饮食中不同比例大豆蛋白对2型糖尿病肾病患者影响的比较：系统评价与网状Meta分析

Comparison of the effects of different percentages of soy protein in the diet on patients with type 2 diabetic nephropathy: systematic reviews and network meta-analysis.

作者信息

Sun Jun, Wei Yu, Miao Runyu, Zhang Xiangyuan, Zhang Boxun, Zhang Lili, Zhao Linhua

机构信息

Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Changchun, China.

Institute of Metabolic Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

出版信息

Front Nutr. 2023 Aug 24;10:1184337. doi: 10.3389/fnut.2023.1184337. eCollection 2023.

DOI:10.3389/fnut.2023.1184337

PMID:37693248

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10484530/

Abstract

BACKGROUND

Dietary soy protein (SP) is a potential intervention for protecting the kidneys and improving glucose and lipid metabolism. However, whether this effect is related to the percentage of SP intake remains unclear.

OBJECTIVE

This study aims to review and analyze the results of randomized clinical trials (RCTs) in patients with type 2 diabetic nephropathy (T2DN) who received diets with different percentages of SP.

METHODS

The databases: PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, China National Knowledge Infrastructure (CNKI), Chinese BioMedical Literature Database (CBM), WanFang, Weipu (VIP), and ClinicalTrials.gov were searched until February 2023, for RCTs on T2DN and SP.

RESULTS

A total of six studies comprising 116 participants were included. The interventions were classified as 0% SP, 35% SP, and 100% SP. To improve serum creatinine (Scr), blood urea nitrogen (BUN), 24-h urine total protein (24hUTP), and glomerular filtration rate (GFR), a 35% SP diet was the most effective, compared to a 0% SP diet, which showed a mean difference of -154.00 (95% confidence interval: -266.69, -41.31) for 24hUTP. Although it had significant benefits for 24hUTP, great heterogeneity was observed. To improve the glycolipid metabolism-related markers such as cholesterol (CHO), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FPG), and weight, the 35% SP diet demonstrated superior efficacy compared to the 0% SP diet. Specifically, the mean difference for CHO was -0.55 (95% confidence interval: -1.08, -0.03), and for LDL-C, it was -17.71 (95% confidence interval: -39.67, -4.24). The other indicators were not statistically significant. Most studies had concerns regarding the risk of bias.

CONCLUSION

The findings of this study demonstrate that both 35% and 100% SP diets are more effective than a diet with no SP in improving renal function and glucolipid metabolism in patients with T2DN. As a result, a diet incorporating 35% SP may be the optimal choice for individuals with T2DN.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=352638, identifier CRD42022352638.

摘要

背景

膳食大豆蛋白（SP）是一种保护肾脏及改善糖脂代谢的潜在干预措施。然而，这种效果是否与SP摄入量的百分比有关尚不清楚。

目的

本研究旨在回顾和分析2型糖尿病肾病（T2DN）患者接受不同SP百分比饮食的随机临床试验（RCT）结果。

方法

检索了以下数据库：PubMed、Embase、Cochrane对照试验中央注册库（CENTRAL）、科学网、中国知网（CNKI）、中国生物医学文献数据库（CBM）、万方、维普（VIP）和ClinicalTrials.gov，检索截至2023年2月的关于T2DN和SP的RCT。

结果

共纳入6项研究，116名参与者。干预措施分为0%SP、35%SP和100%SP。为改善血清肌酐（Scr）、血尿素氮（BUN）、24小时尿总蛋白（24hUTP）和肾小球滤过率（GFR），与0%SP饮食相比，35%SP饮食最有效，24hUTP的平均差异为-154.00（95%置信区间：-266.69，-41.31）。尽管其对24hUTP有显著益处，但观察到很大的异质性。为改善胆固醇（CHO）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、空腹血糖（FPG）和体重等糖脂代谢相关指标，35%SP饮食比0%SP饮食显示出更好的疗效。具体而言，CHO的平均差异为-0.55（95%置信区间：-1.08，-0.03），LDL-C的平均差异为-17.71（95%置信区间：-39.67，-4.24）。其他指标无统计学意义。大多数研究对偏倚风险存在担忧。