Khoo Y S K, Aziz Z
Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
J Clin Pharm Ther. 2009 Apr;34(2):133-45. doi: 10.1111/j.1365-2710.2008.00998.x.
Prevention of cardiovascular disease by modifying its major risk factors, including serum cholesterol levels, is an important strategy. Regular intake of garlic has been suggested, but its impact on cholesterol levels has been inconsistent.
A systematic review to critically summarize the evidence on the effect of garlic on serum cholesterol.
We carried out a comprehensive search of the Cochrane Library, MEDLINE, EMBASE, electronic publishing sites, reference lists of relevant papers and manual searches of relevant journals from inception to March 2008. We contacted experts and local manufacturers and distributors of garlic products to identify additional studies. To evaluate the effects of garlic on cholesterol levels in both healthy and hypercholesterolaemic subjects, randomized controlled trials of garlic ranging from 11 to 24 weeks in duration were included. Data were extracted and trial quality was assessed independently by two reviewers. The data were meta-analysed.
Thirteen trials including 1056 subjects were eligible for the meta-analysis. Overall, administration of garlic did not show any significant difference in effects on all outcome measures examined when compared with placebo. Garlic therapy did not produce any statistically significant reduction in serum total cholesterol level (mean difference, -0.04 mmol/L; 95% CI -0.15 to 0.07 mmol/L), LDL-cholesterol level (mean difference, 0.01 mmol/L; 95% CI -0.10 to 0.11 mmol/L), triglycerides level (mean difference, -0.05 mmol/L; 95% CI -0.17 to 0.06 mmol/L) or apolipoprotein B level (mean difference, -0.02 g/L; 95% CI -0.03 to 0.001 g/L). There was no difference between garlic and placebo on HDL-cholesterol level (mean difference, 0.01 mmol/L; 95% CI -0.03 to 0.05 mmol/L). As moderate to high heterogeneity exists among pooled studies, conclusive recommendations cannot be made at present on the actual effects of garlic therapy on serum cholesterol levels.
The available evidence from randomized controlled trial does not demonstrate any beneficial effects of garlic on serum cholesterol.
通过改变心血管疾病的主要危险因素(包括血清胆固醇水平)来预防心血管疾病是一项重要策略。有人建议定期食用大蒜,但其对胆固醇水平的影响并不一致。
进行一项系统评价,严格总结大蒜对血清胆固醇影响的证据。
我们对考克兰图书馆、医学索引数据库、循证医学数据库、电子出版网站、相关论文的参考文献列表进行了全面检索,并对相关期刊从创刊至2008年3月进行了手工检索。我们联系了专家以及大蒜产品的当地制造商和经销商以确定其他研究。为了评估大蒜对健康受试者和高胆固醇血症受试者胆固醇水平的影响,纳入了为期11至24周的大蒜随机对照试验。数据由两名评价员独立提取并评估试验质量。对数据进行荟萃分析。
13项试验(包括1056名受试者)符合荟萃分析的条件。总体而言,与安慰剂相比,服用大蒜对所有检测的结局指标均未显示出任何显著差异。大蒜治疗未使血清总胆固醇水平产生任何具有统计学意义的降低(平均差,-0.04 mmol/L;95%可信区间-0.15至0.07 mmol/L),低密度脂蛋白胆固醇水平(平均差,0.01 mmol/L;95%可信区间-0.10至0.11 mmol/L),甘油三酯水平(平均差,-0.05 mmol/L;95%可信区间-0.17至0.06 mmol/L)或载脂蛋白B水平(平均差,-0.02 g/L;95%可信区间-0.03至0.001 g/L)。大蒜与安慰剂在高密度脂蛋白胆固醇水平上无差异(平均差,0.01 mmol/L;95%可信区间-0.03至0.05 mmol/L)。由于汇总研究中存在中度至高异质性,目前无法就大蒜治疗对血清胆固醇水平的实际影响给出确凿建议。
随机对照试验的现有证据未证明大蒜对血清胆固醇有任何有益作用。