Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Department of Nephrology, China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Beijing, China.
J Diabetes. 2024 Sep;16(9):e13608. doi: 10.1111/1753-0407.13608.
Accumulating experimental evidence has shown that resveratrol supplementation is effective for treating diabetic nephropathy (DN) in animal models. In this systematic review and meta-analysis, we assessed the effects and multiple mechanisms of resveratrol in animal models of DN.
Before September 2023, preclinical literature was systematically searched and screened across PubMed, Web of Science, EMBASE, and the Cochrane Library. Forty-two studies were included, and the risk of bias tool from SYRCLE was used to assess the methodological quality. Pooled overall effect sizes of the results were generated by STATA 16.0.
The overall results provide preliminary evidence that the consumption of resveratrol can significantly reduce the mesangial index, glomerular basement membrane thickness, glomerular hypertrophy, serum creatinine, blood urea nitrogen, 24-h urinary protein, blood glucose, kidney index, total cholesterol, triglyceride, and low-density lipoprotein cholesterol levels. In contrast, the levels of albumin and high-density lipoprotein cholesterol are significantly increased. However, resveratrol did not significantly reduce creatinine clearance or glycated hemoglobin levels. Dose-response analysis revealed that resveratrol was most effective at improving kidney function and reducing DN when administered at lower doses of ≤15 mg/kg/day or higher doses of 100-200 mg/kg/day, with significant improvements in biochemical kidney injury markers and a better effect on dysglycemia.
The benefits of resveratrol in DN are likely due to its anti-inflammatory, antioxidant, metabolic regulatory, and autophagy-promoting effects. To confirm these findings for clinical use, further large-scale, long-term, high-quality preclinical trials are warranted to accurately assess the anti-DN effects and safety of resveratrol.
越来越多的实验证据表明，白藜芦醇补充剂对治疗动物模型中的糖尿病肾病（DN）有效。在本系统评价和荟萃分析中，我们评估了白藜芦醇在 DN 动物模型中的作用和多种机制。
在 2023 年 9 月之前，系统地检索和筛选了 PubMed、Web of Science、EMBASE 和 Cochrane Library 中的临床前文献。共纳入 42 项研究，并使用 SYRCLE 偏倚风险工具评估方法学质量。通过 STATA 16.0 生成结果的汇总总体效应量。
总体结果初步表明，白藜芦醇的摄入可显著降低肾小球系膜指数、肾小球基底膜厚度、肾小球肥大、血清肌酐、血尿素氮、24 小时尿蛋白、血糖、肾指数、总胆固醇、甘油三酯和低密度脂蛋白胆固醇水平。相反，白蛋白和高密度脂蛋白胆固醇水平显著升高。然而，白藜芦醇并未显著降低肌酐清除率或糖化血红蛋白水平。剂量反应分析表明，白藜芦醇在较低剂量（≤15mg/kg/天）或较高剂量（100-200mg/kg/天）下对改善肾功能和降低 DN 最有效，对生化肾损伤标志物有显著改善作用，对血糖异常的效果更好。
白藜芦醇在 DN 中的益处可能归因于其抗炎、抗氧化、代谢调节和自噬促进作用。为了将这些发现用于临床，需要进一步开展大规模、长期、高质量的临床前试验，以准确评估白藜芦醇的抗 DN 作用和安全性。
