Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China 646000.
Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
J Diabetes Res. 2022 Jul 18;2022:1861009. doi: 10.1155/2022/1861009. eCollection 2022.
Chronic kidney disease (CKD) is a main health problem associated with increased risk of cardiovascular disease, morbidity, and mortality. Recent studies shown that the progression of CKD may be related to the change of intestinal flora. Resistant starch (RS) is a type of dietary fiber that can act as a substrate for microbial fermentation. Some studies have found that the supplementation of RS can improve the intestinal flora disorder in CKD patients. However, the specific effect of RS on CKD patients remains controversial.
We designed this meta-analysis to identify and assess the effects of RS on patients with CKD.
A comprehensive search of MEDLINE, Embase, Web of Science, and Cochrane systematic review databases was conducted in January 2020, and all new trials were updated in August 2021. Randomized trials were collected to assess the effects of RS on patients with CKD. The weighted average effect size of the net change was calculated by using the random-effects model.
The meta-analysis included 8 studies involving 301 participants. RS intake significantly reduced serum indolephenol sulfate (IS), blood phosphorus, IL-6, and uric acid levels in dialysis patients. The mean difference (MD) of serum IS ( = 0.0002) in the dialysis subgroup was -12.57 mol/L (95% CI: -19.28, -5.86 mol/L). The MD of blood phosphorus ( = 0.03) was -0.39 mg/dl (95% CI: -0.78, -0.01 mg/dl). The MD of serum uric acid ( = 0.004) between the dialysis subgroup and the nondialysis subgroup was -31.58 mmol/L (95% CI: -52.99, -10.17 mmol/L). The mean difference (MD) of IL-6 ( = 0.02) in the dialysis subgroup was -1.16 mol/L (95% CI: -2.16, -0.16 mol/L). However, there was no significant change of RS on hs-CRP, serum creatinine, blood urea nitrogen (BUN), blood paracresol sulfate, and blood lipid.
The intake of RS reduced the serum IS, serum phosphorus, IL-6, and uric acid levels significantly in dialysis patients, while hs-CRP, serum creatinine, BUN, serum paracresol sulfate, and blood lipid showed no significant changes.
慢性肾脏病（CKD）是与心血管疾病风险增加、发病率和死亡率相关的主要健康问题。最近的研究表明，CKD 的进展可能与肠道菌群的变化有关。抗性淀粉（RS）是一种膳食纤维，可作为微生物发酵的底物。一些研究发现，RS 的补充可以改善 CKD 患者的肠道菌群失调。然而，RS 对 CKD 患者的具体作用仍存在争议。
我们设计了这项荟萃分析，以确定和评估 RS 对 CKD 患者的影响。
我们于 2020 年 1 月全面检索了 MEDLINE、Embase、Web of Science 和 Cochrane 系统评价数据库，并于 2021 年 8 月更新了所有新试验。收集随机试验以评估 RS 对 CKD 患者的影响。使用随机效应模型计算净变化的加权平均效应大小。
荟萃分析纳入了 8 项研究，共 301 名参与者。RS 摄入可显著降低透析患者的血清吲哚酚硫酸酯（IS）、血磷、IL-6 和尿酸水平。透析亚组血清 IS 的平均差值（MD）为 -0.0002，为 -12.57 μmol/L（95%CI：-19.28，-5.86 μmol/L）。血磷的 MD 为 -0.03，为 -0.39mg/dl（95%CI：-0.78，-0.01mg/dl）。透析亚组与非透析亚组之间血清尿酸的 MD 为 -0.004，为 -31.58mmol/L（95%CI：-52.99，-10.17mmol/L）。透析亚组的 IL-6 的 MD 为 -0.02，为 -1.16 μmol/L（95%CI：-2.16，-0.16 μmol/L）。然而，RS 对 hs-CRP、血清肌酐、血尿素氮（BUN）、血对羟苯甲硫酸酯和血脂没有显著影响。
RS 摄入可显著降低透析患者的血清 IS、血清磷、IL-6 和尿酸水平，而 hs-CRP、血清肌酐、BUN、血清对羟苯甲硫酸酯和血脂无显著变化。
