Evidence map›Paper›PMID 19592634›Full record

SynthesisDiabetes care2009

Heterogeneous effects of fructose on blood lipids in individuals with type 2 diabetes: systematic review and meta-analysis of experimental trials in humans.

John L Sievenpiper, Amanda J Carleton, Sheena Chatha, Henry Y Jiang, Russell J de Souza, Joseph Beyene, Cyril W C Kendall, David J A Jenkins

3 registry-linked trialsOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Diabetes care, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 49 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
49citing papers in PubMed, 12 pooled it
6.1field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01363791 unknown statusnot on this map

Effect of Fructose on Metabolic Control in Humans: A Series of Systematic Reviews and Meta-analyses to Provide Evidence-based Guidance for Nutrition Guidelines Development

TypeobservationalSponsorJohn SievenpiperRan2009 to 2016Enrolled1ConditionsDyslipidemia, Diabetes, Prediabetes, DysglycemiaArmsDietary fructose
NCT01608607 unknown statusnot on this mapstarted 2012, after this paper: background citation

Effect of Fructose-containing Sugar Sweetened Beverages (SSBs) on Body Weight: A Systematic Review and Meta-analysis of Controlled Feeding Trials to Provide Evidence-based Guidance for Nutrition Guidelines Development

TypeobservationalSponsorJohn SievenpiperRan2012 to 2015Enrolled1ConditionsOverweight, Obesity, Diabetes, PrediabetesArmsFructose-containing sugar sweetened beverages
NCT01608620 unknown statusnot on this mapstarted 2012, after this paper: background citation

The Relation of Total and Individual Fructose-containing Sugars With Incident Cardiometabolic Diseases: A Series of Systematic Reviews and Meta-analyses of Prospective Observational Studies

TypeobservationalSponsorJohn SievenpiperRan2012 to 2016Enrolled1ConditionsOverweight, Obesity, Dyslipidemia, Hyperlipidemia
3 · Its place in the literature

Who cites it

49 citing papers in PubMed, 12 syntheses or guidelines pooled it, 172 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

John L SievenpiperClinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada.
Amanda J Carleton
Sheena Chatha
Henry Y Jiang
Russell J de Souza
Joseph Beyene
Cyril W C Kendall
David J A Jenkins
St. Michael's Hospital · CAMcMaster University · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveBecause of blood lipid concerns, diabetes associations discourage fructose at high intakes. To quantify the effect of fructose on blood lipids in diabetes, we conducted a systematic review and meta-analysis of experimental clinical trials investigating the effect of isocaloric fructose exchange for carbohydrate on triglycerides, total cholesterol, LDL cholesterol, and HDL cholesterol in type 1 and 2 diabetes. RESEARCH DESIGN AND

methodsWe searched MEDLINE, EMBASE, CINAHL, and the Cochrane Library for relevant trials of > or =7 days. Data were pooled by the generic inverse variance method and expressed as standardized mean differences with 95% CI. Heterogeneity was assessed by chi(2) tests and quantified by I(2). Meta-regression models identified dose threshold and independent predictors of effects.

resultsSixteen trials (236 subjects) met the eligibility criteria. Isocaloric fructose exchange for carbohydrate raised triglycerides and lowered total cholesterol under specific conditions without affecting LDL cholesterol or HDL cholesterol. A triglyceride-raising effect without heterogeneity was seen only in type 2 diabetes when the reference carbohydrate was starch (mean difference 0.24 [95% CI 0.05-0.44]), dose was >60 g/day (0.18 [0.00-0.37]), or follow-up was < or =4 weeks (0.18 [0.00-0.35]). Piecewise meta-regression confirmed a dose threshold of 60 g/day (R(2) = 0.13)/10% energy (R(2) = 0.36). A total cholesterol-lowering effect without heterogeneity was seen only in type 2 diabetes under the following conditions: no randomization and poor study quality (-0.19 [-0.34 to -0.05]), dietary fat >30% energy (-0.33 [-0.52 to -0.15]), or crystalline fructose (-0.28 [-0.47 to -0.09]). Multivariate meta-regression analyses were largely in agreement.

conclusionsPooled analyses demonstrated conditional triglyceride-raising and total cholesterol-lowering effects of isocaloric fructose exchange for carbohydrate in type 2 diabetes. Recommendations and large-scale future trials need to address the heterogeneity in the data.

Indexed as

Clinical Trials as TopicDiabetes Mellitus, Type 1Diabetes Mellitus, Type 2FructoseHumansLipid MetabolismLipidsSweetening AgentsTriglyceridesFructoseLipidsSweetening AgentsTriglycerides

Identifiers

PMID19592634
PMCPMC2752906
OpenAlexW2032398997

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.