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评估菠萝蛋白酶在糖尿病管理中的作用:对研究证据和作用机制的系统评价

Evaluating the role of bromelain in diabetes management: a systematic review of research evidence and mechanisms of action.

作者信息

Mohammed Jaafaru Sani, Ahmed Abdulrahman T, Singh Mandeep, Hanumanthayya Malathi, Kazmi Syeda Wajida, Chahar Mamata, Kareem Al-Hetty Hussein Riyadh Abdul, Hulail Hanen Mahmod, Alasheqi Mohammed Qasim, Zwamel Ahmed Hussein

机构信息

Medical Analysis Department, Tishk International University, Erbil, Iraq.

College of Nursing, University of Al Maarif, Al Anbar, Iraq.

出版信息

J Pharm Pharmacol. 2025 Jul 1;77(7):884-896. doi: 10.1093/jpp/rgaf021.

Abstract

BACKGROUND

The use of complementary and alternative medicine is becoming increasingly important in the prevention and management of complications related to diabetes.

METHODS

A comprehensive literature search was conducted across major databases (EMBASE, Scopus, PubMed, Google Scholar, Web of Science, Cochrane Library) up to December 2024. The search focused on studies examining the effect of bromelain on glycemic control, lipid profiles, and related mediators in diabetes.

KEY FINDINGS

Bromelain supplementation demonstrated positive effects on key metabolic markers. Bromelain may stimulate AMPK in muscle cells, enhancing glucose uptake and utilization, potentially lowering blood glucose levels, and benefiting individuals with diabetes. Although direct evidence of bromelain's impact on incretin levels is limited, its ability to modulate gastrointestinal function and improve nutrient absorption could indirectly influence incretin secretion. Moreover, Peptides or smaller amino acids resulting from bromelain's proteolytic activity enter the bloodstream and potentially enhance nutrient absorption, which plays an important role in evaluating the therapeutic potential of bromelain in diabetes management.

CONCLUSION

Bromelain supplementation is effective in improving glycemic and lipid indices in diabetes. However, further research is needed to clarify the underlying mechanisms, including bromelain's potential interaction with the incretin system and its role in modulating insulin resistance through various pathways.

摘要

背景

补充和替代医学在糖尿病相关并发症的预防和管理中变得越来越重要。

方法

截至2024年12月,在主要数据库(EMBASE、Scopus、PubMed、谷歌学术、科学网、考克兰图书馆)中进行了全面的文献检索。检索重点是研究菠萝蛋白酶对糖尿病患者血糖控制、血脂水平及相关介质影响的研究。

主要发现

补充菠萝蛋白酶对关键代谢指标有积极影响。菠萝蛋白酶可能刺激肌肉细胞中的AMPK,增强葡萄糖摄取和利用,潜在地降低血糖水平,使糖尿病患者受益。尽管菠萝蛋白酶对肠促胰岛素水平影响的直接证据有限,但其调节胃肠功能和改善营养吸收的能力可能间接影响肠促胰岛素分泌。此外,菠萝蛋白酶蛋白水解活性产生的肽或较小的氨基酸进入血液,可能增强营养吸收,这在评估菠萝蛋白酶在糖尿病管理中的治疗潜力方面起着重要作用。

结论

补充菠萝蛋白酶可有效改善糖尿病患者的血糖和血脂指标。然而,需要进一步研究以阐明其潜在机制,包括菠萝蛋白酶与肠促胰岛素系统的潜在相互作用及其通过各种途径调节胰岛素抵抗的作用。

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