抗性淀粉对2型糖尿病代谢的影响:系统评价和Meta分析

Meta anlaysis on effects of resistant starch on metabolism of type 2 diabetes mellitus

目的探讨抗性淀粉(RS)对2型糖尿病(T2DM)代谢的影响。方法分别在Pubmed、Ovid、Embase、The Cochrane Library数据库中检索RS饮食干预2型糖尿病的随机对照研究的文献,检索时间均至2016年6月21日。文献质量采用Cochrane协作网推荐的偏倚风险评估工具进行评估。相关数据用Stata12.0软件进行整合、分析。结果共检索文献909篇,其中6篇符合纳入标准,共纳入研究对象308例。研究均显示RS干预后T2DM患者的空腹血糖显著降低。有4项研究检测了餐后血糖,并均认为RS干预后T2DM患者的餐后血糖显著降低(依次为P=0.023,P=0.010,P<0.05,P=0.045)。3项研究报道了空腹总胆固醇(TC)及三酰甘油(TG)相关数据,但研究结果分歧较大。Gargari等的研究认为,与对照组相比RS组高密度脂蛋白胆固醇(HDL-C)明显升高(P<0.05),低密度脂蛋白胆固醇(LDL-C)差异无统计学意义(P>0.05)。而Bodinham等的研究中两组间HDL-C和LDL-C差异均无统计学意义(P>0.05)。Gargari等及Bodinham等的研究均认为与对照组比较,RS组TNF-α明显降低(依次为P<0.05,P=0.013),而前者认为RS组IL-6也降低的,后者则认为两组IL-6差异无统计学意义(P>0.05)。结论抗性淀粉能够提高2型糖尿病患者的胰岛素敏感性,改善糖、脂代谢紊乱。

Objective To discuss the effects of resistant starch（RS）on metabolism of type 2 diabetes mellitus（T2 DM）.Methods The databases of Pubmed,Ovid,Embase and Cochrane Library were retrieved for search the randomized controlled trials（RCTs）on RS intervention on T2 DM.The retrieval time was until June 21,2016.The literature quality was assessed by using the bias risk evaluation tool recommended by Cochrane collaboration net.The related data were integrated and analyzed by using the Stata 12.0 software.Results A total of 909 articles were retrieved out,in which 6 articles met the included criteria and 308 cases were included as the research subjects.All the studies demonstrated that fasting blood glucose（FBG）in the patients with T2 DM was decreased significantly after RS intervention.Four studies detected postprandial blood glucose and considered that postprandial glucose was decreased significantly after RS intervention（P=0.023,P=0.010,P〈0.05,P=0.045）.Three studies.reported the related data of fasting total cholesterol（TC）and triglyceride（TG）,but the study results were greatly different from each other.3 stidies indicated that compared with control group,the HDL-C level of the RS group was significantly increased（P〈0.05）,while the level of LDL-C had no obvious difference.In Bodinham′s.study,HDL-C and LDL-C had no obvious difference between the two groups.The study by Gargari′s and Bodinham′s.thought the level of TNF-αin the RS group was significantly decreased（P〈0.05,P=0.013）,however,the former thought that the level of IL-6 in the RS group was also decreased,while the latter thought that compared with the control group,the IL-6 level had no significant difference.Conclusion RS can increase insulin sensitivity inT2 DM patients,and improves glucolipid metabolic disorder.