间歇性禁食方案对非酒精性脂肪性肝病患者血糖、肝脏、人体测量学和临床标志物的影响：随机对照试验的系统评价和荟萃分析。
Effects of intermittent fasting regimens on glycemic, hepatic, anthropometric, and clinical markers in patients with non-alcoholic fatty liver disease: Systematic review and meta-analysis of randomized controlled trials.
机构信息
Department of Biochemistry, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia; Oncology Diagnostic Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
School of Medicine, Federal University of Uberlandia (UFU), Uberlandia 38408-100, Brazil.
出版信息
Clin Nutr ESPEN. 2024 Feb;59:70-80. doi: 10.1016/j.clnesp.2023.11.009. Epub 2023 Nov 28.
OBJECTIVES
Intermittent fasting (IF) regimens have been hypothesized to influence several markers of cardiometabolic and liver function. The objective of our meta-analysis was to investigate the impact of IF regimens on cardiometabolic and liver markers in subjects diagnosed with non-alcoholic fatty liver disease (NAFLD).
METHODS
We searched several online databases (PubMed/Medline, Web of Science, Scopus and Embase) in order to identify suitable publications for inclusion in the meta-analysis. Results were expressed as weighted mean differences (WMD).
RESULTS
From 12343 articles identified in different databases, a total of 7 RCT arms were entered into the quantitative synthesis. The manuscripts were published between 2019 and 2023. IF regimens (the 5:2 diet, 16/8 time-restricting feeding, and alternate day fasting) varied from 2 months to 3 months. IF regimens reduced steatosis scores (WMD: -33.22 CAP dB/m, 95 % CI: -50.72 to -15.72), anthropometric characteristics of obesity (WMD: -0.77 kg/m, 95 % CI: -1.38 to -0.17 for body mass index; WMD: -3.16 kg, 95 % CI: -4.71 to -1.61 for body weight; WMD: -1.90 kg, 95 % CI: -3.51 to -0.29 for waist circumference), as well as ALT (WMD: -9.10 U/L, 95 % CI: -12.45 to -5.75), triglyceride (WMD: -20.83 mg/dl, 95 % CI: -39.01 to -2.66), total cholesterol (WMD: -7.80 mg/dl, 95 % CI: -15.18), HbA1c (WMD: -0.14 %, 95 % CI: -0.20 to -0.08) and HOMA-IR (WMD: -1.21, 95 % CI: -2.08 to -0.34) levels versus controls. Nevertheless, no between-group differences were detected for other biomarkers, e.g., fasting blood glucose, insulin, AST, HDL-C or LDL-C values, and fibrosis scores.
CONCLUSION
IF regimens can improve some markers of cardiometabolic and liver function in patients with NAFLD. However, the available evidence to support the benefits of IF regimens is limited and derived from a small number of studies, thus further research is needed to clarify the impact of IF on the cardiometabolic health of NAFLD patients.
目的
间歇性禁食（IF）方案被假设会影响心血管代谢和肝功能的几个标志物。本荟萃分析的目的是研究 IF 方案对诊断为非酒精性脂肪性肝病（NAFLD）患者的心血管代谢和肝脏标志物的影响。
方法
我们检索了几个在线数据库（PubMed/Medline、Web of Science、Scopus 和 Embase），以确定纳入荟萃分析的合适出版物。结果表示为加权均数差（WMD）。
结果
从不同数据库中识别出的 12343 篇文章中，共有 7 项 RCT 臂被纳入定量综合分析。这些手稿发表于 2019 年至 2023 年。IF 方案（5:2 饮食、16/8 限时喂养和隔日禁食）从 2 个月到 3 个月不等。IF 方案降低了脂肪变性评分（WMD：-33.22 CAP dB/m，95%CI：-50.72 至-15.72）、肥胖的人体测量特征（WMD：-0.77 kg/m，95%CI：-1.38 至-0.17 体重指数；WMD：-3.16 kg，95%CI：-4.71 至-1.61 体重；WMD：-1.90 kg，95%CI：-3.51 至-0.29 腰围），以及 ALT（WMD：-9.10 U/L，95%CI：-12.45 至-5.75）、甘油三酯（WMD：-20.83 mg/dl，95%CI：-39.01 至-2.66）、总胆固醇（WMD：-7.80 mg/dl，95%CI：-15.18）、HbA1c（WMD：-0.14%，95%CI：-0.20 至-0.08）和 HOMA-IR（WMD：-1.21，95%CI：-2.08 至-0.34）水平与对照组相比。然而，对于其他生物标志物，如空腹血糖、胰岛素、AST、HDL-C 或 LDL-C 值和纤维化评分，未检测到组间差异。
结论
IF 方案可改善 NAFLD 患者的一些心血管代谢和肝功能标志物。然而，支持 IF 方案益处的证据有限，且源自少数研究，因此需要进一步研究来阐明 IF 对 NAFLD 患者心血管代谢健康的影响。
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