补充牛奶蛋白对血糖参数的影响：一项 GRADE 评估的系统评价和剂量反应荟萃分析。
Effects of supplementation with milk protein on glycemic parameters: a GRADE-assessed systematic review and dose-response meta-analysis.
机构信息
Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
出版信息
Nutr J. 2023 Oct 6;22(1):49. doi: 10.1186/s12937-023-00878-1.
BACKGROUND
It is suggested that supplementation with milk protein (MP) has the potential to ameliorate the glycemic profile; however, the exact impact and certainty of the findings have yet to be evaluated. This systematic review and dose-response meta-analysis of randomized controlled trials (RCTs) assessed the impact of MP supplementation on the glycemic parameters in adults.
METHODS
A systematic search was carried out among online databases to determine eligible RCTs published up to November 2022. A random-effects model was performed for the meta-analysis.
RESULTS
A total of 36 RCTs with 1851 participants were included in the pooled analysis. It was displayed that supplementation with MP effectively reduced levels of fasting blood glucose (FBG) (weighted mean difference (WMD): -1.83 mg/dL, 95% CI: -3.28, -0.38; P = 0.013), fasting insulin (WMD: -1.06 uU/mL, 95% CI: -1.76, -0.36; P = 0.003), and homeostasis model assessment of insulin resistance (HOMA-IR) (WMD: -0.27, 95% CI: -0.40, -0.14; P < 0.001) while making no remarkable changes in serum hemoglobin A1c (HbA1c) values (WMD: 0.01%, 95% CI: -0.14, 0.16; P = 0.891). However, there was a significant decline in serum levels of HbA1c among participants with normal baseline body mass index (BMI) based on sub-group analyses. In addition, HOMA-IR values were significantly lower in the MP supplement-treated group than their untreated counterparts in short- and long-term supplementation (≤ 8 and > 8 weeks) with high or moderate doses (≥ 60 or 30-60 g/d) of MP or whey protein (WP). Serum FBG levels were considerably reduced upon short-term administration of a low daily dose of WP (< 30 g). Furthermore, the levels of serum fasting insulin were remarkably decreased during long-term supplementation with high or moderate daily doses of WP.
CONCLUSION
The findings of this study suggest that supplementation with MP may improve glycemic control in adults by reducing the values of fasting insulin, FBG, and HOMA-IR. Additional trials with longer durations are required to confirm these findings.
背景
有研究表明，补充牛奶蛋白（MP）有可能改善血糖水平；然而，其确切影响和确定性仍有待评估。本系统评价和剂量-反应荟萃分析对随机对照试验（RCT）进行了评估，以确定 MP 补充对成年人血糖参数的影响。
方法
在在线数据库中进行了系统搜索，以确定截至 2022 年 11 月发表的合格 RCT。对荟萃分析采用随机效应模型。
结果
共有 36 项 RCT 纳入了 1851 名参与者，纳入了汇总分析。结果显示，MP 补充可有效降低空腹血糖（FBG）水平（加权均数差（WMD）：-1.83mg/dL，95%CI：-3.28，-0.38；P=0.013）、空腹胰岛素（WMD：-1.06uU/mL，95%CI：-1.76，-0.36；P=0.003）和稳态模型评估的胰岛素抵抗（HOMA-IR）（WMD：-0.27，95%CI：-0.40，-0.14；P<0.001），而血清血红蛋白 A1c（HbA1c）值无明显变化（WMD：0.01%，95%CI：-0.14，0.16；P=0.891）。然而，基于亚组分析，在基线 BMI 正常的参与者中，HbA1c 血清水平显著下降。此外，在短期和长期（≤8 周和>8 周）补充高或中剂量（≥60 或 30-60g/d）MP 或乳清蛋白（WP）时，MP 补充组的 HOMA-IR 值明显低于未补充组。短期给予低日剂量 WP（<30g）可显著降低血清 FBG 水平。此外，长期补充高或中剂量 WP 可显著降低血清空腹胰岛素水平。
结论
本研究结果表明，MP 补充可能通过降低空腹胰岛素、FBG 和 HOMA-IR 来改善成年人的血糖控制。需要进行更长时间的试验来证实这些发现。
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