Chitosan modifies glycemic levels in people with metabolic syndrome and related disorders: meta-analysis with trial sequential analysis

Abstract

Background Chitosan supplementation has been shown to modulate glycemic levels; however, studies have reported conflicting results. The present meta-analysis with trial sequential analysis was conducted to verify the overall influence of chitosan on glycemic levels in patients with metabolic syndrome. Methods The PubMed, Cochrane library, and EMBASE databases were systematically searched for randomized controlled studies of chitosan intake and glycemic levels. Results A total of ten clinical trials including 1473 subjects were included in this meta-analysis. Pooled effect sizes were determined by random-effects meta-analysis. Subgroup analysis was performed to analyze the sources of heterogeneity and their influence on the overall results. The results revealed a significant reduction in fasting glucose levels (SMD: − 0.39 mmol/L, 95% CI: − 0.62 to − 0.16) and hemoglobin A1c (HbA1c) levels (SMD: -1.10; 95% CI: − 2.15 to − 0.06) following chitosan supplementation but no effect on insulin levels (SMD: − 0.20 pmol/L, 95% CI: − 0.64 to 0.24). Subgroup analyses further demonstrated significant reductions in fasting glucose levels in subjects administered 1.6–3 g of chitosan per day and in studies longer than 13 weeks. Trial sequential analysis of the pooled results of the hypoglycemic effect demonstrated that the cumulative Z-curve crossed both the conventional boundary and trial sequential monitoring boundary for glucose and HbA1c. Conclusions The glucose level of patients who are diabetic and obese/overweight can be improved by supplementation with chitosan for at least 13 weeks at 1.6–3 g per day. Additional clinical research data are needed to confirm the role of chitosan, particularly in regulating glycosylated hemoglobin and insulin.

Chitosan-Encapsulated Nano-selenium Targeting TCF7L2, PPARγ, and CAPN10 Genes in Diabetic Rats

“…Furthermore, the glucose lowering effect of Se might be supported by other mechanisms, such as an acceleration of kidney glucose excretion in rats or stimulation of adipogenesis in adipocytes via stimulating serine/threonine kinases, including the p70 S6 kinase [ 47 ]. Also, Guo et al [ 48 ] reported that chitosan improves blood glucose levels and exerts its antidiabetic effect by upregulating the expression of glucose transporters.…”

“…Chitosan-SeNPs have been shown to lower serum glucose concentrations by inhibiting the activity of α-amylase and α-glucosidase [ 57 ]. Furthermore, Guo et al [ 48 ] reported that chitosan exerts its antidiabetic effect by inhibiting the expression of intestinal α-amylase and α-glucosidase. Moreover, McCue et al [ 58 ] indicated that delaying carbohydrate absorption with Glib offers a prospective therapeutic approach for management of α-amylase and α-glucosidase activities in DM and may be beneficial for borderline diabetic patients.…”

“…The activation of PPAR-γ by CTS-SeNPs treatment is the central mechanism behind the amelioration of diabetic complications and various disease states. Similarly, chitosan exerts its antidiabetic effect by improving the expression of PPARγ [ 48 ]. Another study suggested that chitosan prevents hyperglycemia by inhibiting intestinal glucose digestion and helps in transporting and enhancing glucose uptake, at least in part, by upregulating PPARγ expression of adiponectin in adipocytes [ 48 ].…”

Chitosan Oligosaccharide Ameliorates Metabolic Syndrome Induced by Overnutrition via Altering Intestinal Microbiota

“…Due to molecular weight≤16 kDa, COS is readily soluble in water and particularly useful for a series of industrial purposes. COS has already been proven to be effective in reducing body weight, lowering serum triglyceride and cholesterol levels, and limiting lipid accumulation in hepatocytes and adipose tissue (9,10). The currently reported anti-obesity mechanisms of COS mainly include inhibition of apolipoprotein B (ApoB) levels, PPAR-γ, bile acid secretion, pancreatic lipase production and reduction of serum ghrelin concomitant with increasing leptin (8).…”

Influence of Dietary Chitosan Feeding Duration on Glucose and Lipid Metabolism in a Diabetic Rat Model

“…However, there is little information concerning the hypolipidemic and hypoglycemic effects of chitosan in type 2 diabetes with obesity. Guo et al (2020) have reported that the blood glucose level of patients with diabetes and obesity/overweight can be improved by supplementation with chitosan for at least 13 weeks [12]. Our previous study revealed that 7-week chitosan feeding did not affect blood glucose level but did decrease HOMA-IR index [13].…”