Institute of Biomedicine, Department of Medicine, Federal University of Ceara, Fortaleza 60430-270, Brazil.
Postgraduate Medical Sciences Program, Department of Medicine, Federal University of Ceara, Fortaleza 60430-270, Brazil.
Nutrients. 2022 Sep 3;14(17):3649. doi: 10.3390/nu14173649.
Altered intestinal barrier permeability has been associated with obesity and its metabolic and inflammatory complications in animal models. The purpose of this systematic review is to assess the evidence regarding the association between obesity with or without Metabolic Syndrome (MetS) and alteration of the intestinal barrier permeability in humans. A systematic search of the studies published up until April 2022 in Latin America & Caribbean Health Sciences Literature (LILACS), PubMed, Scopus, Embase, and ScienceDirect databases was conducted. The methodological quality of the studies was assessed using the Newcastle-Ottawa scale (NOS) and the Agency for Healthcare Research and Quality (AHRQ) checklist. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to assess the quality of the evidence. Eight studies were included and classified as moderate to high quality. Alteration of intestinal barrier permeability was evaluated by zonulin, lactulose/mannitol, sucralose, sucrose, lactulose/L-rhamnose, and sucralose/erythritol. Impaired intestinal barrier permeability measured by serum and plasma zonulin concentration was positively associated with obesity with MetS. Nonetheless, the GRADE assessment indicated a very low to low level of evidence for the outcomes. Thus, clear evidence about the relationship between alteration of human intestinal barrier permeability, obesity, and MetS was not found.
肠道屏障通透性的改变与肥胖及其在动物模型中的代谢和炎症并发症有关。本系统评价的目的是评估肥胖症(伴或不伴代谢综合征)与人类肠道屏障通透性改变之间关联的证据。对截至 2022 年 4 月在拉丁美洲和加勒比健康科学文献 (LILACS)、PubMed、Scopus、Embase 和 ScienceDirect 数据库中发表的研究进行了系统检索。使用纽卡斯尔-渥太华量表 (NOS) 和医疗保健研究与质量局 (AHRQ) 检查表评估研究的方法学质量。使用推荐评估、制定和评价 (GRADE) 框架评估证据质量。共纳入 8 项研究,分类为中高质量。肠道屏障通透性的改变通过肠通透素、乳果糖/甘露醇、三氯蔗糖、蔗糖、乳果糖/L-鼠李糖、三氯蔗糖/赤藓糖醇来评估。通过血清和血浆肠通透素浓度测量的肠道屏障通透性受损与肥胖伴代谢综合征呈正相关。然而,GRADE 评估表明,这些结果的证据水平非常低至低。因此,没有发现明确的证据表明人类肠道屏障通透性改变、肥胖症和代谢综合征之间的关系。