大豆蛋白在慢性肾脏病中作用的Meta分析

Meta analysis of the role of soy protein in chronic kidney disease

目的评价大豆蛋白对慢性肾脏病(chronic kidney disease,CKD)的影响,为大豆蛋白在CKD患者饮食结构中的重要性提供参考依据。方法检索PubMed,Embase,Cochrane图书馆,中国知网,中国科学技术杂志,万方中文数据库和中国生物医学(CBM)数据库(建库时间至2020年6月30日)。文献筛选后进行质量评价,采用Rev Man 5.3软件进行Meta分析。结果纳入9篇文献,涉及5个国家,共纳入受试者429例。Meta分析结果显示,大豆蛋白饮食对CKD患者的Scr[SMD=-0.33,95%CI(-0.54,-0.13),P=0.001]、BUN[SMD=-0.45,95%CI(-0.89,-0.01),P=0.05]、低密度脂蛋白胆固醇[SMD=-0.79,95%CI(-1.10,-0.47),P<0.001]水平较对照组有明显降低作用,差异有统计学意义(P<0.05),而对肾小球滤过率、蛋白尿、血磷的影响与对照组相比,差异无统计学意义。结论大豆蛋白能降低CKD患者的Scr、BUN、低密度脂蛋白胆固醇,基于部分文献质量不高,且CKD病程长的特点,部分结论需要更长疗程、更大样本的研究进行验证。

Objective To evaluate the impact of soy protein on chronic kidney disease(CKD)and provide references for the importance of adding soy protein in a CKD diet.Methods The databases of PubMed,Embase,Cochrane Library,National Knowledge Infrastructure of China,Chinese Journal of Science&Technology,WanFang Data Chinese Edition and China Biomedicine(CBM)were searched since their inceptions until June 30,2020.After literature screening,quality evaluation was performed and Rev Man5.3 software utilized for Meta-analysis.Results Nine articles involving a total of 429 subjects from 5 countries were included.Meta-analysis indicated that soy protein diet could lower the levels of serum creatinine(Scr)[SMD=-0.33,95%CI(-0.54,-0.13),P=0.001],blood urea nitrogen(BUN)[SMD=-0.45,95%CI(-0.89,-0.01),P=0.05]and low-density lipoprotein-cholesterol(LDL-C)[SMD=-0.79,95%CI(-1.10,-0.47),P<0.001]in CKD patients.The levels decreased markedly as compared with control group and there were statistical differences(P<0.05).And the effects on glomerular filtration rate(GFR),proteinuria and serum phosphorus were not significantly different from those of control group.Conclusion Soy protein may reduce the levels of Scr,BUN and LDL-C in CKD patients.Based upon a low quality of literature reports and a protracted disease course of CKD,some conclusions should be further verified by larger studies with longer treatment courses.