对测试补充维生素C对血脂影响的随机对照试验进行系统评价和荟萃分析。
Systematic review and meta-analysis of randomised controlled trials testing the effects of vitamin C supplementation on blood lipids.
作者信息
Ashor Ammar W, Siervo Mario, van der Velde Femke, Willis Naomi D, Mathers John C
机构信息
Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne NE4 5PL, UK; College of Medicine, University of Al-Mustansiriyah, Baghdad, Iraq.
Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne NE4 5PL, UK; MRC Human Nutrition Research, Elsie Widdowson Laboratories, 120 Fulbourn Road, Cambridge CB1 9NL, UK.
出版信息
Clin Nutr. 2016 Jun;35(3):626-37. doi: 10.1016/j.clnu.2015.05.021. Epub 2015 Jun 17.
BACKGROUND & AIMS: Randomised controlled trials (RCTs) in humans revealed contradictory results regarding the effect of vitamin C supplementation on blood lipids. We aimed to conduct a systematic review and meta-analysis of RCTs investigating the effect of vitamin C supplementation on total cholesterol, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C) and triglycerides and to determine whether the effects are modified by the participants' or intervention characteristics.
METHODS
Four databases (PubMed, Embase, Scopus and Cochrane Library) were searched from inception until August 2014 for RCTs supplementing adult participants with vitamin C for ≥ 2 weeks and reporting changes in blood lipids.
RESULTS
Overall, vitamin C supplementation did not change blood lipids concentration significantly. However, supplementation reduced total cholesterol in younger participants (≤52 years age) (-0.26 mmol/L, 95% CI: -0.45, -0.07) and LDL-C in healthy participants (-0.32 mmol/L, 95% CI: -0.57, -0.07). In diabetics, vitamin C supplementation reduced triglycerides significantly (-0.15 mmol/L, 95% CI: -0.30, -0.002) and increased HDL-C significantly (0.06 mmol/L, 95% CI: 0.02, 0.11). Meta-regression analyses showed the changes in total cholesterol (β: -0.24, CI: -0.36, -0.11) and in triglycerides (β: -0.17, CI: -0.30, -0.05) following vitamin C supplementation were greater in those with higher concentrations of these lipids at baseline. Greater increase in HDL-C was observed in participants with lower baseline plasma concentrations of vitamin C (β: -0.002, CI: -0.003, -0.0001).
CONCLUSIONS
Overall, vitamin C supplementation had no significant effect on lipid profile. However, subgroup and sensitivity analyses showed significant reductions in blood lipids following supplementation in sub-populations with dyslipidaemia or low vitamin C status at baseline. PROSPERO Database registration: CRD42014013487, http://www.crd.york.ac.uk/prospero/.
背景与目的
人体随机对照试验（RCT）显示，补充维生素C对血脂的影响结果相互矛盾。我们旨在对研究补充维生素C对总胆固醇、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）和甘油三酯影响的随机对照试验进行系统评价和荟萃分析，并确定这些影响是否会因参与者或干预特征而改变。
方法
检索四个数据库（PubMed、Embase、Scopus和Cochrane图书馆），从建库至2014年8月，查找对成年参与者补充维生素C≥2周并报告血脂变化的随机对照试验。
结果
总体而言，补充维生素C并未显著改变血脂浓度。然而，补充维生素C可降低年轻参与者（≤52岁）的总胆固醇（-0.26 mmol/L，95%CI：-0.45，-0.07）以及健康参与者的LDL-C（-0.32 mmol/L，95%CI：-0.57，-0.07）。在糖尿病患者中，补充维生素C可显著降低甘油三酯（-0.15 mmol/L，95%CI：-0.30，-0.002）并显著升高HDL-C（0.06 mmol/L，95%CI：0.02，0.11）。荟萃回归分析显示，补充维生素C后，基线时这些血脂浓度较高者的总胆固醇变化（β：-0.24，CI：-0.36，-0.11）和甘油三酯变化（β：-0.17，CI：-0.30，-0.05）更大。在基线血浆维生素C浓度较低的参与者中，观察到HDL-C的升高幅度更大（β：-0.002，CI：-0.003，-0.0001）。
结论
总体而言，补充维生素C对血脂谱无显著影响。然而，亚组分析和敏感性分析显示，在基线时患有血脂异常或维生素C水平较低的亚人群中，补充维生素C后血脂显著降低。PROSPERO数据库注册号：CRD42014013487，http://www.crd.york.ac.uk/prospero/ 。
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