Zhang Mei, Yang Fan, Feng Qiu, Ou Yanghong, Zhang Jiaxing, Wan Haiyan, Cao Hongyi, Ning Peng
Department of Endocrine and Metabolism, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Geriatric Diseases Institute of Chengdu, Chengdu, China.
Diabetol Metab Syndr. 2024 Jan 22;16(1):25. doi: 10.1186/s13098-024-01266-3.
Abnormalities in glucose and lipid metabolism contribute to the progression and exacerbation of type 2 diabetes mellitus (T2DM). Fish oil and probiotics are dietary supplements that have the potential to improve glucose and lipid metabolism. However, their efficacy remains unclear in T2DM patients.
PubMed, Embase, and the Cochrane Library were retrieved to collect randomized controlled trials (RCTs) on the efficacy of fish oil or probiotic supplementation in T2DM patients from the database inception to December 13, 2023. Primary outcome indicators encompassed glycated hemoglobin (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR) and blood lipid profile (triglyceride (TG) and total cholesterol (TC). Secondary outcome indicators included inflammatory markers such as tumor necrosis factor -α (TNF-α) and adipocytokine (including leptin and adiponectin). The R software was used for statistical analysis, and GraphPad Prism was used for figure rendering.
A total of 60 RCTs involving 3845 T2DM patients were included in the analysis. The results showed that the probiotics (Bifidobacterium, Lactobacillus, Lactococcus, Propionibacterium, etc.) were more effective in reducing HOMA-IR than fish oil (Surca = 0.935). Bifidobacterium demonstrated the highest efficacy in reducing HbA1c levels (Surca = 0.963). Regarding lipid metabolism, fish oil was superior to probiotics in lowering TG and TC levels (Surca values of 0.978 and 0.902, respectively). Furthermore, fish oil outperformed probiotics in reducing TNF-α (Surca = 0.839) and leptin (Surca = 0.712), and increasing adiponectin levels (Surca = 0.742). Node-splitting analysis showed good consistency (P > 0.05 for direct, indirect, and network comparison across various interventions).
In T2DM patients, fish oil was more effective than probiotics in regulating lipid metabolism. Probiotics outperformed fish oil in regulating glucose metabolism particularly; specifically, Bifidobacterium showed higher efficacy in reducing blood glucose.
糖脂代谢异常会促使2型糖尿病（T2DM）病情进展并加重。鱼油和益生菌是有可能改善糖脂代谢的膳食补充剂。然而，它们对T2DM患者的疗效仍不明确。
检索PubMed、Embase和Cochrane图书馆，以收集从数据库建立至2023年12月13日关于鱼油或益生菌补充剂对T2DM患者疗效的随机对照试验（RCT）。主要结局指标包括糖化血红蛋白（HbA1c）、胰岛素抵抗稳态模型评估（HOMA-IR）和血脂谱（甘油三酯（TG）和总胆固醇（TC））。次要结局指标包括炎症标志物，如肿瘤坏死因子-α（TNF-α）和脂肪细胞因子（包括瘦素和脂联素）。使用R软件进行统计分析，并用GraphPad Prism绘制图表。
分析共纳入60项涉及3845例T2DM患者的RCT。结果显示，益生菌（双歧杆菌、乳酸杆菌、乳球菌、丙酸杆菌等）在降低HOMA-IR方面比鱼油更有效（Surca = 0.935）。双歧杆菌在降低HbA1c水平方面疗效最高（Surca = 0.963）。在脂质代谢方面，鱼油在降低TG和TC水平上优于益生菌（Surca值分别为0.978和0.902）。此外，鱼油在降低TNF-α（Surca = 0.839）和瘦素（Surca = 0.712）以及提高脂联素水平（Surca = 0.742）方面优于益生菌。节点拆分分析显示一致性良好（各种干预措施的直接、间接和网络比较的P > 0.05）。
在T2DM患者中，鱼油在调节脂质代谢方面比益生菌更有效。益生菌在调节糖代谢方面优于鱼油；具体而言，双歧杆菌在降低血糖方面显示出更高的疗效。
