磷虾油对人体的脂质调节作用：随机对照试验的系统评价和荟萃分析

Lipid-modifying effects of krill oil in humans: systematic review and meta-analysis of randomized controlled trials.

作者信息

Ursoniu Sorin, Sahebkar Amirhossein, Serban Maria-Corina, Antal Diana, Mikhailidis Dimitri P, Cicero Arrigo, Athyros Vasilios, Rizzo Manfredi, Rysz Jacek, Banach Maciej

机构信息

S. Ursoniu is with the Department of Functional Sciences, Discipline of Public Health, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. A. Sahebkar is with the Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. M.-C. Serban is with the Department of Functional Sciences, Discipline of Pathophysiology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D. Antal is with the Discipline of Pharmaceutical Botany, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D.P. Mikhailidis is with the Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London, London, United Kingdom. A. Cicero is with the Medical & Surgical Sciences Department, Alma Mater Studiorum - University of Bologna, Bologna, Italy. V. Athyros is with the Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration General Hospital, Thessaloniki, Greece. M. Rizzo is with the Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy. J. Rysz and M. Banach are with the Department of Hypertension, Medical University of Lodz, Lodz, Poland.

出版信息

Nutr Rev. 2017 May 1;75(5):361-373. doi: 10.1093/nutrit/nuw063.

DOI:10.1093/nutrit/nuw063

PMID:28371906

Abstract

CONTEXT

Some experimental and clinical trials have shown that krill oil, extracted from small red crustaceans, might be an effective lipid-modifying agent, but the evidence is not conclusive.

OBJECTIVE

The effect of krill oil supplements on plasma lipid concentrations was assessed through a systematic review of the literature and a meta-analysis of available randomized controlled trials.

DATA SOURCES

PubMed and Scopus were searched up to March 25, 2016, to identify RCTs investigating the effect of krill oil supplements on plasma lipids.

STUDY SELECTION

Randomized controlled trials that investigated the impact of at least 2 weeks of supplementation with krill oil on plasma/serum concentrations of at least one of the main lipid parameters (ie, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, or triglycerides) and that reported sufficient information on plasma/serum lipid levels at baseline and at the end of study in both krill oil and control groups were eligible for inclusion.

DATA EXTRACTION

Two reviewers independently extracted the following data: first author's name, year of publication, study location, study design, number of participants in the krill oil and control groups, dosage of krill oil, type of control allocation, treatment duration, demographic characteristics of study participants, and baseline and follow-up plasma concentrations of lipids. Effect size was expressed as the weighted mean difference (WMD) and 95% confidence interval (95%CI).

RESULTS

Meta-analysis of data from 7 eligible trials (14 treatment arms) with 662 participants showed a significant reduction in plasma concentrations of low-density lipoprotein cholesterol (WMD, -15.52 mg/dL; 95%CI, -28.43 to -2.61; P = 0.018) and triglycerides (WMD, -14.03 mg/dL; 95%CI, -21.38 to -6.67; P < 0.001) following supplementation with krill oil. A significant elevation in plasma concentrations of high-density lipoprotein cholesterol was also observed (WMD, 6.65 mg/dL; 95%CI, 2.30 to 10.99; P = 0.003), while a reduction in plasma concentrations of total cholesterol did not reach statistical significance (WMD, -7.50 mg/dL; 95%CI, -17.94 to 2.93; P = 0.159).

CONCLUSION

Krill oil supplementation can reduce low-density lipoprotein cholesterol and triglycerides. Additional clinical studies with more participants are needed to assess the impact of krill oil supplementation on other indices of cardiometabolic risk and on the risk of cardiovascular outcomes.

摘要

背景

一些实验和临床试验表明，从小型红色甲壳类动物中提取的磷虾油可能是一种有效的脂质调节药物，但证据并不确凿。

目的

通过对文献的系统回顾和对现有随机对照试验的荟萃分析，评估磷虾油补充剂对血浆脂质浓度的影响。

数据来源

检索了截至2016年3月25日的PubMed和Scopus数据库，以确定研究磷虾油补充剂对血浆脂质影响的随机对照试验。

研究选择

随机对照试验，研究至少2周的磷虾油补充对至少一种主要脂质参数（即总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇或甘油三酯）的血浆/血清浓度的影响，并且报告了磷虾油组和对照组在基线和研究结束时血浆/血清脂质水平的足够信息，符合纳入标准。

数据提取

两名审阅者独立提取了以下数据：第一作者姓名、发表年份、研究地点、研究设计、磷虾油组和对照组的参与者数量、磷虾油剂量、对照分配类型、治疗持续时间、研究参与者的人口统计学特征以及基线和随访时的血浆脂质浓度。效应大小以加权平均差（WMD）和95%置信区间（95%CI）表示。

结果

对7项符合条件的试验（14个治疗组）的662名参与者的数据进行荟萃分析，结果显示补充磷虾油后，血浆低密度脂蛋白胆固醇浓度显著降低（WMD，-15.52mg/dL；95%CI，-28.43至-2.61；P =0.018），甘油三酯浓度也显著降低（WMD，-14.03mg/dL；95%CI，-21.38至-6.67；P <0.001）。还观察到血浆高密度脂蛋白胆固醇浓度显著升高（WMD，6.65mg/dL；95%CI，2.30至10.99；P =0.003），而血浆总胆固醇浓度的降低未达到统计学显著性（WMD，-7.50mg/dL；95%CI，-17.�4至2.93；P =0.159）。