Na Li, Xueqin Yan, Jiayi Lin, Meng Wu, Xingyu He, Jingxian Yang, Hongling Li, Wenjun Wei, Yinlei Zhang, Yuting Zhong, Guangya Xu, Zhonglin Fan, Xingrong Hu, Yao Wang, Zheng Shi
{"title":"肌肽或-丙氨酸补充治疗对前驱糖尿病或2型糖尿病的影响:随机对照试验的系统回顾和荟萃分析","authors":"Na Li, Xueqin Yan, Jiayi Lin, Meng Wu, Xingyu He, Jingxian Yang, Hongling Li, Wenjun Wei, Yinlei Zhang, Yuting Zhong, Guangya Xu, Zhonglin Fan, Xingrong Hu, Yao Wang, Zheng Shi","doi":"10.1186/s12902-025-02016-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Carnosine and beta-alanine (β-alanine) have shown potential in the management of chronic conditions, including metabolic disorders. However, their therapeutic efficacy in individuals with type 2 diabetes mellitus (T2DM) and prediabetes remains inconclusive due to heterogeneity in clinical trial results and limited synthesis of human evidence.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aim to evaluate the effects of carnosine and β-alanine supplementation on patients with prediabetes and T2DM.</p><p><strong>Methods: </strong>We searched PubMed, Cochrane Library, Web of Science, and Embase from inception to 9 October 2024 for randomized controlled trials that compared carnosine or β-alanine supplementation to placebo in prediabetic and diabetic populations. The quality of evidence was appraised using the Jadad scale, and the risk of bias was assessed using the Cochrane Risk of Bias tool. Data were analyzed using RevMan and Stata, employing fixed-effects models and I-V methods.</p><p><strong>Results: </strong>Eight trials met the inclusion criteria, totaling 377 participants. Our analysis indicated that supplementation significantly reduced fasting blood glucose (FBG) (SMD: -0.53; 95% CI: -0.75 to -0.31; p < 0.00001) and hemoglobin A1c (HbA1c) levels (SMD:-0.36; 95% CI:-0.59 to -0.12; p = 0.003) compared to placebo. No significant effects were observed on body mass index (BMI), fasting insulin. low-density lipoprotein cholesterol (LDL-c) or high-density lipoprotein cholesterol (HDL-c), but a lowering effect was observed in total cholesterol (TC). Notably, Homeostasis Model Assessment of Beta-cell Function (HOMA-β) values were improved, suggesting enhanced β-cell function, while changes in homeostasis model assessment of insulin resistance (HOMA-IR) did not reach statistical significance.</p><p><strong>Conclusions: </strong>Carnosine and β-alanine supplementation show potential as adjunct therapies for improving FBG, HbA1c and HOMA-β in prediabetes and T2DM. 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However, their therapeutic efficacy in individuals with type 2 diabetes mellitus (T2DM) and prediabetes remains inconclusive due to heterogeneity in clinical trial results and limited synthesis of human evidence.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aim to evaluate the effects of carnosine and β-alanine supplementation on patients with prediabetes and T2DM.</p><p><strong>Methods: </strong>We searched PubMed, Cochrane Library, Web of Science, and Embase from inception to 9 October 2024 for randomized controlled trials that compared carnosine or β-alanine supplementation to placebo in prediabetic and diabetic populations. The quality of evidence was appraised using the Jadad scale, and the risk of bias was assessed using the Cochrane Risk of Bias tool. Data were analyzed using RevMan and Stata, employing fixed-effects models and I-V methods.</p><p><strong>Results: </strong>Eight trials met the inclusion criteria, totaling 377 participants. Our analysis indicated that supplementation significantly reduced fasting blood glucose (FBG) (SMD: -0.53; 95% CI: -0.75 to -0.31; p < 0.00001) and hemoglobin A1c (HbA1c) levels (SMD:-0.36; 95% CI:-0.59 to -0.12; p = 0.003) compared to placebo. No significant effects were observed on body mass index (BMI), fasting insulin. low-density lipoprotein cholesterol (LDL-c) or high-density lipoprotein cholesterol (HDL-c), but a lowering effect was observed in total cholesterol (TC). Notably, Homeostasis Model Assessment of Beta-cell Function (HOMA-β) values were improved, suggesting enhanced β-cell function, while changes in homeostasis model assessment of insulin resistance (HOMA-IR) did not reach statistical significance.</p><p><strong>Conclusions: </strong>Carnosine and β-alanine supplementation show potential as adjunct therapies for improving FBG, HbA1c and HOMA-β in prediabetes and T2DM. 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引用次数: 0
摘要
背景:肌肽和β-丙氨酸(β-丙氨酸)在包括代谢紊乱在内的慢性疾病的治疗中显示出潜力。然而,由于临床试验结果的异质性和有限的人类证据合成,它们对2型糖尿病(T2DM)和前驱糖尿病患者的治疗效果仍不确定。目的:本系统综述和荟萃分析旨在评价补充肌肽和β-丙氨酸对糖尿病前期和2型糖尿病患者的影响。方法:我们检索了PubMed, Cochrane Library, Web of Science和Embase从成立到2024年10月9日的随机对照试验,比较了肌肽或β-丙氨酸补充剂与安慰剂在糖尿病前期和糖尿病人群中的作用。采用Jadad量表评价证据质量,采用Cochrane偏倚风险工具评价偏倚风险。数据分析采用RevMan和Stata,采用固定效应模型和I-V方法。结果:8项试验符合纳入标准,共377名受试者。我们的分析表明,补充肌肽可显著降低空腹血糖(FBG) (SMD: -0.53; 95% CI: -0.75至-0.31;p)。结论:补充肌肽和β-丙氨酸可作为改善糖尿病前期和2型糖尿病患者FBG、HbA1c和HOMA-β的辅助疗法。在临床实践中,需要进一步严格的研究来确定最佳剂量、治疗时间和长期疗效。
Effect of carnosine or beta-alanine supplementation therapy for prediabetes or type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials.
Background: Carnosine and beta-alanine (β-alanine) have shown potential in the management of chronic conditions, including metabolic disorders. However, their therapeutic efficacy in individuals with type 2 diabetes mellitus (T2DM) and prediabetes remains inconclusive due to heterogeneity in clinical trial results and limited synthesis of human evidence.
Objective: This systematic review and meta-analysis aim to evaluate the effects of carnosine and β-alanine supplementation on patients with prediabetes and T2DM.
Methods: We searched PubMed, Cochrane Library, Web of Science, and Embase from inception to 9 October 2024 for randomized controlled trials that compared carnosine or β-alanine supplementation to placebo in prediabetic and diabetic populations. The quality of evidence was appraised using the Jadad scale, and the risk of bias was assessed using the Cochrane Risk of Bias tool. Data were analyzed using RevMan and Stata, employing fixed-effects models and I-V methods.
Results: Eight trials met the inclusion criteria, totaling 377 participants. Our analysis indicated that supplementation significantly reduced fasting blood glucose (FBG) (SMD: -0.53; 95% CI: -0.75 to -0.31; p < 0.00001) and hemoglobin A1c (HbA1c) levels (SMD:-0.36; 95% CI:-0.59 to -0.12; p = 0.003) compared to placebo. No significant effects were observed on body mass index (BMI), fasting insulin. low-density lipoprotein cholesterol (LDL-c) or high-density lipoprotein cholesterol (HDL-c), but a lowering effect was observed in total cholesterol (TC). Notably, Homeostasis Model Assessment of Beta-cell Function (HOMA-β) values were improved, suggesting enhanced β-cell function, while changes in homeostasis model assessment of insulin resistance (HOMA-IR) did not reach statistical significance.
Conclusions: Carnosine and β-alanine supplementation show potential as adjunct therapies for improving FBG, HbA1c and HOMA-β in prediabetes and T2DM. Further rigorous studies are warranted to establish optimal dosage, treatment duration, and long-term efficacy in clinical practice.
期刊介绍:
BMC Endocrine Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of endocrine disorders, as well as related molecular genetics, pathophysiology, and epidemiology.