Clinical Nutrition and Risk Factor Modification Centre, St Michael’s Hospital, Toronto, Ontario, Canada.
Hypertension. 2012 Apr;59(4):787-95. doi: 10.1161/HYPERTENSIONAHA.111.182311. Epub 2012 Feb 13.
Concerns have been raised about the adverse effect of fructose on blood pressure. International dietary guidelines, however, have not addressed fructose intake directly. A systematic review and meta-analysis was conducted to assess the effect of fructose in isocaloric exchange for other carbohydrates on systolic, diastolic, and mean arterial blood pressures. Studies were identified using Medline, Embase, and Cochrane databases (through January 9, 2012). Human clinical trials of isocaloric oral fructose exchange for other carbohydrate sources for ≥7 days were included in the analysis. Data were pooled by the generic inverse variance method using random-effects models and expressed as mean differences with 95% CI. Heterogeneity was assessed by the Q-statistic and quantified by I(2). Study quality was assessed using the Heyland Methodological Quality Score. Thirteen isocaloric (n=352) and 2 hypercaloric (n=24) trials met the eligibility criteria. Overall, fructose intake in isocaloric exchange for other carbohydrates significantly decreased diastolic (mean difference: -1.54 [95% CI: -2.77 to -0.32]) and mean arterial pressure (mean difference: -1.16 [95% CI: -2.15 to -0.18]). There was no significant effect of fructose on systolic blood pressure (mean difference: -1.10 [95% CI: -2.46 to 0.44]). The hypercaloric fructose feeding trials found no significant overall mean arterial blood pressure effect of fructose in comparison with other carbohydrates. To confirm these results, longer and larger trials are needed. Contrary to previous concerns, we found that isocaloric substitution of fructose for other carbohydrates did not adversely affect blood pressure in humans.
人们对果糖对血压的不良影响表示担忧。然而，国际饮食指南并没有直接涉及果糖的摄入量。本研究通过系统评价和荟萃分析来评估等热量交换的果糖摄入对收缩压、舒张压和平均动脉压的影响。研究通过 Medline、Embase 和 Cochrane 数据库（截至 2012 年 1 月 9 日）进行检索。分析中纳入了为期至少 7 天的等热量口服果糖与其他碳水化合物源交换的人体临床试验。数据通过随机效应模型的通用倒数方差法进行汇总，并以均数差值和 95%CI 表示。通过 Q 统计量评估异质性，并以 I(2)表示。使用 Heyland 方法学质量评分评估研究质量。13 项等热量（n=352）和 2 项高卡路里（n=24）试验符合入选标准。总体而言，果糖等热量交换摄入其他碳水化合物后，舒张压（平均差值：-1.54 [95%CI：-2.77 至 -0.32]）和平均动脉压（平均差值：-1.16 [95%CI：-2.15 至 -0.18]）显著降低。果糖对收缩压无显著影响（平均差值：-1.10 [95%CI：-2.46 至 0.44]）。与其他碳水化合物相比，高卡路里的果糖喂养试验发现果糖对平均动脉血压的总体影响无显著差异。需要更长时间和更大规模的试验来证实这些结果。与之前的担忧相反，我们发现等热量交换的果糖摄入对人体血压没有不良影响。
