益生菌对妊娠期糖尿病患者血糖控制和血脂谱影响的Meta分析

Effects of probiotics on blood glucose and blood lipid profile in patients with gestational diabetics:a Meta-analysis of randomized controlled trials

目的评价益生菌对妊娠期糖尿病(GDM)患者血糖控制和血脂谱的影响。方法在7个数据库(Web of Science、Embase、Pubmed、中国知网、中国生物医学文献数据库、万方数据库、维普数据库)中搜索从建库至今所有关于益生菌和GDM患者的文献,按纳入排除标准共纳入6篇随机对照试验(RCT)。主要结果是空腹血糖(FBG)、空腹血清胰岛素(FSI)和胰岛素抵抗指数(IRI),次要结果是妊娠体重增加和血脂谱的变化。结果共涉及454例GDM患者,实验组228例,对照组226例。与对照组相比,补充益生菌能降低GDM妇女的胰岛素水平[MD=-2.42,95%CI(-4.48,-0.36),P=0.020]和IRI[MD=-0.56,95%CI(-0.96,-0.17),P=0.005]。而对FBG[MD=-2.19,95%CI(-5.18,0.79),P=0.150]、孕期体重增加[MD=-0.28,95%CI(-0.82,0.26),P=0.300]、血脂无影响。结论与对照组相比,补充益生菌可降低空腹血清胰岛素和IRI,但对FBG、孕期体重增加和血脂无显著影响。

Objective To evaluate the effects of probiotics on blood glucose and blood lipid profiles in patients with gestational diabetes mellitus(GDM). Methods Literatures on probiotics and GDM patients from the establishment of database to present were searched in 7 databases(Web of Science,Embase,Pubmed,CNKI,CBM,Wanfang and VIP database). Results Six randomized controlled trials(RCTs)were included according to the inclusion/exclusion criteria.The primary outcomes were fasting blood glucose(FBG),fasting serum insulin(FSI),and insulin resistance index(IRI),while the secondary outcomes were changes in pregnancy weight and lipid profile.A total of 454 patients with GDM were involved,including 228 in the probiotics group and 226 in the control group.Compared with the control group,probiotic supplementation reduced the insulin levels of women with GDM [MD=-2.42,95%CI(-4.48,-0.36),P=0.020] and IRI [MD=-0.56,95%CI(-0.96,-0.17),P=0.005],while did not affect FBG [MD=-2.19,95%CI(-5.18,0.79),P=0.15],weight gain during pregnancy [MD=-0.28,95%CI(-0.82,0.26),P=0.30] and blood lipids. Conclusion Compared with the control group,supplementation of probiotics reduced fasting serum insulin and IR,but had no significant effect on FBG,weight gain during pregnancy and lipids.