Effects of time-restricted eating on markers of glucose metabolism and regulation in individuals with prediabetes or type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials.

Methods

A literature search was performed in MEDLINE, Embase and CENTRAL from inception to 5 August 2025.

在MEDLINE、Embase和CENTRAL数据库中进行了文献检索，检索时间从数据库创建开始至2025年8月5日。

Moreover, forward and backward citation searches were performed.

此外，进行了向前和向后引用搜索。

Eligible studies were RCTs in adults with prediabetes or type 2 diabetes, lasting ≥2 weeks, reporting markers of glucose metabolism and regulation, comparing TRE (≤12 h eating window) with a non-time-restricted control diet.

符合条件的研究是针对成人的随机对照试验（RCTs），研究对象为糖尿病前期或2型糖尿病患者，持续时间≥2周，报告了葡萄糖代谢和调节的标志物，比较了限时进食（≤12小时进食窗口）与非时间限制对照饮食。

Studies involving pregnancy, other fasting regimens, or non-peer-reviewed publications were excluded.

排除了涉及怀孕、其他禁食方案或未经同行评审的出版物的研究。

Data were pooled as weighted mean differences with 95% CIs using random-effects generic inverse variance models in Cochrane Review Manager Web, and results are presented as forest plots.

数据使用Cochrane Review Manager Web中的随机效应通用逆方差模型汇总为加权平均差异，并以95%置信区间表示，结果以森林图展示。

The certainty of evidence was defined using Grading of Recommendations, Assessment, Development and Evaluations methodology, and risk of bias was estimated by using the Revised Cochrane risk-of-bias tool for randomised trials (RoB 2).

证据的确定性是使用 GRADE 方法论定义的，偏倚风险是通过使用修订版的随机试验 Cochrane 偏倚风险工具（RoB 2）来估计的。

Results

Out of 2043 records identified through the database search, as well as 1249 from forward and backward citation searches, ten RCTs including 599 participants were included.

在通过数据库搜索识别出的2043条记录，以及通过向前和向后引文搜索识别出的1249条记录中，共有10项随机对照试验（RCTs），包括599名参与者被纳入研究。

The mean length of the studies was 4 months, and the eating windows ranged from 4 to 10 h per day.

研究的平均时长为4个月，每天的进食窗口时间范围为4到10小时。

The pooled meta-analysisshowed no overall effect of TRE on HbA1c (-3.33 mmol/mol; 95% CI -6.87, 0.20 (-0.30% points; -0.63, 0.02); p=0.06, moderate certainty).

汇总的荟萃分析显示，时间限制性进食（TRE）对糖化血红蛋白（HbA1c）没有总体影响（-3.33 mmol/mol; 95% 置信区间 -6.87, 0.20（-0.30%点; -0.63, 0.02）; p=0.06，中等确定性）。

Nevertheless, following stratification by subgroups, TRE resulted in a reduction in HbA1c of 0.93 mmol/mol (-1.70, -0.17 [-0.09% points; -0.16, -0.02]; p=0.02) in individuals with prediabetes but not in individuals with type 2 diabetes (-4.68 mmol/mol; -10.08, 0.72 (-0.43% points; -0.92, 0.07); p=0.09).

然而，在按亚组分层后，TRE在糖尿病前期个体中导致HbA1c降低了0.93 mmol/mol（-1.70, -0.17 [-0.09%点；-0.16, -0.02]；p=0.02），但在2型糖尿病个体中并未如此（-4.68 mmol/mol；-10.08, 0.72 [-0.43%点；-0.92, 0.07]；p=0.09）。

TRE reduced fasting blood glucose in the pooled analysis (-0.30 mmol/l; -0.53, -0.07; p<0.01, moderate certainty) as well as in the subgroup analyses in individuals with prediabetes (-0.14 mmol/l; -0.27, -0.01; p=0.03) and with type 2 diabetes (-0.48 mmol/l; -0.78, -0.17; p<0.01).

TRE在汇总分析中降低了空腹血糖（-0.30 mmol/l；-0.53, -0.07；p<0.01，中等确定性），以及在糖尿病前期个体（-0.14 mmol/l；-0.27, -0.01；p=0.03）和2型糖尿病个体（-0.48 mmol/l；-0.78, -0.17；p<0.01）的亚组分析中。

Moreover, TRE lowered body weight by 1.6 kg (-2.2, -1.0; p<0.001) in the pooled analysis.

此外，在汇总分析中，TRE使体重降低了1.6公斤（95%置信区间-2.2至-1.0；p<0.001）。

The evidence was limited by imprecision arising from wide confidence intervals in some of the included studies, which may be due to small sample sizes.

由于一些纳入研究的95%置信区间较宽，这可能是由于样本量小，因此证据受到了不精确性的限制。

Lastly, the effects of TRE on markers of insulin sensitivity, beta cell function and continuous glucose monitoring measurements were inconclusive.

最后，间歇性禁食对胰岛素敏感性标志物、β细胞功能和连续血糖监测测量的影响尚无定论。

conclusions/interpretation

Moderate-certainty evidence indicates that TRE reduces fasting blood glucose but not HbA1c.

中等质量的证据表明，间歇性禁食可以降低空腹血糖，但对糖化血红蛋白（HbA1c）没有影响。

The subgroup analyses revealed that TRE improved HbA1c and fasting glucose in individuals with prediabetes and improved fasting glucose in individuals with type 2 diabetes.

亚组分析显示，间歇性禁食改善了糖尿病前期个体的糖化血红蛋白（HbA1c）和空腹血糖，并改善了2型糖尿病个体的空腹血糖。

Future large-scale studies should investigate long-term effects of TRE in prevention and treatment of type 2 diabetes.

未来的大规模研究应探究间歇性禁食在预防和治疗2型糖尿病方面的长期效果。

trial_registration

PROSPERO CRD42024523591 FUNDING: This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

PROSPERO CRD42024523591 资金来源：本研究未获得来自任何公共、商业或非营利部门资金机构的特定资助。

Three authors (JS, A-DT, THA) are employed at Steno Diabetes Center Copenhagen, a public hospital and research institution under the Capital Region of Denmark, partly funded by a grant from the Novo Nordisk Foundation.

三名作者（JS, A-DT, THA）受雇于位于丹麦首都地区的公共医院和研究机构——Steno糖尿病中心哥本哈根，该中心部分资金来自诺和诺德基金会的资助。