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Effect of Carnosine or β-Alanine Supplementation on Markers of Glycemic Control and Insulin Resistance in Humans and Animals: A Systematic Review and Meta-analysis

There is growing evidence that supplementation with carnosine, or its rate-limiting precursor β-alanine, can ameliorate aspects of metabolic dysregulation that occur in diabetes and its related conditions. The purpose of this systematic review and meta-analysis was to evaluate the effect of carnosin...

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Autores principales: Matthews, Joseph J, Dolan, Eimear, Swinton, Paul A, Santos, Lívia, Artioli, Guilherme G, Turner, Mark D, Elliott-Sale, Kirsty J, Sale, Craig
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8634390/
https://www.ncbi.nlm.nih.gov/pubmed/34333586
http://dx.doi.org/10.1093/advances/nmab087
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author Matthews, Joseph J
Dolan, Eimear
Swinton, Paul A
Santos, Lívia
Artioli, Guilherme G
Turner, Mark D
Elliott-Sale, Kirsty J
Sale, Craig
author_facet Matthews, Joseph J
Dolan, Eimear
Swinton, Paul A
Santos, Lívia
Artioli, Guilherme G
Turner, Mark D
Elliott-Sale, Kirsty J
Sale, Craig
author_sort Matthews, Joseph J
collection PubMed
description There is growing evidence that supplementation with carnosine, or its rate-limiting precursor β-alanine, can ameliorate aspects of metabolic dysregulation that occur in diabetes and its related conditions. The purpose of this systematic review and meta-analysis was to evaluate the effect of carnosine or β-alanine supplementation on markers of glycemic control and insulin resistance in humans and animals. We performed a systematic search of 6 electronic databases up to 31 December 2020. Primary outcomes were changes in 1) fasting glucose, 2) glycated hemoglobin (HbA1c), and 3) 2-h glucose following a glucose-tolerance test. A set of additional outcomes included fasting insulin and homeostatic model assessment of β-cell function (HOMA-β) and insulin resistance (HOMA-IR). We assessed risk of bias using the Cochrane risk of bias (RoB) 2.0 (human studies) and the Systematic Review Center for Laboratory Animal Experimentation (SYRCLE) RoB (animal studies) tools; and used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess certainty. We used Bayesian hierarchical random-effects models, with informative priors for human data and noninformative priors for animal data. Inferences were made on posterior samples generated by Hamiltonian Markov Chain Monte Carlo using 90% credible intervals (90% CrI) and calculated probabilities. Twenty studies (n = 4 human, n = 16 rodent) were included, providing data for 2 primary outcomes (fasting glucose and HbA1c) and 3 additional outcomes (fasting insulin, HOMA-β, and HOMA-IR). The model provides evidence that supplementation decreases fasting glucose [humans: mean difference (MD)(0.5) = –0.95 mmol · L(–1) (90% CrI: –2.1, 0.08); rodent: MD(0.5) = –2.26 mmol · L(–1) (90% CrI: –4.03, –0.44)], HbA1c [humans: MD(0.5) = –0.91% (90% CrI: –1.46, –0.39); rodents: MD(0.5) = –1.05% (90% CrI: –1.64, –0.52)], HOMA-IR [humans: standardized mean difference (SMD)(0.5) = –0.41 (90% CrI: –0.82, –0.07); rodents: SMD(0.5) = –0.63 (90% CrI: –1.98, 0.65)], and fasting insulin [humans: SMD(0.5) = –0.41 (90% CrI: –0.77, –0.07)]. GRADE assessment showed our certainty in the effect estimate of each outcome to be moderate (human outcomes) or very low (rodent outcomes). Supplementation with carnosine or β-alanine may reduce fasting glucose, HbA1c, and HOMA-IR in humans and rodents, and fasting insulin in humans; both compounds show potential as therapeutics to improve glycemic control and insulin resistance. This review was registered at PROSPERO as CRD42020191588.
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spelling pubmed-86343902021-12-01 Effect of Carnosine or β-Alanine Supplementation on Markers of Glycemic Control and Insulin Resistance in Humans and Animals: A Systematic Review and Meta-analysis Matthews, Joseph J Dolan, Eimear Swinton, Paul A Santos, Lívia Artioli, Guilherme G Turner, Mark D Elliott-Sale, Kirsty J Sale, Craig Adv Nutr Review There is growing evidence that supplementation with carnosine, or its rate-limiting precursor β-alanine, can ameliorate aspects of metabolic dysregulation that occur in diabetes and its related conditions. The purpose of this systematic review and meta-analysis was to evaluate the effect of carnosine or β-alanine supplementation on markers of glycemic control and insulin resistance in humans and animals. We performed a systematic search of 6 electronic databases up to 31 December 2020. Primary outcomes were changes in 1) fasting glucose, 2) glycated hemoglobin (HbA1c), and 3) 2-h glucose following a glucose-tolerance test. A set of additional outcomes included fasting insulin and homeostatic model assessment of β-cell function (HOMA-β) and insulin resistance (HOMA-IR). We assessed risk of bias using the Cochrane risk of bias (RoB) 2.0 (human studies) and the Systematic Review Center for Laboratory Animal Experimentation (SYRCLE) RoB (animal studies) tools; and used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess certainty. We used Bayesian hierarchical random-effects models, with informative priors for human data and noninformative priors for animal data. Inferences were made on posterior samples generated by Hamiltonian Markov Chain Monte Carlo using 90% credible intervals (90% CrI) and calculated probabilities. Twenty studies (n = 4 human, n = 16 rodent) were included, providing data for 2 primary outcomes (fasting glucose and HbA1c) and 3 additional outcomes (fasting insulin, HOMA-β, and HOMA-IR). The model provides evidence that supplementation decreases fasting glucose [humans: mean difference (MD)(0.5) = –0.95 mmol · L(–1) (90% CrI: –2.1, 0.08); rodent: MD(0.5) = –2.26 mmol · L(–1) (90% CrI: –4.03, –0.44)], HbA1c [humans: MD(0.5) = –0.91% (90% CrI: –1.46, –0.39); rodents: MD(0.5) = –1.05% (90% CrI: –1.64, –0.52)], HOMA-IR [humans: standardized mean difference (SMD)(0.5) = –0.41 (90% CrI: –0.82, –0.07); rodents: SMD(0.5) = –0.63 (90% CrI: –1.98, 0.65)], and fasting insulin [humans: SMD(0.5) = –0.41 (90% CrI: –0.77, –0.07)]. GRADE assessment showed our certainty in the effect estimate of each outcome to be moderate (human outcomes) or very low (rodent outcomes). Supplementation with carnosine or β-alanine may reduce fasting glucose, HbA1c, and HOMA-IR in humans and rodents, and fasting insulin in humans; both compounds show potential as therapeutics to improve glycemic control and insulin resistance. This review was registered at PROSPERO as CRD42020191588. Oxford University Press 2021-07-31 /pmc/articles/PMC8634390/ /pubmed/34333586 http://dx.doi.org/10.1093/advances/nmab087 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Matthews, Joseph J
Dolan, Eimear
Swinton, Paul A
Santos, Lívia
Artioli, Guilherme G
Turner, Mark D
Elliott-Sale, Kirsty J
Sale, Craig
Effect of Carnosine or β-Alanine Supplementation on Markers of Glycemic Control and Insulin Resistance in Humans and Animals: A Systematic Review and Meta-analysis
title Effect of Carnosine or β-Alanine Supplementation on Markers of Glycemic Control and Insulin Resistance in Humans and Animals: A Systematic Review and Meta-analysis
title_full Effect of Carnosine or β-Alanine Supplementation on Markers of Glycemic Control and Insulin Resistance in Humans and Animals: A Systematic Review and Meta-analysis
title_fullStr Effect of Carnosine or β-Alanine Supplementation on Markers of Glycemic Control and Insulin Resistance in Humans and Animals: A Systematic Review and Meta-analysis
title_full_unstemmed Effect of Carnosine or β-Alanine Supplementation on Markers of Glycemic Control and Insulin Resistance in Humans and Animals: A Systematic Review and Meta-analysis
title_short Effect of Carnosine or β-Alanine Supplementation on Markers of Glycemic Control and Insulin Resistance in Humans and Animals: A Systematic Review and Meta-analysis
title_sort effect of carnosine or β-alanine supplementation on markers of glycemic control and insulin resistance in humans and animals: a systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8634390/
https://www.ncbi.nlm.nih.gov/pubmed/34333586
http://dx.doi.org/10.1093/advances/nmab087
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