Efficacy of inulin supplementation in improving insulin control, HbA1c and HOMA-IR in patients with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials.

Type 2 diabetes mellitus is a chronic disease that occurs among the general population. The insulin-lowering and homeostasis model assessment of insulin resistance-improving effects of inulin are unconfirmed. We conducted this meta-analysis to examine the efficiency and safety of inulin for improving insulin control, homeostasis model assessment of insulin resistance and HbA1c in patients with type 2 diabetes mellitus. We searched the Web of Science, PubMed, Embase and Cochrane Library databases for relevant articles published before June 1, 2019. In total, 225 randomized controlled trials regarding the efficiency of inulin for the treatment of type 2 diabetes mellitus compared to the efficacy of placebo or other treatments were examined. According to the inclusion and exclusion criteria, 9 trials with a total of 661 participants were included. We concluded that inulin supplementation can significantly improve fasting plasma glucose (SMD = -0.55, 95% CI -0.73 to -0.36, p = 0), HOMA-IR (SMD = -0.81, 95% CI -1.59 to -0.03, p = 0.042) and HbA1c (SMD = -0.69, 95% CI -0.92 to -0.46, p = 0). Further subgroup analyses revealed a significant role of inulin supplementation for treatment durations ≥8 weeks (p = 0.038 for insulin, p = 0.002 for HOMA-IR, p = 0.032 for FPG, p = 0 for HbA1c).

The Effect of Protein-Enriched Meal Replacement on Waist Circumference Reduction among Overweight and Obese Chinese with Hyperlipidemia.

OBJECTIVE: In China, high-fat diets and excessive energy intake have led to an increasing prevalence of obesity which was previously uncommon. The current study examined the effects of meal replacement (MR) on weight control in overweight or obese Chinese individuals with hyperlipidemia. METHODS: Patients, 18-65 years, with body mass index 25-35 kg/m(2) and triglycerides >1.7 and <5.4 mmol/L were enrolled. Major exclusion criteria were: type II diabetes, fasting glucose ≥7.0 mmol/L, glycosylated hemoglobin ≥6.5%; weight loss surgery or use of weight loss drugs; weight fluctuations >2%; use of cholesterol-lowering drugs. Eligible patients were randomized 1:1 to a high-protein (HP) diet (2.2 g protein/kg/day) or a standard-protein (SP) diet (1.1 g protein/kg/ day) provided twice daily for 3 months. Assessments included body weight, waist-hip ratio, body fat percentage, blood lipids, blood glucose, insulin, liver and kidney function. RESULTS: Although mean weight loss and percent BMI reduction were greater with HP than SP at 12 weeks, the differences were not significant. There was, however, a significantly greater decrease in waist-hip ratio with HP versus SP (-0.03 ± 0.03 vs. -0.01 ± 0.04; p < 0.05). Triglycerides decreased from baseline in both groups; however, the difference was not significant. Both HP and SP were well tolerated. This study demonstrated that in obese Chinese patients with hyperlipidemia, a protein-enriched MR diet resulted in significantly reduced waist circumference compared to a standard protein diet. CONCLUSION: This first study of protein-enriched partial meal replacement in a free-living Chinese population suggests a new and promising strategy for reducing abdominal obesity in China.

Effects of probiotics on nonalcoholic fatty liver disease: a systematic review and meta-analysis.

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) has become prevalent in recent decades, especially in developed countries, and approaches for the prevention and treatment of NAFLD are not clear. The aim of this research was to analyze and summarize randomized controlled trials that investigated the effects of probiotics on NAFLD. METHODS: Seven databases (PubMed, Embase, the Web of Science, the Cochrane Library, China National Knowledge Infrastructure, Wan Fang Data, and VIP Database) were searched. Then, eligible studies were identified. Finally, proper data extraction, synthesis and analysis were performed by trained researchers. RESULTS: Anthropometric parameters: with use of probiotics weight was reduced by 2.31 kg, and body mass index (BMI) was reduced by 1.08 kg/m2. Liver function: probiotic treatment reduced the alanine aminotransferase level by 7.22 U/l, the aspartate aminotransferase level by 7.22 U/l, the alkaline phosphatase level by 25.87 U/l, and the glutamyl transpeptidase level by -5.76 U/l. Lipid profiles: total cholesterol, low-density lipoprotein cholesterol, and triglycerides were significantly decreased after probiotic treatment. Their overall effects (shown as standard mean difference) were -0.73, -0.54, and -0.36, respectively. Plasma glucose: probiotics reduced the plasma glucose level by 4.45 mg/dl and the insulin level by 0.63. Cytokines: probiotic treatment decreased tumor necrosis factor alpha by 0.62 and leptin by 1.14. Degree of liver fat infiltration (DFI): the related risk of probiotics for restoring DFI was 2.47 (95% confidence interval, 1.61-3.81, p < 0.001). CONCLUSION: Probiotic treatment or supplementation is a promising therapeutic method for NAFLD.