低 2 型糖尿病患者糖化血红蛋白（HbA1c）和体重指数（BMI）方面具有显著效果（<0.05）。然而，也发现杏仁在空腹血糖、餐后 2 小时血糖、炎症标志物（C 反应蛋白和肿瘤坏死因子-α，TNF-α）、胰高血糖素样肽-1（GLP-1）、稳态模型评估的胰岛素抵抗（HOMA-IR）和空腹胰岛素方面的影响不显著（>0.05）。本综述中观察到的与 HbA1c 和 BMI 降低相关的结果的生物学机制可能基于杏仁的营养成分和生物学效应，包括高纤维含量和低血糖指数谱。