全餐和部分代餐对葡萄糖代谢相关因素的影响：随机对照试验的系统评价和荟萃分析

Effect of Total and Partial Meal Replacements on Factors Related to Glucose Metabolism: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

作者信息

Maddahi Niloofar Sadat, Sohouli Mohammad Hassan, Izze da Silva Magalhães Elma, Ezoddin Neda, Nadjarzadeh Azadeh

机构信息

Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd 8915173149, Iran.

Nutrition and Food Security Research Center, , Shahid Sadoughi University of Medical Sciences, Yazd 8915173149, Iran.

出版信息

Nutr Rev. 2025 Jul 1;83(7):e1619-e1625. doi: 10.1093/nutrit/nuae206.

DOI:10.1093/nutrit/nuae206

PMID:39777517

Abstract

CONTEXT

Although some evidence shows the beneficial effects of meal replacements (MRs) on glucose metabolism as one of the main factors of diabetes, there are still no comprehensive findings in this field.

OBJECTIVE

We investigated the effects of total and partial MRs on fasting blood sugar (FBS), insulin, glycated hemoglobin (HbA1c), and homeostatic model assessment for insulin resistance (HOMA-IR) in this comprehensive study and meta-analysis.

DATA SOURCES

To find pertinent randomized controlled trials (RCTs) up to March 2024, databases including PubMed/Medline, Web of Science, Scopus, and Embase were searched.

DATA EXTRACTION

This study included all RCTs investigating the effects of MRs on factors related to glucose metabolism. The pooled weighted mean difference (WMD) and 95% CIs were computed using the random-effects model.

DATA ANALYSIS

The findings from 52 studies indicated significant reductions in FBS (WMD: -3.10 mg/dL; 95% CI: -4.99, -1.20; P < .001), insulin (WMD: -1.79 μU/mL; 95% CI: -3.51, -0.08; P = .40), HOMA-IR (WMD: -0.86; 95% CI: -1.68, -0.04; P = .040), and HbA1c (WMD: -0.24%; 95% CI: -0.35%, -0.13%; P < .001) levels following MR consumption compared with the control group. The findings obtained from the subgroup analysis showed that MRs cause a greater decrease in FBS, insulin, and HOMA-IR in the >50-years age group compared with those aged ≤50 years and also during interventions ≤24 weeks compared with >24 weeks.

CONCLUSION

In conclusion, it appears that MRs, along with other lifestyle factors, can lead to significant improvements in glucose metabolism.

摘要

背景

尽管有一些证据表明代餐（MRs）对作为糖尿病主要因素之一的葡萄糖代谢有有益影响，但该领域仍缺乏全面的研究结果。

目的

在这项综合研究和荟萃分析中，我们研究了全代餐和部分代餐对空腹血糖（FBS）、胰岛素、糖化血红蛋白（HbA1c）以及胰岛素抵抗稳态模型评估（HOMA-IR）的影响。

数据来源

为了查找截至2024年3月的相关随机对照试验（RCTs），检索了包括PubMed/Medline、科学网、Scopus和Embase在内的数据库。

数据提取

本研究纳入了所有调查代餐对葡萄糖代谢相关因素影响的随机对照试验。使用随机效应模型计算合并加权平均差（WMD）和95%置信区间（CIs）。

数据分析

52项研究的结果表明，与对照组相比，食用代餐后FBS（WMD：-3.10mg/dL；95%CI：-4.99，-1.20；P<.001）、胰岛素（WMD：-1.79μU/mL；95%CI：-3.51，-0.08；P=.40）、HOMA-IR（WMD：-0.86；95%CI：-1.68，-0.04；P=.040）和HbA1c（WMD：-0.24%；95%CI：-0.35%，-0.13%；P<.001）水平显著降低。亚组分析结果显示，与年龄≤50岁的人群相比，代餐在年龄>50岁的人群中导致FBS、胰岛素和HOMA-IR的下降幅度更大；与干预时间>24周相比，在干预时间≤24周时也是如此。