Short-chain fatty acids and insulin sensitivity: a systematic review and meta-analysis

Pham, NHT; Joglekar, MV; Wong, WKM; Nassif, NT; Simpson, AM; Hardikar, AA

Short-chain fatty acids and insulin sensitivity: a systematic review and meta-analysis

Pham, NHT Joglekar, MV Wong, WKM Nassif, NT Simpson, AM Hardikar, AA

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Publisher:: Oxford University Press (OUP)
Publication Type:: Journal Article
Citation:: Nutrition Reviews

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Field	Value	Language
dc.contributor.author	Pham, NHT
dc.contributor.author	Joglekar, MV
dc.contributor.author	Wong, WKM
dc.contributor.author	Nassif, NT
dc.contributor.author	Simpson, AM
dc.contributor.author	Hardikar, AA
dc.date.accessioned	2023-06-09T11:15:37Z
dc.date.available	2023-06-09T11:15:37Z
dc.identifier.citation	Nutrition Reviews
dc.identifier.issn	0029-6643
dc.identifier.issn	1753-4887
dc.identifier.uri	http://hdl.handle.net/10453/170685
dc.description.abstract	<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Context</jats:title> <jats:p>There is substantial evidence that reduced short-chain fatty acids (SCFAs) in the gut are associated with obesity and type 2 diabetes, although findings from clinical interventions that can increase SCFAs are inconsistent.</jats:p> </jats:sec> <jats:sec> <jats:title>Objective</jats:title> <jats:p>This systematic review and meta-analysis aimed to assess the effect of SCFA interventions on fasting glucose, fasting insulin, and homeostatic model assessment of insulin resistance (HOMA-IR).</jats:p> </jats:sec> <jats:sec> <jats:title>Data Sources</jats:title> <jats:p>Relevant articles published up to July 28, 2022, were extracted from PubMed and Embase using the MeSH (Medical Subject Headings) terms of the defined keywords [(short-chain fatty acids) AND (obesity OR diabetes OR insulin sensitivity)] and their synonyms. Data analyses were performed independently by two researchers who used the Cochrane meta-analysis checklist and the PRISMA guidelines.</jats:p> </jats:sec> <jats:sec> <jats:title>Data Extraction</jats:title> <jats:p>Clinical studies and trials that measured SCFAs and reported glucose homeostasis parameters were included in the analysis. Standardized mean differences (SMDs) with 95%CIs were calculated using a random-effects model in the data extraction tool Review Manager version 5.4 (RevMan 5.4). The risk-of-bias assessment was performed following the Cochrane checklist for randomized and crossover studies.</jats:p> </jats:sec> <jats:sec> <jats:title>Data Analysis</jats:title> <jats:p>In total, 6040 nonduplicate studies were identified, 23 of which met the defined criteria, reported fasting insulin, fasting glucose, or HOMA-IR values, and reported change in SCFA concentrations post intervention. Meta-analyses of these studies indicated that fasting insulin concentrations were significantly reduced (overall effect: SMD = −0.15; 95%CI = −0.29 to −0.01, P = 0.04) in treatment groups, relative to placebo groups, at the end of the intervention. Studies with a confirmed increase in SCFAs at the end of intervention also had a significant effect on lowering fasting insulin (P = 0.008). Elevated levels of SCFAs, compared with baseline levels, were associated with beneficial effects on HOMA-IR (P &lt; 0.00001). There was no significant change in fasting glucose concentrations.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Increased postintervention levels of SCFAs are associated with lower fasting insulin concentrations, offering a beneficial effect on insulin sensitivity.</jats:p> </jats:sec> <jats:sec> <jats:title>Systematic Review Registration</jats:title> <jats:p>PROSPERO registration number CRD42021257248.</jats:p> </jats:sec>
dc.language	en
dc.publisher	Oxford University Press (OUP)
dc.relation.ispartof	Nutrition Reviews
dc.relation.isbasedon	10.1093/nutrit/nuad042
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	11 Medical and Health Sciences, 17 Psychology and Cognitive Sciences
dc.subject.classification	Nutrition & Dietetics
dc.title	Short-chain fatty acids and insulin sensitivity: a systematic review and meta-analysis
dc.type	Journal Article
utslib.for	11 Medical and Health Sciences
utslib.for	17 Psychology and Cognitive Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Science
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
pubs.organisational-group	/University of Technology Sydney/Faculty of Science/School of Life Sciences
pubs.organisational-group	/University of Technology Sydney/Centre for Health Technologies (CHT)
utslib.copyright.status	closed_access	*
dc.date.updated	2023-06-09T11:15:35Z
pubs.publication-status	Published online

Abstract:

Abstract Context There is substantial evidence that reduced short-chain fatty acids (SCFAs) in the gut are associated with obesity and type 2 diabetes, although findings from clinical interventions that can increase SCFAs are inconsistent. Objective This systematic review and meta-analysis aimed to assess the effect of SCFA interventions on fasting glucose, fasting insulin, and homeostatic model assessment of insulin resistance (HOMA-IR). Data Sources Relevant articles published up to July 28, 2022, were extracted from PubMed and Embase using the MeSH (Medical Subject Headings) terms of the defined keywords [(short-chain fatty acids) AND (obesity OR diabetes OR insulin sensitivity)] and their synonyms. Data analyses were performed independently by two researchers who used the Cochrane meta-analysis checklist and the PRISMA guidelines. Data Extraction Clinical studies and trials that measured SCFAs and reported glucose homeostasis parameters were included in the analysis. Standardized mean differences (SMDs) with 95%CIs were calculated using a random-effects model in the data extraction tool Review Manager version 5.4 (RevMan 5.4). The risk-of-bias assessment was performed following the Cochrane checklist for randomized and crossover studies. Data Analysis In total, 6040 nonduplicate studies were identified, 23 of which met the defined criteria, reported fasting insulin, fasting glucose, or HOMA-IR values, and reported change in SCFA concentrations post intervention. Meta-analyses of these studies indicated that fasting insulin concentrations were significantly reduced (overall effect: SMD = −0.15; 95%CI = −0.29 to −0.01, P = 0.04) in treatment groups, relative to placebo groups, at the end of the intervention. Studies with a confirmed increase in SCFAs at the end of intervention also had a significant effect on lowering fasting insulin (P = 0.008). Elevated levels of SCFAs, compared with baseline levels, were associated with beneficial effects on HOMA-IR (P < 0.00001). There was no significant change in fasting glucose concentrations. Conclusion Increased postintervention levels of SCFAs are associated with lower fasting insulin concentrations, offering a beneficial effect on insulin sensitivity. Systematic Review Registration PROSPERO registration number CRD42021257248.

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