Drieling Rebecca L, Gardner Christopher D, Ma Jun, Ahn David K, Stafford Randall S
Program on Prevention Outcomes and Practices, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California 94305-5411, USA.
Arch Intern Med. 2010 Sep 27;170(17):1541-7. doi: 10.1001/archinternmed.2010.310.
Although modifiable cardiovascular disease risk factors are common, some patients eschew conventional drug treatments in favor of natural alternatives. Pine bark extract, a dietary supplement source of antioxidant oligomeric proanthocyanidin complexes, has multiple putative cardiovascular benefits. Studies published to date about the supplement have notable methodological limitations.
We randomized 130 individuals with increased cardiovascular disease risk to take 200 mg of a water-based extract of pine bark (n = 64; Toyo-FVG, Toyo Bio-Pharma, Torrance, California; Shinyaku Co, Ltd, Saga, Japan; also marketed as Flavagenol in Japan) or placebo (n = 66) once per day. Blood pressure, our primary outcome, and other cardiovascular disease risk factors were measured at baseline and at 6 and 12 weeks. Statistical analyses were conducted using regression models.
Baseline characteristics did not differ between the study groups. Over the 12-week intervention, the sum of systolic and diastolic blood pressures decreased by 1.0 mm Hg (95% confidence interval, -4.2 to 2.1 mm Hg) in the pine bark extract-treated group and by 1.9 mm Hg (-5.5 to 1.7 mm Hg) in the placebo group (P = .87). Other outcomes were likewise not significantly different, including body mass index, lipid panel measures, liver transaminase test results, lipoprotein cholesterol particle size, and levels of insulin, lipoprotein(a), fasting glucose, and high-sensitivity C-reactive protein. There were no subgroups for whom intake of pine bark extract affected cardiovascular disease risk factors.
This pine bark extract (at a dosage of 200 mg/d) was safe but was not associated with improvement in cardiovascular disease risk factors. Although variations among participants, dosages, and chemical preparations could contribute to different findings compared with past studies, our results are consistent with a general failure of antioxidants to demonstrate cardiovascular benefits.
clinicaltrials.gov Identifier: NCT00425945.
尽管可改变的心血管疾病风险因素很常见,但一些患者避开传统药物治疗而青睐天然替代品。松树皮提取物是抗氧化低聚原花青素复合物的膳食补充剂来源,具有多种假定的心血管益处。迄今为止发表的关于该补充剂的研究存在显著的方法学局限性。
我们将130名心血管疾病风险增加的个体随机分为两组,一组每天服用200毫克松树皮水基提取物(n = 64;东洋FVG,东洋生物制药公司,加利福尼亚州托伦斯市;日本佐贺县的正药株式会社;在日本也作为Flavagenol销售),另一组服用安慰剂(n = 66)。主要结局指标血压以及其他心血管疾病风险因素在基线、6周和12周时进行测量。使用回归模型进行统计分析。
研究组之间的基线特征无差异。在为期12周的干预期间,松树皮提取物治疗组的收缩压与舒张压之和下降了1.0毫米汞柱(95%置信区间为-4.2至2.1毫米汞柱),安慰剂组下降了1.9毫米汞柱(-5.5至1.7毫米汞柱)(P = 0.87)。其他结局同样无显著差异,包括体重指数、血脂指标、肝转氨酶检测结果、脂蛋白胆固醇颗粒大小以及胰岛素、脂蛋白(a)、空腹血糖和高敏C反应蛋白水平。没有亚组显示服用松树皮提取物会影响心血管疾病风险因素。
这种松树皮提取物(剂量为200毫克/天)是安全的,但与心血管疾病风险因素的改善无关。尽管与过去的研究相比,参与者、剂量和化学制剂的差异可能导致不同的结果,但我们的结果与抗氧化剂总体上未能证明对心血管有益的情况一致。
clinicaltrials.gov标识符:NCT00425945。