全谷物对超重及肥胖成年人胰岛素抵抗影响的Meta分析  

Effects of whole grains on insulin resistance in overweight and obese adults:a Meta-analysis

作　　者：舒幸 姜皓琪 李彬 胡安拉[1] Shu Xing;Jiang Haoqi;Li Bin;Hu Anla(Department of Nutrition and Food Hygiene,School of Public Health,Anhui Medical University,Hefei 230032,China)

机构地区：[1]安徽医科大学公共卫生学院营养与食品卫生学系,合肥230032

出　　处：《卫生研究》2023年第2期292-299,共8页Journal of Hygiene Research

基　　金：国家自然科学基金(No.81502806);安徽高校自然科学研究重点项目(No.KJ2019A0227)。

摘　　要：目的采用Meta分析方法,分析在随机对照试验中,全谷物摄入对超重及肥胖成年人胰岛素抵抗的影响。方法在PubMed、EMBASE、MEDLINE、Cochrane Library、中国生物医学文献数据库(CBM)、中国知网(CNKI)等数据库进行数据检索,检索时间从建库至2021年8月9日。筛选出关于全谷物对超重及肥胖成年人胰岛素抵抗影响的随机对照试验,对符合纳入标准的文献进行资料提取和质量评价,采用R4.1.2软件进行Meta分析。结果共纳入10项随机对照研究,Meta分析表明,全谷物摄入可降低超重及肥胖成年人空腹血糖(fasting plasma glucose,FPG)(MD=-0.08,95%CI-0.12~-0.04)、胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)(MD=-0.37,95%CI-0.60~-0.14)和定量胰岛素敏感性指数(quantitative insulin sensitivity index,QUICKI)(MD=0.006,95%CI 0.005~0.007),但在空腹胰岛素(fasting insulin,FINS)、餐后血糖(postprandial glucose,PG)、餐后胰岛素(postprandial insulin,PI)以及甘油三酯(triglyceride,TG)上,全谷物摄入对超重及肥胖成年人的效果差异未显现出统计学意义。亚组分析发现,FPG在德国人、质量评分4分、全谷物摄入量150~200 g以及各人群健康分组中均有统计学意义;而HOMA-IR仅在摄入量分组中具有统计学意义,且全谷物摄入量在100~150 g具有保护作用;QUICKI各组间均无统计学意义。在敏感性分析和发表偏倚中,FINS、PG、PI以及TG在分别去除1篇文献后,结果均变成有统计学意义;而HOMA-IR在去除1篇文献后,结果变成无统计学意义。同时,Egger回归分析显示各指标均不存在发表偏倚,文献结果整体较稳定。根据已有的亚组分析结果,对全谷物摄入剂量做了进一步的线性剂量-反应分析,发现全谷物每日摄入量在140~160 g,FPG效应量值较好。结论每日摄入140~160 g全谷物可以改善超重及肥胖成年人FPG水平。OBJECTIVE To conduct a Meta-analysis of the effects of whole grains on insulin resistance in overweight and obese adults in randomize controlled trials.METHODS Data were retrieved from PubMed,EMBASE,MEDLINE,Cochrane Library,CBM,CNKI and other databases from the database establishment to August 9,2021.Randomize controlled trials of the effects of whole grains on insulin resistance in overweight and obese adults were screened out.Data extraction and quality evaluation were conducted for the literatures meeting the inclusion criteria.The Meta-analysis was conducted using R4.1.2 software.RESULTS A total of 10 randomized controlled trials were included.Among the overweight and obese adults,the whole grains intake decreased their fasting plasma glucose(FPG)(MD=-0.08,95%CI-0.12,-0.04),homeostasis model assessment of insulin resistance(HOMA-IR)(MD=-0.37,95%CI-0.60,-0.14)and quantitative insulin sensitivity index(QUICKI)(MD=0.006,95%CI 0.005,0.007).However,there were no statistically significant among fasting insulin(FINS),postprandial blood glucose(PG),postprandial insulin(PI),and triglycerides(TG)in overweight and obese adults.In subgroup analysis,FPG was statistically significant in German,quality score 4,150-200 g intake of whole grain,and health subgroups of each population.There was no statistical significance of the QUICKI group.In sensitivity analysis and publication bias,FINS,PG,PI and TG became significant after one article was removed.However,HOMA-IR result were not statistically significant after the removal of one article.Meanwhile,the publication bias of each index was analyzed by Egger regression.Based on the results of subgroup analysis,a further dose-response analysis was conducted on the whole grains intake.The result showed that the FPG effects scale was better when the daily intake of whole grains was between 140 g and 160 g.CONCLUSION Daily intake of 140 g to 160 g of whole grains improves FPG levels in overweight and obese adults.

关 键 词：全谷物 超重及肥胖 胰岛素抵抗 随机对照试验 META分析 

分 类 号：R151.4[医药卫生—营养与食品卫生学] R153[医药卫生—公共卫生与预防医学]