Feringa Harm H H, Laskey Dayne A, Dickson Justine E, Coleman Craig I
Yale School of Medicine, New Haven, CT, USA.
J Am Diet Assoc. 2011 Aug;111(8):1173-81. doi: 10.1016/j.jada.2011.05.015.
Recent animal studies have suggested that grape seed extract has beneficial effects on the cardiovascular system. Randomized trials in human beings have yielded conflicting results. The objective of this systematic review was to assess the effect of grape seed extract on changes in blood pressure, heart rate, lipid levels, and C-reactive protein (CRP) levels. We searched MEDLINE (January 1, 1950, through October 31, 2010), Agricola (January 1, 1970, through October 31, 2010), Scopus (January 1, 1996, through October 31, 2010), and the Cochrane Central Register of Controlled Trials (through October 31, 2010) for randomized controlled trials in human beings of grape seed extract reporting efficacy data on at least one of the following end points: systolic or diastolic blood pressure, heart rate, total cholesterol, low-density or high-density lipoprotein cholesterol, triglycerides, or CRP. A manual search of references from primary and review articles was performed to identify additional relevant trials. For all endpoints except CRP, the mean change in each parameter from baseline was treated as a continuous variable and the effect size was calculated as the weighted mean difference between the means in the grape seed extract and control groups. Data on CRP were pooled as a standardized mean difference. Nine randomized, controlled trials (N=390) met the inclusion criteria, and a meta-analysis was conducted. Upon meta-analysis, grape seed extract significantly lowered systolic blood pressure (weighted mean difference -1.54 mm Hg (95% confidence interval -2.85 to -0.22, P=0.02]), and heart rate (weighted mean difference -1.42 bpm (95% confidence interval -2.50 to -0.34, P=0.01]). No significant effect on diastolic blood pressure, lipid levels, or CRP was found. No statistical heterogeneity was observed for any analysis (I(2)<39% for all). Egger's weighted regression statistic suggested low likelihood of publication bias in all analysis (P>0.05 for all), except for the effect on diastolic blood pressure (P=0.046). Based on the currently available literature, grape seed extract appears to significantly lower systolic blood pressure and heart rate, with no effect on lipid or CRP levels. Larger randomized, double-blinded trials evaluating different dosages of grape seed extract and for longer follow-up durations are needed.
近期的动物研究表明，葡萄籽提取物对心血管系统有有益作用。在人类中进行的随机试验结果却相互矛盾。本系统评价的目的是评估葡萄籽提取物对血压、心率、血脂水平和C反应蛋白（CRP）水平变化的影响。我们检索了MEDLINE（1950年1月1日至2010年10月31日）、Agricola（1970年1月1日至2010年10月31日）、Scopus（1996年1月1日至2010年10月31日）以及Cochrane对照试验中央注册库（截至2010年10月31日），以查找关于葡萄籽提取物的人体随机对照试验，这些试验报告了至少以下一个终点的疗效数据：收缩压或舒张压、心率、总胆固醇、低密度或高密度脂蛋白胆固醇、甘油三酯或CRP。对主要文章和综述文章的参考文献进行了手工检索，以识别其他相关试验。对于除CRP之外的所有终点，将每个参数相对于基线的平均变化视为连续变量，并将效应大小计算为葡萄籽提取物组和对照组均值之间的加权平均差。CRP数据合并为标准化平均差。九项随机对照试验（N = 390）符合纳入标准，并进行了荟萃分析。经荟萃分析，葡萄籽提取物显著降低了收缩压（加权平均差 -1.54 mmHg（95%置信区间 -2.85至 -0.22，P = 0.02]）和心率（加权平均差 -1.42 bpm（95%置信区间 -2.50至 -0.34，P = 0.01]）。未发现对舒张压、血脂水平或CRP有显著影响。所有分析均未观察到统计学异质性（所有I(2)<39%）。Egger加权回归统计表明，除了对舒张压的影响（P = 0.046）外，所有分析中发表偏倚的可能性较低（所有P>0.05）。基于目前可得的文献，葡萄籽提取物似乎能显著降低收缩压和心率，对血脂或CRP水平无影响。需要进行更大规模的随机双盲试验，评估不同剂量的葡萄籽提取物并进行更长时间的随访。
