A comparison of the effects of resistant starch types on glycemic response in individuals with type 2 diabetes or prediabetes: A systematic review and meta-analysis.
A comparison of the effects of resistant starch types on glycemic response in individuals with type 2 diabetes or prediabetes: A systematic review and meta-analysis.
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比较抗性淀粉类型对2型糖尿病或糖尿病患者血糖反应的影响：系统评价和荟萃分析。
DOI：
10.3389/fnut.2023.1118229
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发表时间：
2023
影响因子：
5
通讯作者：
Frost, Gary
中科院分区：
文献类型：
--
作者：
Pugh, Jennifer E.;Cai, Mingzhu;Altieri, Nunzia;Frost, Gary
到2030年，2型糖尿病(T2D)的诊断人数预计将达到6.43亿人，这将增加心血管疾病和其他合并症的发病率。可快速消化的淀粉会升高餐后血糖，影响血糖稳态，增加发生T2D的风险。当有完整的植物细胞壁(抗性淀粉类型1)保护时，当直链淀粉(抗性淀粉类型2)浓度较高时，当分子经历回生(抗性淀粉类型3)或化学修饰(抗性淀粉类型4)时，淀粉可以逃脱小肠内源性酶的消化。使用抗性淀粉的饮食干预可能会改善葡萄糖代谢和胰岛素敏感性。然而，很少有研究探讨抗性淀粉类型的差异效应。这篇系统的综述和荟萃分析旨在比较来自完整植物细胞结构的抗性淀粉(抗性淀粉类型1)和来自变性淀粉分子的抗性淀粉(抗性淀粉类型2-5)对T2D和前驱糖尿病患者空腹和餐后血糖的影响。系统地搜索数据库(PubMed、Scope us、Ovid MEDLINE、Cochrane和Web of Science)以查找随机对照试验。采用随机效应模型确定95%可信区间的标准均数差(SMD)。亚组分析在T2D受试者与糖尿病前期受试者和抗性淀粉类型之间进行。该研究确定了36项随机对照试验(n=982)，其中31项可纳入荟萃分析。抗性淀粉1型和2型可降低急性餐后血糖[SMD(95%CI)=-0.54(-1.0，-0.07)]和[-0.96(-1.61，-0.31)]。抗性淀粉2型改善了急性餐后胰岛素反应[-0.71(-1.31，-0.11)]。在慢性研究中，抗性淀粉1型和2型分别降低餐后血糖[-0.38(-0.73，-0.02)，-0.29(-0.53，-0.04)]，摄入抗性淀粉2型可改善空腹血糖[-0.39(-0.66，-0.13)]和胰岛素[-0.40(-0.60，-0.21)]。抗性淀粉类型1和2可能通过离散的机制影响血糖稳态，因为它们似乎对血糖的影响不同。需要对抗性淀粉类型3、4和5进行进一步研究，以阐明它们对葡萄糖代谢的影响。添加抗性淀粉作为对T2D或糖尿病前期患者的饮食干预，可能会防止血糖控制的进一步恶化。
Type 2 diabetes (T2D) diagnoses are predicted to reach 643 million by 2030, increasing incidences of cardiovascular disease and other comorbidities. Rapidly digestible starch elevates postprandial glycemia and impinges glycemic homeostasis, elevating the risk of developing T2D. Starch can escape digestion by endogenous enzymes in the small intestine when protected by intact plant cell walls (resistant starch type 1), when there is a high concentration of amylose (resistant starch type 2) and when the molecule undergoes retrogradation (resistant starch type 3) or chemical modification (resistant starch type 4). Dietary interventions using resistant starch may improve glucose metabolism and insulin sensitivity. However, few studies have explored the differential effects of resistant starch type. This systematic review and meta-analysis aims to compare the effects of the resistant starch from intact plant cell structures (resistant starch type 1) and resistant starch from modified starch molecules (resistant starch types 2–5) on fasting and postprandial glycemia in subjects with T2D and prediabetes. Databases (PubMed, SCOPUS, Ovid MEDLINE, Cochrane, and Web of Science) were systematically searched for randomized controlled trials. Standard mean difference (SMD) with 95% confidence intervals (CI) were determined using random-effects models. Sub-group analyses were conducted between subjects with T2D versus prediabetes and types of resistant starch. The search identified 36 randomized controlled trials (n = 982), 31 of which could be included in the meta-analysis. Resistant starch type 1 and type 2 lowered acute postprandial blood glucose [SMD (95% CI) = -0.54 (–1.0, –0.07)] and [–0.96 (–1.61, –0.31)]. Resistant starch type 2 improved acute postprandial insulin response [–0.71 (–1.31, –0.11)]. In chronic studies, resistant starch type 1 and 2 lowered postprandial glucose [–0.38 (–0.73, –0.02), –0.29 (–0.53, –0.04), respectively] and resistant starch type 2 intake improved fasting glucose [–0.39 (–0.66, –0.13)] and insulin [–0.40 (–0.60, –0.21)]. Resistant starch types 1 and 2 may influence glucose homeostasis via discrete mechanisms, as they appear to influence glycemia differently. Further research into resistant starch types 3, 4, and 5 is required to elucidate their effect on glucose metabolism. The addition of resistant starch as a dietary intervention for those with T2D or prediabetes may prevent further deterioration of glycemic control.
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影响因子：
15.5
作者：
Bindels LB;Segura Munoz RR;Gomes-Neto JC;Mutemberezi V;Martínez I;Salazar N;Cody EA;Quintero-Villegas MI;Kittana H;de Los Reyes-Gavilán CG;Schmaltz RJ;Muccioli GG;Walter J;Ramer-Tait AE
通讯作者：
Ramer-Tait AE
DOI：
10.1152/ajpgi.00346.2017
发表时间：
2018-07-01
影响因子：
4.5
作者：
Christiansen, Charlotte Bayer;Gabe, Maria Buur Nordskov;Holst, Jens Juul
通讯作者：
Holst, Jens Juul
影响因子：
23.2
作者：
Edwards CH;Ryden P;Mandalari G;Butterworth PJ;Ellis PR
通讯作者：
Ellis PR
影响因子：
2.9
作者：
Bodinham CL;Smith L;Thomas EL;Bell JD;Swann JR;Costabile A;Russell-Jones D;Umpleby AM;Robertson MD
通讯作者：
Robertson MD
影响因子：
7.7
作者：
Ceriello, A
通讯作者：
Ceriello, A