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Effects of the resistant starch on glucose, insulin, insulin resistance, and lipid parameters in overweight or obese adults: a systematic review and meta-analysis.
Nutrition & Diabetes ( IF 6.1 ) Pub Date : 2019-06-05 , DOI: 10.1038/s41387-019-0086-9
Yong Wang 1 , Jing Chen 2 , Ying-Han Song 3 , Rui Zhao 1 , Lin Xia 1 , Yi Chen 1 , Ya-Ping Cui 1 , Zhi-Yong Rao 4 , Yong Zhou 1 , Wen Zhuang 1 , Xiao-Ting Wu 1
Affiliation  

BACKGROUND The role of resistant starch (RS) in glucose, insulin, insulin resistance or sensitivity, and lipid parameters have been reported in several studies and remained controversial. A pooled analysis which assessed these parameters has not been performed. Thus, we conducted a meta-analysis to sum up existing evidence about the issue. METHODS We searched in MEDLINE and PUBMED for studies that were published before November 2018. Meta-analysis of diabetics and nondiabetics trials were performed by use of a random-effects model. RESULTS A total of 13 case-control studies that included 428 subjects with body mass index ≥25 were identified. RS supplementation reduced fasting insulin in overall and stratified (diabetics and nondiabetics trials) analysis (SMD = -0.72; 95% CI: -1.13 to -0.31; SMD = -1.26; 95% CI: -1.66 to -0.86 and SMD = -0.64; 95% CI: -1.10 to -0.18, respectively), and reduced fasting glucose in overall and stratified analysis for diabetic trials (SMD = -0.26; 95% CI: -0.5 to -0.02 and SMD = -0.28; 95% CI: -0.54 to -0.01, respectively). RS supplementation increased HOMA-S% (SMD = 1.19; 95% CI: 0.59-1.78) and reduced HOMA-B (SMD =-1.2; 95% CI: -1.64 to -0.77), LDL-c concentration (SMD =-0.35; 95% CI: -0.61 to -0.09), and HbA1c (SMD = -0.43; 95% CI: -0.74 to -0.13) in overall analysis. CONCLUSIONS This meta-analysis has provided evidence that RS supplementation can improve fasting glucose, fasting insulin, insulin resistance and sensitivity, especially for diabetic with overweight or obesity. However, owing to potential sophistication, individual difference and composition of intestinal microbiota, this result should be carefully taken into account.

中文翻译:

抗性淀粉对超重或肥胖成年人葡萄糖,胰岛素,胰岛素抵抗和脂质参数的影响:系统评价和荟萃分析。

背景技术在一些研究中已经报道了抗性淀粉(RS)在葡萄糖,胰岛素,胰岛素抗性或敏感性以及脂质参数中的作用,并且仍然存在争议。尚未进行评估这些参数的汇总分析。因此,我们进行了荟萃分析,以总结有关该问题的现有证据。方法我们在MEDLINE和PUBMED中搜索了2018年11月之前发表的研究。通过随机效应模型对糖尿病和非糖尿病患者进行了荟萃分析。结果总共鉴定出13个病例对照研究,包括428个体重指数≥25的受试者。在整体和分层(糖尿病和非糖尿病试验)分析中,RS补充剂可降低空腹胰岛素(SMD = -0.72; 95%CI:-1.13至-0.31; SMD = -1.26; 95%CI:-1.66至-0.86,SMD =- 0.64;95%CI:-1.10至-0.18),并在糖尿病试验的整体和分层分析中降低了空腹血糖(SMD = -0.26; 95%CI:-0.5至-0.02和SMD = -0.28; 95%CI: -0.54至-0.01)。RS补充可增加HOMA-S%(SMD = 1.19; 95%CI:0.59-1.78)和降低HOMA-B(SMD = -1.2; 95%CI:-1.64至-0.77),LDL-c浓度(SMD =-整体分析中,结果为0.35; 95%CI:-0.61至-0.09)和HbA1c(SMD = -0.43; 95%CI:-0.74至-0.13)。结论这项荟萃分析提供了补充RS可以改善空腹血糖,空腹胰岛素,胰岛素抵抗和敏感性的证据,特别是对于患有超重或肥胖的糖尿病患者。但是,由于潜在的复杂性,肠道菌群的个体差异和组成,应仔细考虑此结果。并在糖尿病试验的整体和分层分析中分别降低了空腹血糖(SMD = -0.26; 95%CI:-0.5至-0.02和SMD = -0.28; 95%CI:-0.54至-0.01)。RS补充可增加HOMA-S%(SMD = 1.19; 95%CI:0.59-1.78)和降低HOMA-B(SMD = -1.2; 95%CI:-1.64至-0.77),LDL-c浓度(SMD =-整体分析中,结果为0.35; 95%CI:-0.61至-0.09)和HbA1c(SMD = -0.43; 95%CI:-0.74至-0.13)。结论这项荟萃分析提供了补充RS可以改善空腹血糖,空腹胰岛素,胰岛素抵抗和敏感性的证据,特别是对于患有超重或肥胖的糖尿病患者。但是,由于潜在的复杂性,肠道菌群的个体差异和组成,应仔细考虑此结果。并在糖尿病试验的整体和分层分析中分别降低了空腹血糖(SMD = -0.26; 95%CI:-0.5至-0.02和SMD = -0.28; 95%CI:-0.54至-0.01)。RS补充可增加HOMA-S%(SMD = 1.19; 95%CI:0.59-1.78)和降低HOMA-B(SMD = -1.2; 95%CI:-1.64至-0.77),LDL-c浓度(SMD =-整体分析中,结果为0.35; 95%CI:-0.61至-0.09)和HbA1c(SMD = -0.43; 95%CI:-0.74至-0.13)。结论这项荟萃分析提供了补充RS可以改善空腹血糖,空腹胰岛素,胰岛素抵抗和敏感性的证据,特别是对于患有超重或肥胖的糖尿病患者。但是,由于潜在的复杂性,肠道菌群的个体差异和组成,应仔细考虑此结果。并在糖尿病试验的整体和分层分析中降低了空腹血糖(分别为SMD = -0.26; 95%CI:-0.5至-0.02和SMD = -0.28; 95%CI:-0.54至-0.01)。RS补充可增加HOMA-S%(SMD = 1.19; 95%CI:0.59-1.78)和降低HOMA-B(SMD = -1.2; 95%CI:-1.64至-0.77),LDL-c浓度(SMD =-整体分析中,结果为0.35; 95%CI:-0.61至-0.09)和HbA1c(SMD = -0.43; 95%CI:-0.74至-0.13)。结论这项荟萃分析提供了补充RS可以改善空腹血糖,空腹胰岛素,胰岛素抵抗和敏感性的证据,特别是对于患有超重或肥胖的糖尿病患者。但是,由于潜在的复杂性,肠道菌群的个体差异和组成,应仔细考虑此结果。并在糖尿病试验的整体和分层分析中降低了空腹血糖(分别为SMD = -0.26; 95%CI:-0.5至-0.02和SMD = -0.28; 95%CI:-0.54至-0.01)。RS补充可增加HOMA-S%(SMD = 1.19; 95%CI:0.59-1.78)和降低HOMA-B(SMD = -1.2; 95%CI:-1.64至-0.77),LDL-c浓度(SMD =-整体分析中,结果为0.35; 95%CI:-0.61至-0.09)和HbA1c(SMD = -0.43; 95%CI:-0.74至-0.13)。结论这项荟萃分析提供了补充RS可以改善空腹血糖,空腹胰岛素,胰岛素抵抗和敏感性的证据,特别是对于患有超重或肥胖的糖尿病患者。但是,由于潜在的复杂性,肠道菌群的个体差异和组成,应仔细考虑此结果。26; 95%CI:-0.5至-0.02,SMD = -0.28;95%CI:分别为-0.54至-0.01)。RS补充可增加HOMA-S%(SMD = 1.19; 95%CI:0.59-1.78)和降低HOMA-B(SMD = -1.2; 95%CI:-1.64至-0.77),LDL-c浓度(SMD =-整体分析中,结果为0.35; 95%CI:-0.61至-0.09)和HbA1c(SMD = -0.43; 95%CI:-0.74至-0.13)。结论这项荟萃分析提供了补充RS可以改善空腹血糖,空腹胰岛素,胰岛素抵抗和敏感性的证据,特别是对于患有超重或肥胖的糖尿病患者。但是,由于潜在的复杂性,肠道菌群的个体差异和组成,应仔细考虑此结果。26; 95%CI:-0.5至-0.02,SMD = -0.28;95%CI:分别为-0.54至-0.01)。RS补充可增加HOMA-S%(SMD = 1.19; 95%CI:0.59-1.78)和降低HOMA-B(SMD = -1.2; 95%CI:-1.64至-0.77),LDL-c浓度(SMD =-整体分析中,结果为0.35; 95%CI:-0.61至-0.09)和HbA1c(SMD = -0.43; 95%CI:-0.74至-0.13)。结论这项荟萃分析提供了补充RS可以改善空腹血糖,空腹胰岛素,胰岛素抵抗和敏感性的证据,特别是对于患有超重或肥胖的糖尿病患者。但是,由于潜在的复杂性,肠道菌群的个体差异和组成,应仔细考虑此结果。78)和降低的HOMA-B(SMD = -1.2; 95%CI:-1.64至-0.77),LDL-c浓度(SMD = -0.35; 95%CI:-0.61至-0.09)和HbA1c(SMD = -0.43; 95%CI:-0.74至-0.13)。结论这项荟萃分析提供了补充RS可以改善空腹血糖,空腹胰岛素,胰岛素抵抗和敏感性的证据,特别是对于患有超重或肥胖的糖尿病患者。但是,由于潜在的复杂性,肠道菌群的个体差异和组成,应仔细考虑此结果。78)和降低的HOMA-B(SMD = -1.2; 95%CI:-1.64至-0.77),LDL-c浓度(SMD = -0.35; 95%CI:-0.61至-0.09)和HbA1c(SMD = -0.43; 95%CI:-0.74至-0.13)。结论这项荟萃分析提供了补充RS可以改善空腹血糖,空腹胰岛素,胰岛素抵抗和敏感性的证据,特别是对于患有超重或肥胖的糖尿病患者。但是,由于潜在的复杂性,肠道菌群的个体差异和组成,应仔细考虑此结果。胰岛素抵抗和敏感性,特别是对于超重或肥胖的糖尿病患者。但是,由于潜在的复杂性,肠道菌群的个体差异和组成,应仔细考虑此结果。胰岛素抵抗和敏感性,特别是对于超重或肥胖的糖尿病患者。但是,由于潜在的复杂性,肠道菌群的个体差异和组成,应仔细考虑此结果。
更新日期:2019-06-05
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