Systematic review assessing the effectiveness of dietary intervention on gut microbiota in adults with type 2 diabetes.
Systematic review assessing the effectiveness of dietary intervention on gut microbiota in adults with type 2 diabetes.
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DOI：
10.1007/s00125-018-4632-0
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发表时间：
2018-08
期刊：
影响因子：
8.2
通讯作者：
Avery L
中科院分区：
文献类型：
--
作者：
Houghton D;Hardy T;Stewart C;Errington L;Day CP;Trenell MI;Avery L
尽管人们对 2 型糖尿病的病理生理学了解有所提高，但对疾病进展和治疗反应的个体差异的解释并不完整。肠道微生物群与 2 型糖尿病的病理生理学有关，并可能解释这种变异性。我们进行了一项系统评价，以评估饮食和体力活动/运动干预措施在调节肠道微生物群和改善成人 2 型糖尿病患者血糖控制方面的有效性。我们进行了一项系统性检索，以确定有关饮食和体力活动/运动干预措施对确诊 2 型糖尿病个体肠道微生物群和血糖控制影响的研究报告。使用数据提取表格捕获研究特征、方法学质量和与干预措施相关的细节。在有足够数据的情况下进行荟萃分析，并以叙述方式报告其他结果。八项研究符合系统评价的资格标准。没有发现任何研究报告体力活动/锻炼对肠道微生物群和血糖控制的影响。然而，有关饮食干预的研究报告表明，此类干预措施与肠道微生物群的组成和多样性的改变有关。 HbA1c（标准化平均差 [SMD] -2.31 mmol/mol [95% CI -2.76, -1.85] [0.21%；95% CI -0.26, -0.16]；I2 = 0%，p < 0.01）有统计学显着改善，但空腹血糖没有改善（SMD -0.25 mmol/l） [95% CI -0.85, 0.35]，I2 = 87%，p > 0.05)，空腹胰岛素 (SMD -1.82 pmol/l [95% CI -7.23，3.60]，I2 = 54%，p > 0.05) 或 HOMA-IR (SMD -0.15) [95% CI -0.63, 0.32]，I2 = 69%，p > 0.05）将饮食干预与对照组进行比较。双歧杆菌属 (SMD 1.29% [95% CI -4.45, 7.03], I2 = 33%, p > 0.05)、罗斯布里亚属 (SMD -0.85% [95% CI -2.91, 1.21], I2 = 79%, p > 0.05）或乳酸菌（SMD 0.04% [95% CI -0.01, 0.09]，I2 = 0%，p > 0.05）将饮食干预与对照组进行比较。然而，肠道微生物群还存在其他显着变化，包括不同分类水平的变化，包括门、科、属和种、厚壁菌门：拟杆菌门比率以及多样性矩阵（α和β）的变化。饮食干预对炎症、短链脂肪酸或人体测量学的影响很小或没有影响。研究发现，饮食干预可以调节 2 型糖尿病患者的肠道微生物群并改善血糖控制。尽管纳入研究的结果令人鼓舞，但本综述强调需要进一步开展良好的干预研究，以便为针对肠道微生物群的饮食干预措施的临床使用提供信息。本文的在线版本 (10.1007/s00125-018-4632-0) 包含经过同行评审但未经编辑的补充材料，可供授权用户使用。
Despite improved understanding of the pathophysiology of type 2 diabetes mellitus, explanations for individual variability in disease progression and response to treatment are incomplete. The gut microbiota has been linked to the pathophysiology of type 2 diabetes mellitus and may account for this variability. We conducted a systematic review to assess the effectiveness of dietary and physical activity/exercise interventions in modulating the gut microbiota and improving glucose control in adults with type 2 diabetes mellitus. A systematic search was conducted to identify studies reporting on the effect of dietary and physical activity/exercise interventions on the gut microbiota and glucose control in individuals with a confirmed diagnosis of type 2 diabetes mellitus. Study characteristics, methodological quality and details relating to interventions were captured using a data-extraction form. Meta-analyses were conducted where sufficient data were available, and other results were reported narratively. Eight studies met the eligibility criteria of the systematic review. No studies were found that reported on the effects of physical activity/exercise on the gut microbiota and glucose control. However, studies reporting on dietary interventions showed that such interventions were associated with modifications to the composition and diversity of the gut microbiota. There was a statistically significant improvement in HbA1c (standardised mean difference [SMD] −2.31 mmol/mol [95% CI −2.76, −1.85] [0.21%; 95% CI −0.26, −0.16]; I2 = 0%, p < 0.01), but not in fasting blood glucose (SMD −0.25 mmol/l [95% CI −0.85, 0.35], I2 = 87%, p > 0.05), fasting insulin (SMD −1.82 pmol/l [95% CI −7.23, 3.60], I2 = 54%, p > 0.05) or HOMA-IR (SMD −0.15 [95% CI −0.63, 0.32], I2 = 69%, p > 0.05) when comparing dietary interventions with comparator groups. There were no significant changes in the relative abundance of bacteria in the genera Bifidobacterium (SMD 1.29% [95% CI −4.45, 7.03], I2 = 33%, p > 0.05), Roseburia (SMD −0.85% [95% CI −2.91, 1.21], I2 = 79%, p > 0.05) or Lactobacillus (SMD 0.04% [95% CI −0.01, 0.09], I2 = 0%, p > 0.05) when comparing dietary interventions with comparator groups. There were, however, other significant changes in the gut microbiota, including changes at various taxonomic levels, including phylum, family, genus and species, Firmicutes:Bacteroidetes ratios and changes in diversity matrices (α and β). Dietary intervention had minimal or no effect on inflammation, short-chain fatty acids or anthropometrics. Dietary intervention was found to modulate the gut microbiota and improve glucose control in individuals with type 2 diabetes. Although the results of the included studies are encouraging, this review highlights the need for further well-conducted interventional studies to inform the clinical use of dietary interventions targeting the gut microbiota. The online version of this article (10.1007/s00125-018-4632-0) contains peer-reviewed but unedited supplementary material, which is available to authorised users.
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影响因子：
11.1
作者：
Amar, Jacques;Chabo, Chantal;Waget, Aurelie;Klopp, Pascale;Vachoux, Christelle;Bermudez-Humaran, Luis G.;Smirnova, Natalia;Berge, Mathieu;Sulpice, Thierry;Lahtinen, Sampo;Ouwehand, Arthur;Langella, Philippe;Rautonen, Nina;Sansonetti, Philippe J.;Burcelin, Remy
通讯作者：
Burcelin, Remy
DOI：
10.1038/ismej.2014.45
发表时间：
2014-10
期刊：
The ISME journal
影响因子：
--
作者：
通讯作者：
--
影响因子：
5
作者：
Firouzi, Somayyeh;Majid, Hazreen Abdul;Barakatun-Nisak, Mohd-Yusof
通讯作者：
Barakatun-Nisak, Mohd-Yusof
影响因子：
3.6
作者：
Andreasen, Anne Sofie;Larsen, Nadja;Pedersen, Bente Klarlund
通讯作者：
Pedersen, Bente Klarlund
影响因子：
3.3
作者：
Kim, Min-Soo;Hwang, Seong-Soo;Bae, Jin-Woo
通讯作者：
Bae, Jin-Woo