Effects of whey protein on glycemic control and serum lipoproteins in patients with metabolic syndrome and related conditions: a systematic review and meta-analysis of randomized controlled clinical trials

Amirani, Elaheh; Milajerdi, Alireza; Reiner, Željko; Mirzaei, Hamed; Mansournia, Mohammad Ali; Asemi, Zatollah

doi:10.1186/s12944-020-01384-7

Lipids in Health and Disease

Table 3 Subgroup analyses for the effects of whey protein intake on glycemic control and serum lipoproteins

From: Effects of whey protein on glycemic control and serum lipoproteins in patients with metabolic syndrome and related conditions: a systematic review and meta-analysis of randomized controlled clinical trials

Variables		Subgroups	Number of effect sizes	Pooled WMD	95% CI	I² (%)	Between-study I² (%)
FPG	Participants’ age	Adult	12	− 0.30	−1.29, 0.69	90.3	< 0.001
	Participants’ age	Adult+Elderly	8	−3.79	−4.65, −2.93	86.0	< 0.001
	Participants’ health condition	Healthy	12	−2.12	− 2.87, −1.37	90.9	0.40
	Participants’ health condition	Chronic disease	8	−2.76	−4.05, −1.47	89.8	0.40
	Intervention type	Isolated	6	0.35	−1.57, 2.28	76.8	< 0.01
	Intervention type	Whey proteins	14	−2.72	−3.43, − 2.01	92.0	< 0.01
	Study duration	< 12 week	9	−1.62	−2.64, −0.60	90.6	0.09
	Study duration	≥12 week	11	−2.74	−3.58, −1.89	90.3	0.09
	Sample size	n < 50	13	−2.05	−2.89, −1.22	91.7	0.38
	Sample size	n ≥ 50	7	−2.64	−3.67, −1.61	86.5	0.38
	Type of control	Placebo product	3	−1.22	−3.33, 1.43	00.0	< 0.001
		Carbohydrate supplementation	13	−0.73	−1.61, 0.15	88.9
		Non-intervention	4	−4.54	−5.56, −3.51	92.8
HbA1C	Participants’ age	Adult	3	−0.15	−0.21, − 0.08	96.2	0.16
	Participants’ age	Adult+Elderly	3	−0.09	−0.14, − 0.04	36.6	0.16
	Participants’ health condition	Healthy	3	−0.08	−0.12, − 0.03	00.0	0.02
	Participants’ health condition	Chronic disease	3	−0.17	−0.23, − 0.10	96.1	0.02
	Study duration	< 12 week	3	−0.06	−0.10, − 0.01	49.4	< 0.001
	Study duration	≥12 week	3	−0.33	−0.42, − 0.24	91.2	< 0.001
	Sample size	n < 50	3	−0.11	−0.16, − 0.06	94.7	0.91
	Sample size	n ≥ 50	3	−0.11	−0.17, − 0.05	20.1	0.91
Insulin	Participants’ age	Adult	9	−1.43	−2.21, 0.65	48.0	0.01
	Participants’ age	Adult+Elderly	5	−0.34	−0.74, 0.07	7.09	0.01
	Participants’ health condition	Healthy	10	−0.39	−0.078, − 0.00	63.6	0.01
	Participants’ health condition	Chronic disease	4	−1.67	−2.63, −0.70	33.4	0.01
	Intervention type	Isolated	4	−1.15	−2.10, −0.20	67.2	0.09
	Intervention type	Whey proteins	10	−0.42	− 0.81, − 0.03	62.9	0.09
	Study duration	< 12 week	7	−0.49	−0.95, − 0.03	68.5	0.59
	Study duration	≥12 week	7	−0.69	−1.27, − 0.11	61.7	0.59
	Sample size	n < 50	7	−0.60	−1.17, − 0.02	69.8	0.89
	Sample size	n ≥ 50	7	−0.55	−1.01, − 0.09	60.3	0.89
	Type of control	Placebo product	2	−3.30	−5.18, 1.42	00.0	0.01
		Carbohydrate supplementation	9	−0.64	−1.16, − 0.11	56..8
		Non-intervention	5	−0.30	−0.81, 0.21	70.6
HOMA-IR	Participants’ age	Adult	9	−0.25	− 0.38, − 0.11	64.9	0.02
	Participants’ age	Adult+Elderly	4	−0.07	−0.13, − 0.01	64.8	0.02
	Participants’ health condition	Healthy	8	−0.07	− 0.13, − 0.01	59.6	< 0.001
	Participants’ health condition	Chronic disease	5	−0.48	−0.70, − 0.26	42.2	< 0.001
	Intervention type	Isolated	4	−0.20	−0.33, − 0.06	72.8	0.04
	Intervention type	Whey proteins	9	−0.07	− 0.13, − 0.01	64.1	0.04
	Study duration	< 12 week	7	−0.04	−0.14, 0.06	80.2	< 0.18
	Study duration	≥12 week	6	−0.12	−0.19, − 0.06	00.0	< 0.18
	Sample size	n < 50	6	−0.11	−0.19, − 0.04	74.2	0.47
	Sample size	n ≥ 50	7	−0.07	−0.16, 0.01	64.1	0.47
	Type of control	Placebo product	2	−0.86	−1.43, − 0.29	00.0	< 0.01
		Carbohydrate supplementation	8	−0.22	−0.35, − 0.10	61.6
		Non-intervention	3	−0.06	−0.12, 0.01	66.1
TC	Participants’ age	Adult	12	−12.86	−16.11, −9.61	81.7	0.06
	Participants’ age	Adult+Elderly	10	−9.07	−11.39, −6.74	96.1	0.06
	Participants’ health condition	Healthy	15	−8.75	−10.87, −6.63	94.3	0.001
	Participants’ health condition	Chronic disease	7	−16.40	−20.53, − 12.27	84.7	0.001
	Intervention type	Isolated	7	−9.67	−12.52, −6.82	95.6	0.10
	Intervention type	Whey proteins	15	− 11.77	−14.43, −9.11	99.5	0.10
	Study duration	< 12 week	10	−15.83	−18.33, − 13.34	96.1	< 0.001
	Study duration	≥12 week	12	−3.01	−5.90, −0.12	40.6	< 0.001
	Sample size	n < 50	14	−11.24	− 13.32, −9.15	95.3	0.04
	Sample size	n ≥ 50	8	−6.21	−10.71, − 1.71	44.1	0.04
	Type of control	Placebo product	2	−1.99	−10.44, 6.47	00.0	0.07
		Carbohydrate supplementation	16	−11.49	−13.76, −9.22	91.0
		Non-intervention	4	−8.92	−12.63, −5.20	97.5
TG	Participants’ age	Adult	11	−6.78	−10.71, −2.85	76.4	< 0.001
	Participants’ age	Adult+Elderly	11	− 21.43	− 24.28, −18.58	94.2	< 0.001
	Participants’ health condition	Healthy	15	−15.58	− 17.99, − 13.16	94.1	0.02
	Participants’ health condition	Chronic disease	7	−25.04	−32.96, −17.11	1.0	0.02
	Intervention type	Isolated	7	−13.90	− 16.94, 10.87	97.0	0.04
	Intervention type	Whey proteins	15	−19.86	−23.47, − 16.25	69.8	0.04
	Study duration	< 12 week	9	−15.63	−18.60, − 12.66	96.2	0.43
	Study duration	≥12 week	13	−17.52	−21.19, − 13.85	66.3	0.43
	Sample size	n < 50	13	−17.05	−19.50, − 14.59	94.9	0.11
	Sample size	n ≥ 50	9	−11.33	−18.06, −4.59	36.9	0.11
	Type of control	Placebo product	2	−25.36	−41.44, −0.29	00.0	0.20
		Carbohydrate supplementation	16	−15.14	−17.90, − 12.38	93.9
		Non-intervention	4	−18.81	−23.18, − 14.44	00.0
LDL	Participants’ age	Adult	9	−1.73	−5.32, 1.87	47.1	0.001
	Participants’ age	Adult+ Elderly	10	−8.9	−10.98, −6.81	96.9
	Participants’ health condition	Healthy	14	− 8.31	− 10.25, − 6.36	95.7	0.001
	Participants’ health condition	Chronic disease	5	0.45	−4.39, 5.29	20.7
	Intervention type	Isolated	5	−10.49	−13.75, −7.22	88.7	< 0.01
	Intervention type	Whey proteins	14	−6.41	−8.67, −4.15	96.1
	Study duration	< 12 week	8	−18.51	−21.39, − 15.62	96.1	< 0.001
	Study duration	≥12 week	11	0.22	−2.09, 2.52	73.7	< 0.001
	Sample size	n < 50	11	−5.88	−7.98, −3.79	94.9	0.02
	Sample size	n ≥ 50	8	−10.56	−14.11, − 7.02	94.1	0.02
	Type of control	Placebo product	2	4.36	−2.84, 11.56	54.4	< 0.01
		Carbohydrate supplementation	14	−7.75	−10.28, 5.23	81.3
		Non-intervention	3	−7.98	−10.74, −5.22	99.2
HDL	Participants’ age	Adult	11	−1.65	−2.41, −0.89	34.4	< 0.001
	Participants’ age	Adult+ Elderly	10	1.40	1.10, 1.71	94.3
	Participants’ health condition	Healthy	14	1.48	1.17, 1.79	94.5	< 0.001
	Participants’ health condition	Chronic disease	7	−1.94	−2.68, −1.20	87.1	< 0.001
	Intervention type	Isolated	6	1.57	1.25, 1.89	97.7	< 0.001
	Intervention type	Whey proteins	15	−1.15	−1.79, −0.51	83.6	< 0.001
	Study duration	< 12 week	9	1.05	0.76, 1.35	97.6	0.13
	Study duration	≥12 week	12	0.32	−0.58, 1.22	34.9	0.13
	Sample size	n < 50	13	1.15	0.85, 1.44	96.3	< 0.001
	Sample size	n ≥ 50	8	−0.66	−1.59, 0.28	56.0	< 0.001
	Type of control	Placebo product	2	1.61	−0.09, 3.32	78.0	0.15
		Carbohydrate supplementation	16	1.04	0.74, 1.33	95.5
		Non-intervention	3	0.03	−1.03, 1.09	70.6

HOMA IR homeostasis model assessment of insulin resistance, HbA1c glycated hemoglobin, TG triglyceride, TC total cholesterol, HDL-C HDL-cholesterol, LDL-C LDL-cholesterol

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