Fekete Ágnes A, Givens D Ian, Lovegrove Julie A
Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research (ICMR), Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6AP, UK.
Food Production and Quality Research Division, School of Agriculture, Policy and Development, Faculty of Life Sciences, University of Reading, Reading RG6 6AP, UK.
Nutrients. 2015 Jan 20;7(1):659-81. doi: 10.3390/nu7010659.
There is an urgent need to treat individuals with high blood pressure (BP) with effective dietary strategies. Previous studies suggest a small, but significant decrease in BP after lactotripeptides (LTP) ingestion, although the data are inconsistent. The study aim was to perform a comprehensive meta-analysis of data from all relevant randomised controlled trials (RCT). Medline, Cochrane library, EMBASE and Web of Science were searched until May 2014. Eligibility criteria were RCT that examined the effects of LTP on BP in adults, with systolic BP (SBP) and diastolic BP (DBP) as outcome measures. Thirty RCT met the inclusion criteria, which resulted in 33 sets of data. The pooled treatment effect for SBP was -2.95 mmHg (95% CI: -4.17, -1.73; p < 0.001), and for DBP was -1.51 mmHg (95% CI: -2.21, -0.80; p < 0.001). Sub-group analyses revealed that reduction of BP in Japanese studies was significantly greater, compared with European studies (p = 0.002 for SBP and p < 0.001 for DBP). The 24-h ambulatory BP (AMBP) response to LTP supplementation was statistically non-significant (p = 0.101 for SBP and p = 0.166 for DBP). Both publication bias and "small-study effect" were identified, which shifted the treatment effect towards less significant SBP and non-significant DBP reduction after LTP consumption. LTP may be effective in BP reduction, especially in Japanese individuals; however sub-group, meta-regression analyses and statistically significant publication biases suggest inconsistencies.
迫切需要采用有效的饮食策略来治疗高血压患者。先前的研究表明，摄入乳三肽（LTP）后血压虽有小幅但显著的下降，尽管数据并不一致。本研究的目的是对所有相关随机对照试验（RCT）的数据进行全面的荟萃分析。检索了Medline、Cochrane图书馆、EMBASE和科学网直至2014年5月。纳入标准为研究LTP对成年人血压影响的RCT，以收缩压（SBP）和舒张压（DBP）作为结局指标。30项RCT符合纳入标准，产生了33组数据。SBP的合并治疗效应为-2.95 mmHg（95%CI：-4.17，-1.73；p<0.001），DBP为-1.51 mmHg（95%CI：-2.21，-0.80；p<0.001）。亚组分析显示，与欧洲研究相比，日本研究中血压的降低更为显著（SBP为p = 0.002，DBP为p<0.001）。补充LTP后24小时动态血压（AMBP）反应无统计学意义（SBP为p = 0.101，DBP为p = 0.166）。发现了发表偏倚和“小研究效应”，这使得LTP摄入后治疗效应向SBP降低不显著和DBP降低无统计学意义转变。LTP可能对降低血压有效，尤其是在日本人中；然而，亚组分析、荟萃回归分析和具有统计学意义的发表偏倚表明存在不一致性。
