Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Nutrition, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
Phytother Res. 2022 May;36(5):1839-1853. doi: 10.1002/ptr.7365. Epub 2022 Apr 20.
An enhanced risk for cardiovascular disease (CVD) still exists even when T2DM patients have tight control on blood sugar. Thus, identification of treatment approaches that address CVD risk factors may be useful for patients beyond the blood sugar management. Although emerging evidence suggests that nuts consumption have beneficial effects on cardiometabolic health, the effects of almond intake in patients with type 2 diabetes are still controversial. Therefore, our objective was to investigate the effect of almond on cardiometabolic outcomes in patients with T2DM through a systematic review and meta-analysis of available randomized controlled trials (RCTs). A systematic search was conducted in PubMed, Web of Science, Scopus, Embase, and Google Scholar to identify relevant RCTs up to March 2021. There was no language and time limitation. Weighted mean difference (WMD) was pooled using a random effects model. Heterogeneity, sensitivity analysis, and publication bias were reported using standard methods. Nine RCTs were included in the final analysis. Almond intake resulted in significant reduction in low-density lipoprotein cholesterol (LDL-C) (WMD: -5.28 mg/dL; 95% CI, -9.92, -0.64; p = .026) compared with the control group. This lowering effect of LDL-C was robust in subgroups with almond consumption >50 g/day, and baseline LDL-C level <130 mg/dL. However, the effect of almond on total cholesterol, triglycerides, high-density lipoprotein cholesterol, fasting plasma glucose, insulin, hemoglobin A1c, body mass index, weight, body fat, systolic and diastolic blood pressure, and CRP was not significant compared with the control group. In summary, the current meta-analysis indicated that almond consumption decreased LDL-C, and had no favorable effect on other cardiometabolic outcomes in patients with T2DM. However, further high-quality studies are needed to firmly establish the clinical efficacy of the almond.
即使 2 型糖尿病患者血糖控制得很严格，他们患心血管疾病（CVD）的风险仍然会增加。因此，确定可以解决 CVD 风险因素的治疗方法可能对血糖管理之外的患者有用。尽管有新的证据表明，食用坚果对心脏代谢健康有益，但杏仁摄入量对 2 型糖尿病患者的影响仍存在争议。因此，我们的目的是通过对现有随机对照试验（RCT）的系统评价和荟萃分析，研究杏仁对 2 型糖尿病患者心脏代谢结局的影响。我们在 PubMed、Web of Science、Scopus、Embase 和 Google Scholar 中进行了系统检索，以确定截至 2021 年 3 月的相关 RCT。没有语言和时间限制。使用随机效应模型汇总加权均数差（WMD）。使用标准方法报告异质性、敏感性分析和发表偏倚。最终分析纳入了 9 项 RCT。与对照组相比，杏仁摄入可显著降低低密度脂蛋白胆固醇（LDL-C）（WMD：-5.28mg/dL；95%CI，-9.92，-0.64；p=0.026）。这种 LDL-C 的降低作用在杏仁摄入量>50g/天和基线 LDL-C水平<130mg/dL 的亚组中是稳健的。然而，与对照组相比，杏仁对总胆固醇、甘油三酯、高密度脂蛋白胆固醇、空腹血糖、胰岛素、糖化血红蛋白 A1c、体重指数、体重、体脂、收缩压和舒张压以及 CRP 没有显著影响。总之，目前的荟萃分析表明，杏仁摄入可降低 LDL-C，但对 2 型糖尿病患者的其他心脏代谢结局没有有利影响。然而，需要进一步的高质量研究来确定杏仁的临床疗效。
