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益生菌干预改善了妊娠期糖尿病的代谢结果:随机对照试验的元分析
Xiaowen Lan1, Bowen Li1, Jianxin Zhao1
1State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi 214122, Jiangsu, China; School of Food Science and Technology, Jiangnan University, Wuxi 214122, Jiangsu, China.
Clinical nutrition (Edinburgh, Scotland)
|May 30, 2024
概括
益生菌显著改善妊娠糖尿病 (GDM) 中的关键代谢标志物. 这一元分析显示,禁食葡萄糖,胰岛素和胰岛素抵抗性降低,这表明益生菌是一种有价值的辅助疗法,用于GDM管理.
科学领域:
- 生殖医学和产科生殖医学
- 代谢障碍 代谢障碍 代谢障碍
- 微生物组研究 微生物组研究
背景情况:
- 孕期糖尿病 (GDM) 对母亲和胎儿的健康构成风险.
- 优化GDM管理对于改善妊娠结果至关重要.
- 益生菌正在研究其潜在的代谢益处.
研究的目的:
- 对GDM中益生菌使用的随机对照试验进行元分析.
- 为优化使用益生菌的GDM临床实践提供基于证据的建议.
- 评估益生菌对GDM患者血糖控制和胰岛素敏感性的影响.
主要方法:
- 系统地搜索PubMed,Cochrane和Embase数据库的文献,直到2023年5月.
- 11项随机对照试验的元分析,涉及713名参与者.
- 使用Stata的统计分析,包括异质性评估 (Cochran的Q,I2) 和证据质量的GRADE方法.
主要成果:
- 益生菌的使用 (中位数为6x109 CFU/天) 显著降低了禁食葡萄糖 (MD: -4.16 mg/dL),禁食胰岛素 (MD: -3.33 μIU/ml) 和HOMA-IR (MD: -0.71).
- 益生菌显著改善了QUICKI (MD:0.01),表明胰岛素敏感性增强.
- 亚组分析显示,在基线BMI,葡萄糖和胰岛素水平较高的患者中,益处更大. 禁食葡萄糖和QUICKI的证据质量很高,禁食胰岛素和HOMA-IR的证据质量中等.
结论:
- 益生菌干预在降低GDM患者的禁食血糖,禁食胰岛素和HOMA-IR方面表现出显著的有效性.
- 益生菌有效地增加了QUICKI水平,表明胰岛素敏感性得到改善.
- 这些发现支持益生菌作为管理GDM的辅助疗法的潜力.
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