长期禁食及其对炎症生物标志物的影响：一项全面的范围综述

IF 12.4 1区医学 Q1 CELL BIOLOGY

Ageing Research Reviews Pub Date : 2025-06-06 DOI:10.1016/j.arr.2025.102797

Isabella de Ciutiis , Shadia Djakovic , Maria Lastra Cagigas , Andrius Masedunskas , Lee Smith , Claudio Franceschi , Luigi Fontana

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引用次数: 0

摘要

尽管长时间禁食越来越受欢迎，但其生物学效应和潜在风险尚不清楚，声称它可以减少炎症。这项系统的范围综述研究了长时间禁食（≥48 h）对关键炎症生物标志物的影响：c反应蛋白（CRP）、白细胞介素-6 （IL-6）和肿瘤坏死因子-α (TNF-α)。方法根据PRISMA-ScR指南，综合检索PubMed、Medline （Ovid）、Web of Science、Embase （Classic and Embase）和Scopus，检索截止到2024年8月发表的研究。符合条件的研究是同行评审的人类临床试验，研究了长时间禁食对炎症标志物的影响。结果在多个数据库中进行系统检索后，有14项研究符合纳入标准。与普遍的看法相反，大多数研究报告在长时间禁食期间炎症生物标志物没有变化或增加。在禁食期间，CRP水平经常显著上升，尤其是超重或肥胖的人。一些研究也报告了TNF-α和IL-6的增加，尽管结果不太一致。重要的是，几项研究显示，进食后CRP水平降低或正常化，表明禁食的炎症反应可能是短暂的或适应性的。这些差异可能是由于禁食时间、参与者特征和研究设计的差异。本综述发现关于长时间禁食对炎症影响的证据有限且不一致，研究设计不同且缺乏标准方案。总的来说，长时间禁食似乎会导致炎症增加，这可能是一种适应性机制。未来的研究，特别是随机对照试验，需要评估禁食对不同人群炎症和代谢性疾病的长期影响。

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Long-term fasting and its influence on inflammatory biomarkers: A comprehensive scoping review

Objectives

Despite the rising popularity of prolonged fasting, its biological effects and potential risks remain unclear, with claims suggesting it reduces inflammation. This systematic scoping review examines the impact of prolonged fasting (≥48 h) on key inflammatory biomarkers: C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α).

Methods

Following PRISMA-ScR guidelines, a comprehensive search of PubMed, Medline (Ovid), Web of Science, Embase (Classic and Embase), and Scopus was conducted for studies published up to August 2024. Eligible studies were peer-reviewed human clinical trials that investigated prolonged fasting’s effects on inflammatory markers.

Results

Following a systematic search across multiple databases, 14 studies met the inclusion criteria. Contrary to popular belief, the majority of studies reported either no change or an increase in inflammatory biomarkers during prolonged fasting. CRP levels frequently rose—often significantly—during fasting periods, particularly in individuals with overweight or obesity. Some studies also reported increases in TNF-α and IL-6, though results were less consistent. Importantly, several studies showed a reduction or normalization of CRP levels after refeeding, suggesting that the inflammatory response to fasting may be transient or adaptive. These discrepancies may be due to differences in fasting duration, participant characteristics, and study design.

Conclusions

This review finds limited and inconsistent evidence on prolonged fasting's effects on inflammation, with varied study designs and lack of standard protocols. Overall, prolonged fasting appears to lead to an increase in inflammation that may represent an adaptive mechanism. Future research, particularly randomized controlled trials, is needed to assess the long-term impacts of fasting on inflammation and metabolic diseases across different populations.

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来源期刊

Ageing Research Reviews 医学-老年医学

CiteScore

19.80

自引率

2.30%

发文量

216

审稿时长

55 days

期刊介绍： With the rise in average human life expectancy, the impact of ageing and age-related diseases on our society has become increasingly significant. Ageing research is now a focal point for numerous laboratories, encompassing leaders in genetics, molecular and cellular biology, biochemistry, and behavior. Ageing Research Reviews (ARR) serves as a cornerstone in this field, addressing emerging trends. ARR aims to fill a substantial gap by providing critical reviews and viewpoints on evolving discoveries concerning the mechanisms of ageing and age-related diseases. The rapid progress in understanding the mechanisms controlling cellular proliferation, differentiation, and survival is unveiling new insights into the regulation of ageing. From telomerase to stem cells, and from energy to oxyradical metabolism, we are witnessing an exciting era in the multidisciplinary field of ageing research. The journal explores the cellular and molecular foundations of interventions that extend lifespan, such as caloric restriction. It identifies the underpinnings of manipulations that extend lifespan, shedding light on novel approaches for preventing age-related diseases. ARR publishes articles on focused topics selected from the expansive field of ageing research, with a particular emphasis on the cellular and molecular mechanisms of the aging process. This includes age-related diseases like cancer, cardiovascular disease, diabetes, and neurodegenerative disorders. The journal also covers applications of basic ageing research to lifespan extension and disease prevention, offering a comprehensive platform for advancing our understanding of this critical field.