Effect and safety of nutritional supplements on clinical outcomes in patients with acute pancreatitis: a systematic review and network meta-analysis.

IF 5.7 2区医学 Q1 NUTRITION & DIETETICS

Nutrition Journal Pub Date : 2026-02-27 DOI:10.1186/s12937-026-01295-w

Kaifeng Su, Ruifeng Duan, Yang Wu

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引用次数: 0

Abstract

BACKGROUND: The effectiveness of nutritional supplements is controversial compared to standard supplementation in the clinical management of individuals with acute pancreatitis (AP). We performed a network meta-analysis (NMA) to compare and rank their efficacy. METHODS: Four databases (Web of Science, Cochrane, Embase, PubMed) were searched for randomized controlled trials. Random-effects models to derive outcome estimates, with risk ratios (RRs) and 95% confidence intervals (CIs) calculated for each comparison. The surface under the cumulative ranking (SUCRA) was used to rank the relative efficacy of all therapies. RESULTS: Seventeen trials including 1,313 patients were analyzed. ω-3 fatty acid supplementation emerged as the most effective intervention. It significantly shortened hospital stay (mean difference = -5.82 days; 95% CI -10.62 to -1.01) and intensive care unit (ICU) stay (mean difference = -6.09 days; 95% CI -8.98 to -3.20). It also reduced ICU stay in patients with severe acute pancreatitis (SAP) (mean difference = -6.09 days; 95% CI -8.98 to -3.02). Moreover, ω-3 fatty acids reduced the risk of sepsis (RR = 0.35; 95% CI 0.14–0.89) in AP and SAP (RR = 0.30; 95% CI 0.10–0.93). Synbiotics dramatically reduced the incidence of bacteremia (RR = 0.27; 95% CI = 0.09–0.86). It also reduced ICU stay with the enteral route (mean difference = -3.22 days; 95% CI, -3.95 to -2.49). However, none of the regimens produced significant improvements in mortality, infectious complications, time to oral feeding, or multiorgan failure (MOF). CONCLUSIONS: This NMA preliminary suggests that ω-3 fatty acid supplementation demonstrates the greatest efficacy in reducing the length of hospital and ICU stays in individuals with AP. Hence, it should be considered for routine use in AP, as it may reduce the future medical burden. Furthermore, increasing ω-3 fatty acids and synbiotics may contribute to a reduced incidence of sepsis and bacteremia, respectively.

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营养补充剂对急性胰腺炎患者临床结局的影响和安全性：系统综述和网络荟萃分析。

背景：在急性胰腺炎（AP）患者的临床治疗中，营养补充剂的有效性与标准补充剂相比存在争议。我们进行了网络荟萃分析（NMA）来比较和排名他们的疗效。方法：检索Web of Science、Cochrane、Embase、PubMed四个数据库，检索随机对照试验。随机效应模型得出结果估计，并计算每个比较的风险比（rr）和95%置信区间（ci）。采用累积排序表（SUCRA）对各疗法的相对疗效进行排序。结果：共分析了17项试验，1313例患者。ω-3脂肪酸的补充是最有效的干预措施。它显著缩短了住院时间（平均差异= -5.82天；95% CI = -10.62至-1.01）和重症监护病房（ICU）住院时间（平均差异= -6.09天；95% CI = -8.98至-3.20）。它还减少了重症急性胰腺炎（SAP）患者的ICU住院时间（平均差异= -6.09天；95% CI = -8.98至-3.02）。此外，ω-3脂肪酸降低AP和SAP患者脓毒症的风险（RR = 0.35; 95% CI 0.14-0.89）（RR = 0.30; 95% CI 0.10-0.93）。合成抗生素显著降低了菌血症的发生率（RR = 0.27; 95% CI = 0.09-0.86）。它还减少了肠内途径的ICU住院时间（平均差异= -3.22天；95% CI, -3.95至-2.49）。然而，没有一种方案在死亡率、感染并发症、口服喂养时间或多器官衰竭（MOF）方面产生显著改善。结论：该NMA初步提示ω-3脂肪酸补充在减少AP患者住院和ICU住院时间方面效果最大。因此，应考虑将其作为AP患者的常规使用，因为它可能减轻未来的医疗负担。此外，ω-3脂肪酸和合成制剂的增加可能分别有助于降低败血症和菌血症的发生率。

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来源期刊

Nutrition Journal NUTRITION & DIETETICS-

CiteScore

9.80

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Nutrition Journal publishes surveillance, epidemiologic, and intervention research that sheds light on i) influences (e.g., familial, environmental) on eating patterns; ii) associations between eating patterns and health, and iii) strategies to improve eating patterns among populations. The journal also welcomes manuscripts reporting on the psychometric properties (e.g., validity, reliability) and feasibility of methods (e.g., for assessing dietary intake) for human nutrition research. In addition, study protocols for controlled trials and cohort studies, with an emphasis on methods for assessing dietary exposures and outcomes as well as intervention components, will be considered. Manuscripts that consider eating patterns holistically, as opposed to solely reductionist approaches that focus on specific dietary components in isolation, are encouraged. Also encouraged are papers that take a holistic or systems perspective in attempting to understand possible compensatory and differential effects of nutrition interventions. The journal does not consider animal studies. In addition to the influence of eating patterns for human health, we also invite research providing insights into the environmental sustainability of dietary practices. Again, a holistic perspective is encouraged, for example, through the consideration of how eating patterns might maximize both human and planetary health.