目标:虽然益生菌,益生元和合生元已被证明具有健康益处,它们对心脏代谢危险因素的影响尚不清楚.因此,我们进行了一项全面审查,以检查它们在人体测量方面的有效性,心脏代谢和炎症标志物。
方法:我们从七个电子数据库中检索到的期刊开始至2023年1月13日,对合格的系统综述进行了综述(CINAHL,EMBASE,ProQuest,PubMed,Scopus,科克伦图书馆,和WebofScience)。使用多重系统评估2(AMSTAR2)工具评估方法学质量,并将证据的确定性分为五类。对SRMA和主要研究水平的结果效应大小进行随机效应荟萃分析。使用校正的覆盖面积评估重叠制品的程度。
结果:24篇系统综述,代表265项独特研究,包括1076个独特的效应大小和25,973个受试者。合生元显然在改善体重方面更有效(-1.91kg,95CI-3.45千克至-0.37千克,p=0.02),总胆固醇(-12.17mg/dl,95CI-17.89mg/dl至-6.46mg/dl,p<0.001),低密度脂蛋白(-12.26mg/dl,95CI-18.27mg/dl至-6.25mg/dl,p<0.01),腰围(-1.85厘米,95CI-2.77厘米至-0.94厘米,p<0.01),和空腹血糖(-9.68mg/dl,95CI-16.18mg/dl至-3.18mg/dl,p<0.01)。益生元在改善体重指数方面更有效(-0.34kg/m2,95CI-0.48kg/m2至-0.20kg/m2,p<0.01),和HOMA-IR(-0.92,95CI-1.91至0.07,p=0.06)。益生菌被证明在降低舒张压方面更有效(-1.34mmHg,95CI-2.14mmHg至-0.55mmHg,P<0.01)改善胰岛素水平变化(-0.84mIU/mL,95CI-1.27mIU/mL至-0.41mIU/mL,p<0.01),和身体脂肪的百分比(-0.66%,95CI-0.70%至-0.61%,p<0.01)。对于所有结果,证据的可信度被列为四级.
结论:前,pro-,合生元可以显著提高人体测量指数,葡萄糖和脂质分布,血压,和肥胖个体的炎症标志物。虽然建议他们的补充剂对这个人群有希望,真正的临床影响取决于根据特定适应症定制这些干预措施,并根据个体患者的需求定制治疗策略.
OBJECTIVE: Though probiotics, prebiotics and synbiotics have been shown to confer health benefits, their effects on cardiometabolic risk factors remain unclear. Therefore, we conducted an umbrella review to examine their effectiveness on
anthropometric, cardiometabolic and inflammatory markers.
METHODS: We conducted an umbrella review on eligible systematic reviews with meta-analysis (SRMA) published from journals\' inception till 13 January 2023 retrieved from seven electronic databases (CINAHL, EMBASE, ProQuest, PubMed, Scopus, The Cochrane Library, and Web of Science). Methodological quality was appraised using the Assessment of Multiple Systematic Reviews 2 (AMSTAR2) tool and certainty of evidence was graded into five classes. Random-effects meta-analyses were performed on outcome effect sizes at the SRMA and primary study levels. Extent of overlapping articles were evaluated using corrected cover area.
RESULTS: 24 systematic reviews representing 265 unique studies, 1076 unique effect sizes and 25,973 subjects were included. Synbiotics were evidently more effective in improving weight (-1.91 kg, 95%CI -3.45 kg to -0.37 kg, p = 0.02), total cholesterol (-12.17 mg/dl, 95%CI -17.89 mg/dl to -6.46 mg/dl, p < 0.001), low-density lipoprotein (-12.26 mg/dl, 95%CI -18.27 mg/dl to -6.25 mg/dl, p < 0.01), waist circumference (-1.85 cm, 95%CI -2.77 cm to -0.94 cm, p < 0.01), and fasting plasma glucose (-9.68 mg/dl, 95%CI -16.18 mg/dl to -3.18 mg/dl, p < 0.01). Prebiotics were more effective in improving body mass index (-0.34 kg/m2, 95%CI -0.48 kg/m2 to -0.20 kg/m2, p < 0.01), and HOMA-IR (-0.92, 95%CI -1.91 to 0.07, p = 0.06). Probiotics were shown to be more effective in reducing diastolic blood pressure (-1.34 mmHg, 95%CI -2.14 mmHg to -0.55 mmHg, P < 0.01) improving insulin level change (-0.84 mIU/mL, 95%CI -1.27 mIU/mL to -0.41 mIU/mL, p < 0.01), and the percentage of body fat (-0.66%, 95%CI -0.70% to -0.61%, p < 0.01). For all outcomes, the credibility of evidence was classified as class IV.
CONCLUSIONS: Pre-, pro-, and synbiotics can significantly enhance
anthropometric indices, glucose and lipid profiles, blood pressure, and inflammatory markers in individuals confronting obesity. While suggesting their supplementation holds promise for this population, the true clinical impact hinges on tailoring these interventions to specific indications and customizing treatment strategies to align with individual patient needs.