粪菌移植治疗成人超重/肥胖病人有效性与安全性的Meta分析

The effectiveness and safety of fecal microbiota transplantation in overweight and obese adults:a meta-analysis

目的:系统评价粪菌移植(FMT)治疗成人超重/肥胖病人的有效性与安全性。方法:对Pubmed、Embase、Cochrane Library、Web of Science、知网、维普、万方、中国生物医学数据库进行系统检索,检索时限为自建库起至2024年1月23日。按照纳入和排除标准进行文献筛选和数据提取,采用RevMan 5.4软件进行Meta分析及质量评价。结果:最终纳入8篇随机对照试验(RCT),共201名病人。Meta分析结果显示:与对照组相比,试验组能降低超重/肥胖成人病人的甘油三脂水平[MD=-0.25,95%CI:-0.44~-0.07,P <0.01],升高高密度脂蛋白(HDL)水平[MD=0.09,95%CI:0.02~0.16,P=0.01]。但试验组和对照组身体质量指数(BMI)[MD=-0.77,95%CI:-1.56~0.03,P=0.06]、体质量[MD=1.24,95%CI:-5.43~7.91,P=0.71]、总胆固醇[MD=-0.2,95%CI:-0.55~0.15,P=0.26]、低密度脂蛋白(LDL)[MD=-0.05,95%CI:-0.51~0.41,P=0.83]、空腹血糖(FBG)[MD=0.01,95%CI:-0.14~0.16,P=0.91]及糖化血红蛋白(HbA1c)[MD=-0.05,95%CI:-0.23~0.13,P=0.58]比较,差异无统计学意义。FMT不良反应主要表现为胃肠道症状且均较轻。结论:FMT对成人超重/肥胖病人的BMI、体质量、总胆固醇、LDL、FBG及HbA1c水平无明显作用,仅对甘油三脂及HDL有一定改善,但在短期内相对安全。为阐明FMT在成人超重/肥胖中的作用,必须进行更多、样本量更大的研究。

Objective:To systematically assess the effectiveness and safety of fecal bacteria transplantation(FMT)for treating overweigh and obese adults.Methods:The databases of Pubmed,Embase,Cochrane Library,Web of Science,CNKI,Wanfang,VIP and CBM were searched from inception to January 23,2024.The literature screening and data extraction were carried out in accordance with the inclusion and exclusion criteria,while RevMan 5.4 software was used for Meta-analysis and quality evaluating.Results:The study included 8 randomised controlled trials(RCTs)involving a total of 201 patients.The meta-analysis results indicated that in overweight and obese adults,the experimental group showed a decrease triglyceride levels[MD=-0.25,95%CI:-0.44~-0.07,P<0.01]and an increase in high-density lipoprotein(HDL)levels[MD=0.09,95%CI:0.02~0.16,P=0.01]compared to the control group,However,there were no significant differences observed in BMI[MD=-0.77,95%CI:-1.56~0.03,P=0.06],body weight[MD=1.24,95%CI:-5.43~7.91,P=0.71],total cholesterol[MD=-0.2,95%CI:-0.55~0.15,P=0.26],low density lipoprotein(LDL)[MD=-0.05,95%CI:-0.51~0.41,P=0.83],fasting blood glucose(FBG)[MD=0.01,95%CI:-0.14~0.16,P=0.91]and glycosylated hemoglobin(HbA1c)[MD=-0.05,95%CI:-0.23~0.13,P=0.58].The adverse events of FMT were primarily involved mild gastrointestinal symptoms.Conclusions:The use of FMT does not impact BMI,body weight,total cholesterol,LDL,FBG and HbA1c levels in overweight and obesity adults.It does have a slight effect on HDL levels,but is relatively safe in the short term.Further research with larger sample sizes is necessary to better understand the role of FMT in treating overweight and obese adults.