The influence of fasting and energy-restricted diets on leptin and adiponectin levels in humans: A systematic review and meta-analysis

脂联素 瘦素 医学 荟萃分析 内科学 内分泌学 脂肪因子 肥胖 胰岛素抵抗
作者
Hamed Kord,Grant M. Tinsley,Heitor O. Santos,Hamid Zand,Ali Mohammad Nazary,Somaye Fatahi,Zeinab Mokhtari,Ammar Salehi‐Sahlabadi,Shing Cheng Tan,Jamal Rahmani,Mihnea‐Alexandru Găman,Brijesh Sathian,Amir Sadeghi,Behzad Hatami,Samira Soltanieh,Shahin Aghamiri,Hiba Bawadi,Azita Hekmatdoost
出处
期刊:Clinical Nutrition [Elsevier BV]
卷期号:40 (4): 1811-1821 被引量:49
标识
DOI:10.1016/j.clnu.2020.10.034
摘要

Summary

Background & aims

Fasting and energy-restricted diets have been evaluated in several studies as a means of improving cardiometabolic biomarkers related to body fat loss. However, further investigation is required to understand potential alterations of leptin and adiponectin concentrations. Thus, we performed a systematic review and meta-analysis to derive a more precise estimate of the influence of fasting and energy-restricted diets on leptin and adiponectin levels in humans, as well as to detect potential sources of heterogeneity in the available literature.

Methods

A comprehensive systematic search was performed in Web of Science, PubMed/MEDLINE, Cochrane, SCOPUS and Embase from inception until June 2019. All clinical trials investigating the effects of fasting and energy-restricted diets on leptin and adiponectin in adults were included.

Results

Twelve studies containing 17 arms and a total of 495 individuals (intervention = 249, control = 246) reported changes in serum leptin concentrations, and 10 studies containing 12 arms with a total of 438 individuals (intervention = 222, control = 216) reported changes in serum adiponectin concentrations. The combined effect sizes suggested a significant effect of fasting and energy-restricted diets on leptin concentrations (WMD: −3.690 ng/ml, 95% CI: −5.190, −2.190, p ≤ 0.001; I2 = 84.9%). However, no significant effect of fasting and energy-restricted diets on adiponectin concentrations was found (WMD: −159.520 ng/ml, 95% CI: −689.491, 370.451, p = 0.555; I2 = 74.2%). Stratified analyses showed that energy-restricted regimens significantly increased adiponectin (WMD: 554.129 ng/ml, 95% CI: 150.295, 957.964; I2 = 0.0%). In addition, subsequent subgroup analyses revealed that energy restriction, to ≤50% normal required daily energy intake, resulted in significantly reduced concentrations of leptin (WMD: −4.199 ng/ml, 95% CI: −7.279, −1.118; I2 = 83.9%) and significantly increased concentrations of adiponectin (WMD: 524.04 ng/ml, 95% CI: 115.618, 932.469: I2 = 0.0%).

Conclusion

Fasting and energy-restricted diets elicit significant reductions in serum leptin concentrations. Increases in adiponectin may also be observed when energy intake is ≤50% of normal requirements, although limited data preclude definitive conclusions on this point.
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