间歇性禁食对非酒精性脂肪肝影响的Meta分析

The effect of intermittent fasting on nonalcoholic fatty liver disease:a meta-analysis

目的系统评价间歇性禁食对非酒精性脂肪肝(NAFLD)的影响。方法计算机检索PubMed、EMbase、Web of Science、Cochrane Library、CNKI、WanFang Data和CBM数据库,搜集间歇性禁食对NAFLD影响的研究,检索时限均从建库至2022年10月1日。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用R软件进行Meta分析。结果共纳入7个研究。Meta分析结果显示:间歇性禁食可以降低NAFLD患者肝纤维化[MD=−0.93,95%CI(−1.67,−0.19),P<0.05]、谷草转氨酶[MD=−8.96,95%CI(−11.83,−6.10),P<0.05]、谷氨酰转肽酶[MD=−7.86,95%CI(−12.00,−3.73),P<0.05]和炎症分子水平[MD=−2.03,95%CI(−3.69,−0.36),P<0.05];同时减少饮食(总能量)摄入[MD=−255.99,95%CI(−333.15,−178.82),P<0.05]、体重[MD=−2.42,95%CI(3.81,−1.02),P<0.05]、BMI[MD=−0.52,95%CI(−0.92,−0.13),P<0.05]和脂肪量[MD=−2.37,95%CI(−4.17,−0.57),P<0.05]。结论当前研究证据显示,间歇性禁食可以改善患者的NAFLD并有助于患者减重。受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。

Objective To systematically review the effect of intermittent fasting on non-alcoholic fatty liver disease(NAFLD).Methods The PubMed,EMbase,Web of Science,Cochrane Library,CNKI,WanFang Data and CBM databases were electronically searched to collect studies on the effect of intermittent fasting on NAFLD from inception to October 1,2022.Two researchers independently screened the literature,extracted data and evaluated the risk of bias of the included studies.R software was then used for meta-analysis.Results A total of 7 studies were included.The results of meta-analysis showed that intermittent fasting could reduce liver fibrosis(MD=−0.93,95%CI 1.67 to 0.19,P<0.05),the levels of glutamic oxaloacetic transaminase(MD=−8.96,95%CI−11.83 to−6.10,P<0.05),glutamyl transpeptidase(MD=−7.86,95%CI−12.00 to−3.73,P<0.05),and inflammatory molecules(MD=−2.03,95%CI−3.69 to−0.36,P<0.05).In addition,it reduced dietary(total energy)intake(MD=−255.99,95%CI−333.15 to−178.82,P<0.05),body weight(MD=−2.42,95%CI−3.81 to−1.02,P<0.05),BMI(MD=−0.52,95%CI−0.92 to−0.13,P<0.05)and fat mass(MD=−2.37,95%CI−4.17 to−0.57,P<0.05).Conclusion Current research evidence shows that intermittent fasting can improve NAFLD and help patients lose weight.Due to the limited quantity and quality of the included studies,more high-quality studies are needed to verify the above conclusion.