Laczkó-Zöld Eszter, Csupor-Löffler Boglárka, Kolcsár Edina-Blanka, Ferenci Tamás, Nan Monica, Tóth Barbara, Csupor Dezső
Department of Pharmacognosy and Phytotherapy, "George Emil Palade" University of Medicine, Pharmacy, Sciences, and Technology of Târgu Mureş, Târgu Mureş, Romania.
Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary.
Front Nutr. 2024 Jan 11;10:1200801. doi: 10.3389/fnut.2023.1200801. eCollection 2023.
Several studies have shown that L. (Cucurbitaceae, bitter melon) has beneficial effects on metabolic syndrome (MetS) parameters and exerts antidiabetic, anti-hyperlipidemic, and anti-obesity activities. Since the findings of these studies are contradictory, the goal of this systematic review and meta-analysis was to assess the efficacy of bitter melon in the treatment of metabolic syndrome, with special emphasis on the anti-diabetic effect. Embase, Cochrane, PubMed, and Web of Science databases were searched for randomized controlled human trials (RCTs). The meta-analysis was reported according to the PRISMA statement. The primary outcomes of the review are body weight, BMI, fasting blood glucose, glycated hemoglobin A1c, systolic blood pressure, diastolic blood pressure, serum triglyceride, HDL, LDL, and total cholesterol levels. Nine studies were included in the meta-analysis with 414 patients in total and 4-16 weeks of follow-up. In case of the meta-analysis of change scores, no significant effect could be observed for bitter melon treatment over placebo on fasting blood glucose level (MD = -0.03; 95% CI: -0.38 to 0.31; I = 34%), HbA1c level (MD = -0.12; 95% CI: -0.35 to 0.11; I = 56%), HDL (MD = -0.04; 95% CI: -0.17 to 0.09; I = 66%), LDL (MD = -0.10; 95% CI: -0.28 to 0.08; I = 37%), total cholesterol (MD = -0.04; 95% CI: -0.17 to 0.09; I = 66%,), body weight (MD = -1.00; 95% CI: -2.59-0.59; I = 97%), BMI (MD = -0.42; 95% CI: -0.99-0.14; I = 95%), systolic blood pressure (MD = 1.01; 95% CI: -1.07-3.09; I = 0%) and diastolic blood pressure levels (MD = 0.24; 95% CI: -1.04-1.53; I = 0%). treatment was not associated with a notable change in ALT, AST, and creatinine levels compared to the placebo, which supports the safety of this plant. However, the power was overall low and the meta-analyzed studies were also too short to reliably detect long-term metabolic effects. This highlights the need for additional research into this plant in carefully planned clinical trials of longer duration.
多项研究表明，葫芦科苦瓜属植物苦瓜对代谢综合征（MetS）参数具有有益作用，并具有抗糖尿病、抗高血脂和抗肥胖活性。由于这些研究的结果相互矛盾，本系统评价和荟萃分析的目的是评估苦瓜在治疗代谢综合征方面的疗效，特别强调其抗糖尿病作用。我们在Embase、Cochrane、PubMed和科学网数据库中检索了随机对照人体试验（RCT）。本荟萃分析按照PRISMA声明进行报告。该评价的主要结局指标为体重、体重指数（BMI）、空腹血糖、糖化血红蛋白A1c、收缩压、舒张压、血清甘油三酯、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）和总胆固醇水平。共有9项研究纳入荟萃分析，总计414例患者，随访时间为4至16周。在对变化分数进行荟萃分析时，与安慰剂相比，苦瓜治疗在空腹血糖水平（MD = -0.03；95%置信区间：-0.38至0.31；I² = 34%）、糖化血红蛋白A1c水平（MD = -0.12；95%置信区间：-0.35至0.11；I² = 56%）、HDL（MD = -0.04；95%置信区间：-0.17至0.09；I² = 66%）、LDL（MD = -0.10；95%置信区间：-0.28至0.08；I² = 37%）、总胆固醇（MD = -0.04；95%置信区间：-0.17至0.09；I² = 66%）、体重（MD = -1.00；95%置信区间：-2.59至0.59；I² = 97%）、BMI（MD = -0.42；95%置信区间：-0.99至0.14；I² = 95%）、收缩压（MD = 1.01；95%置信区间：-1.07至3.09；I² = 0%）和舒张压水平（MD = 0.24；95%置信区间：-1.04至1.53；I² = 0%）方面未观察到显著效果。与安慰剂相比，苦瓜治疗与谷丙转氨酶（ALT）、谷草转氨酶（AST）和肌酐水平的显著变化无关，这支持了这种植物的安全性。然而，总体检验效能较低，且荟萃分析的研究时间也过短，无法可靠地检测长期代谢效应。这突出表明需要在精心设计的更长疗程临床试验中对这种植物进行更多研究。
