L. Fagbemi, Carlo Soldaini, Adele Costabile, Sofia Kolida, C. Ciacci, Y. Jeanes
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引用次数: 0
摘要
乳糜泻(CD)患者罹患心血管疾病(CVD)的风险较高,这可能是炎症造成的。益生菌可通过改变炎症等多种机制影响心血管疾病风险。我们对针对 CD 患者的益生菌干预措施进行了系统性回顾。我们共系统检索了4个数据库中截至2023年3月发表的研究。所有结果,包括任何心血管风险因素,都进行了整理和报告。我们筛选了 8084 篇文章,有 11 篇关于 7 项研究性试验和 2 项非研究性试验的报告符合定性分析的纳入标准。共有 1 项研究性试验和 2 项非研究性试验被认为存在较高的偏倚风险。研究之间存在很大的异质性,只有两项研究对是否坚持无麸质饮食进行了测量。没有报告与心血管风险相关的具体结果。有两项研究报告称,儿童在补充益生菌后,血清TNF-α会随着时间的推移而明显降低。一项研究报告称,在为期 3 周的干预中,肠道渗透性没有发生明显变化。目前还没有足够的证据表明益生菌对 CD 炎症有积极影响,部分原因是有关坚持无麸质饮食和活动性疾病的数据有限。
Probiotic Interventions in Coeliac Disease: A Systematic Review with a Focus on Cardiovascular Risk
People with coeliac disease (CD) have a higher risk of developing cardiovascular disease (CVD), potentially due to inflammation. Probiotics can influence CVD risk through several mechanisms including modifying inflammation. We performed a systematic review of probiotic interventions in people with CD. In total, 4 databases were systematically searched for studies published up to March 2023. All outcomes, inclusive of any cardiovascular risk factors, were collated and reported. We screened 8084 articles and 11 publications reporting on 7 RCTs and 2 non-RCTs met the inclusion criteria for qualitative analysis. In total, 1 RCT and both non-RCTs were considered to have a high risk of bias. There was large heterogeneity between the studies and adherence to a gluten-free diet was only measured in two studies. No specific outcomes related to cardiovascular risk were reported. Two studies reported a significant reduction on serum TNF-α in children over time after probiotic supplementation. One study reported no significant change in intestinal permeability over a 3-week intervention. Currently there is insufficient evidence to advocate a positive impact of probiotics on inflammation in CD, due, in part, to the limited data on adherence to the gluten-free diet and active disease.