The effect of probiotic and synbiotic supplementation on biomarkers of inflammation and oxidative stress in diabetic patients: A systematic review and meta-analysis of randomized controlled trials
The effect of probiotic and synbiotic supplementation on biomarkers of inflammation and oxidative stress in diabetic patients: A systematic review and meta-analysis of randomized controlled trials
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益生菌和合生元补充剂对糖尿病患者炎症和氧化应激生物标志物的影响：随机对照试验的系统回顾和荟萃分析
DOI：
10.1016/j.phrs.2019.02.016
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发表时间：
2019
影响因子：
9.3
通讯作者：
Wang Yaoxian
中科院分区：
文献类型：
--
作者：
Zheng Hui Juan;Guo Jing;Jia Qi;Huang Yi Shan;Huang Wei Jun;Zhang Wenting;Zhang Fan;Liu Wei Jing;Wang Yaoxian
肠道微生物群在糖尿病管理中的作用已被证明。目前的几项试验正在研究益生菌和益生元（广泛用于调节肠道微生物群）对糖尿病患者炎症因子和氧化应激生物标志物的影响;然而，他们的发现存在争议。目前荟萃分析的目的是评估益生菌和合生元补充剂对糖尿病患者血清高敏C反应蛋白（hs-CRP）和氧化应激生物标志物水平的影响。我们检索了PubMed、Web of Science和The科克伦图书馆数据库，从开始到2018年10月31日。纳入了报告益生菌或合生元对糖尿病患者循环（血清和血浆）炎症标志物（hs-CRP）和氧化应激指标（丙二醛[MDA]，谷胱甘肽[GSH]，一氧化氮[NO]和总抗氧化能力[TAC]）的影响的随机对照试验（RCT）。对符合条件的研究进行偏倚风险评估，并使用固定或随机效应模型对临床异质性进行定性和定量综合。我们的荟萃分析确定了16个合格的RCT（n = 1060）。这些试验的方法学质量各不相同。这些试验的汇总数据表明，与接受安慰剂的受试者相比，益生菌和合生元消耗显著降低了糖尿病患者的hs-CRP水平（标准化平均差异[SMD]=-0.38; 95%置信区间[CI]：-0.51，-0.24; P = 0.000）和MDA（SMD=-0.61; 95% CI：-0.89，-0.32; P = 0.000）。此外，发现益生菌和共生菌补充剂增加了TAC（SMD = 0.31; 95%CI：0.09，0.52; P = 0.006）、NO（SMD，0.62; 95%CI，0.25至0.99; P = 0.001）和GSH（SMD = 0.41; 95%CI：0.26，0.55，P = 0.000）水平。这项系统性综述和荟萃分析的结果表明，益生菌和合生元补充剂可能有助于改善糖尿病患者的炎症和氧化应激生物标志物。需要进一步的研究来制定这些患者炎症和氧化应激管理的临床实践指南。
The role of gut microbiota in the management of diabetes has been shown. Several current trials are investigating the effect of probiotics and prebiotics, which are widely used to modulate intestinal microbiota, on inflammatory factors and biomarkers of oxidative stress in diabetic patients; however, their findings are controversial. The aim of the current meta-analysis was to evaluate the effects of probiotic and synbiotic supplementation on levels of serum high-sensitivity C-reactive protein (hs-CRP) and biomarkers of oxidative stress in diabetic patients. We searched the PubMed, Web of Science, and The Cochrane Library databases from the inception to October 31, 2018. Randomized controlled trials (RCTs) which reported the effect of probiotics or synbiotics on circulating (serum and plasma) inflammatory marker (hs-CRP) and oxidative stress indicators (malondialdehyde [MDA], glutathione [GSH], nitric oxide [NO], and total antioxidant capacity [TAC]) among patients with diabetes were included. Eligible studies were assessed for risk of bias and subjected to qualitative and quantitative synthesis using either fixed- or random-effects models accounting for clinical heterogeneity. Our meta-analysis identified 16 eligible RCTs (n = 1060). The methodological quality varied across these trials. Pooled data from these trials demonstrated that probiotic and synbiotic consumption significantly decreased hs-CRP level (standardized mean difference [SMD]=-0.38; 95% confidence interval [CI]:-0.51,-0.24; P = 0.000) and MDA (SMD=-0.61; 95% CI: -0.89, -0.32; P = 0.000) in diabetic patients compared to those in subjects receiving placebos. In addition, probiotic and symbiotic supplementation was found to increase TAC (SMD = 0.31; 95% CI: 0.09, 0.52; P = 0.006), NO (SMD, 0.62; 95% CI, 0.25 to 0.99; P = 0.001) and GSH (SMD = 0.41; 95% CI: 0.26, 0.55, P = 0.000) levels. The results of this systematic review and meta-analysis suggest that probiotic and synbiotic supplementation may help to improve biomarkers of inflammation and oxidative stress in diabetic patients. Further studies are needed to develop clinical practice guidelines for the management of inflammation and oxidative stress in these patients.