Modulation of Inflammatory Markers in Type 2 Diabetes Mellitus Through Gut Microbiome-Targeted Interventions: An umbrella review on meta-analyses.

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2024-11-15 DOI:10.1016/j.clnesp.2024.11.011

Arman Habibi, Negin Letafatkar, Nazila Sattari, Sara Nobakht, Zahra Rafat, Saman Soltani Moghdam, Arian Mirdamadi, Mona Javid, Parsa Jamilian, Soheil Hassanipour, Mohammad-Hossein Keivanlou, Ehsan Amini-Salehi

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引用次数: 0

Abstract

Background & aims: Type 2 diabetes mellitus (T2DM) poses a significant global health challenge due to various lifestyle factors contributing to its prevalence and associated complications. Chronic low-grade inflammation, characterized by elevated levels of inflammatory markers such as C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α), plays a pivotal role in the pathogenesis of T2DM. Modulation of the gut microbiota through microbiome-targeted therapy (MTT), including probiotics, prebiotics, and synbiotics, has emerged as a potential strategy to mitigate inflammation and improve metabolic outcomes in T2DM.

Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines to evaluate the impact of MTT on inflammatory markers in patients with T2DM. Searches were performed in PubMed, Scopus, and Web of Science databases up to June 2024, with inclusion criteria limited to English-language meta-analyses of randomized controlled trials (RCTs) assessing the effects of probiotics, prebiotics, or synbiotics on inflammatory markers in T2DM patients.

Results: Ten meta-analyses met the inclusion criteria, comprising studies investigating the effects of various MTT interventions on CRP, IL-6, and TNF-α levels in T2DM patients. Meta-analysis results indicated significant reductions in CRP (SMD: -0.070; 95% CI: -0.119 to -0.020) and TNF-α (SMD: -0.370; 95% CI: -0.554 to -0.186) levels following MTT, while IL-6 reductions (SMD: -0.070; 95% CI: -0.269 to 0.129) did not reach statistical significance. However, heterogeneity in study quality, intervention protocols, and participant demographics posed challenges in interpretation.

Conclusions: While improvements in inflammatory markers with MTT have been observed, significant limitations-such as heterogeneity in study quality and variation in intervention protocols-highlight the need for further research to confirm its efficacy and clarify underlying mechanisms. Future studies should aim to address these limitations by exploring variations in dosage, supplement formulations, and bacterial strains, which are crucial for improving the reliability and broader applicability of MTT in the management of T2DM.

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通过肠道微生物靶向干预调节 2 型糖尿病患者的炎症标志物：荟萃分析综述。

背景与目的：由于各种生活方式因素导致 2 型糖尿病（T2DM）的发病率和相关并发症，因此它对全球健康构成了重大挑战。以 C 反应蛋白（CRP）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）等炎症标志物水平升高为特征的慢性低度炎症在 T2DM 的发病机制中起着举足轻重的作用。通过微生物组靶向疗法（MTT）（包括益生菌、益生元和合成益生菌）调节肠道微生物组已成为缓解炎症和改善 T2DM 代谢结果的潜在策略：按照 PRISMA 指南进行了系统综述和荟萃分析，以评估 MTT 对 T2DM 患者炎症指标的影响。研究人员在 PubMed、Scopus 和 Web of Science 数据库中进行了检索（截至 2024 年 6 月），纳入标准仅限于评估益生菌、益生元或合生元对 T2DM 患者炎症指标影响的随机对照试验 (RCT) 的英文荟萃分析：十项荟萃分析符合纳入标准，包括调查各种 MTT 干预措施对 T2DM 患者 CRP、IL-6 和 TNF-α 水平影响的研究。元分析结果表明，MTT后CRP（SMD：-0.070；95% CI：-0.119至-0.020）和TNF-α（SMD：-0.370；95% CI：-0.554至-0.186）水平显著降低，而IL-6的降低（SMD：-0.070；95% CI：-0.269至0.129）未达到统计学意义。然而，研究质量、干预方案和参与者人口统计学方面的异质性给解释带来了挑战：虽然已观察到 MTT 可改善炎症指标，但其显著的局限性--如研究质量的异质性和干预方案的差异--凸显了进一步研究的必要性，以确认其疗效并阐明其潜在机制。未来的研究应致力于通过探索剂量、补充剂配方和细菌菌株的变化来解决这些局限性，这对于提高 MTT 在 T2DM 治疗中的可靠性和更广泛的适用性至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.