个性化营养对成人2型糖尿病和糖尿病前期管理的有效性：一项系统评价

Effectiveness of Personalized Nutrition on Management Diabetes Mellitus Type 2 and Prediabetes in Adults: A Systematic Review.

作者信息

Munawaroh Elisa Fauziyatul, Herawati Dewi Marhaeni Diah, Megawati Ginna, Wijayakesuma Andi, Apriani Lika, Sofiatin Yulia, Dani Dani

机构信息

Magister Program of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.

Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.

出版信息

Diabetes Metab Syndr Obes. 2025 Aug 9;18:2783-2796. doi: 10.2147/DMSO.S528619. eCollection 2025.

DOI:10.2147/DMSO.S528619

PMID:40821750

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12350580/

Abstract

BACKGROUND

Diabetes mellitus type 2 and prediabetes are diet-related diseases with varied individual responses to routine dietary interventions. Personalized nutrition, a novel approach tailored to individual variability in response to nutrients, may offer improved outcomes.

PURPOSE

This systematic review analyzed the effectiveness of personalized nutrition compared to control diet for managing diabetes mellitus type 2 and prediabetes.

METHODS

A comprehensive search was conducted in Medline, PubMed, and Cochrane CENTRAL for randomized controlled trials (RCTs) published in English up to March 31, 2024. Studies involving humans were screened independently by two reviewers, who also extracted data and assessed study quality using the Risk of Bias 2 tool. The SWiM (Synthesis Without Meta-Analysis) approach was used to summarize effect estimates and combine p-values.

RESULTS

Eight studies, including five RCTs, met the inclusion criteria. Two studies had high risk of bias and another six had some concern bias. Personalized nutrition significantly reduced HbA1c (median mean difference: -0.925%, p < 0.01, 4 studies), though the effect was minimal in studies with some concern of bias (-0.035%). Fasting glucose showed no significant change (p = 0.12, 2 studies) in prediabetics, while PPGR improved significantly (-14.85 mg/dLxh, p < 0.01, 2 studies). Energy intake did not significantly differ (p = 0.06). Personalized nutrition reduced body weight (-0.58%) compared to control only when including high-risk studies; this effect was not significant in lower-risk studies (p = 0.06). Personalized nutrition also significantly reduced carbohydrate intake (-10.8% of energy, p = 0.02) compared to control diet. It also improved gut microbiome diversity and richness from baseline in prediabetics.

CONCLUSION

Personalized nutrition shows promise in improving HbA1c, PPGR, and reducing carbohydrate intake, with potential effects on body weight, in adults with diabetes mellitus type 2 or prediabetes. Effects on fasting glucose and energy intake remain unclear.

摘要

背景

2型糖尿病和糖尿病前期是与饮食相关的疾病，个体对常规饮食干预的反应各不相同。个性化营养是一种针对个体对营养素反应差异而量身定制的新方法，可能会带来更好的效果。

目的

本系统评价分析了与对照饮食相比，个性化营养在管理2型糖尿病和糖尿病前期方面的有效性。

方法

在Medline、PubMed和Cochrane CENTRAL中进行全面检索，以查找截至2024年3月31日发表的英文随机对照试验（RCT）。两名审稿人独立筛选涉及人类的研究，他们还提取数据并使用偏倚风险2工具评估研究质量。采用SWiM（无Meta分析的综合）方法总结效应估计值并合并p值。

结果

八项研究，包括五项RCT，符合纳入标准。两项研究存在高偏倚风险，另外六项存在一些偏倚问题。个性化营养显著降低了糖化血红蛋白（中位数平均差异：-0.925%，p<0.01，4项研究），尽管在存在一些偏倚问题的研究中效果最小（-0.035%）。糖尿病前期患者的空腹血糖无显著变化（p=0.12，2项研究），而餐后血糖反应改善显著（-14.85mg/dLxh，p<0.01，2项研究）。能量摄入无显著差异（p=0.06）。仅纳入高风险研究时，个性化营养与对照相比可减轻体重（-0.58%）；在低风险研究中，这种效果不显著（p=0.06）。与对照饮食相比，个性化营养还显著降低了碳水化合物摄入量（能量的-10.8%，p=0.02）。它还改善了糖尿病前期患者肠道微生物群的多样性和丰富度，使其高于基线水平。