姜黄和姜黄素降低心血管危险因素患者血脂水平的疗效和安全性：随机对照试验的荟萃分析。
Efficacy and safety of turmeric and curcumin in lowering blood lipid levels in patients with cardiovascular risk factors: a meta-analysis of randomized controlled trials.
机构信息
Department of Clinical Nutrition, The Second Affiliated Hospital of Chongqing Medical University, No.76, Linjiang Road, Chongqing, 400010, People's Republic of China.
Department of Infectious Diseases, Institute for Viral Hepatitis, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
出版信息
Nutr J. 2017 Oct 11;16(1):68. doi: 10.1186/s12937-017-0293-y.
BACKGROUND
Dyslipidemia is an important and common cardiovascular risk factor in the general population. The lipid-lowering effects of turmeric and curcumin are unconfirmed. We performed a meta-analysis to assess the efficacy and safety of turmeric and curcumin in lowering blood lipids in patients at risk of cardiovascular disease (CVD).
METHODS
A comprehensive literature search was conducted on PubMed, Embase, Ovid, Medline and Cochrane Library databases to identify randomized controlled trials (published as of November 2016) that assessed the effect of turmeric and curcumin on blood lipid levels including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG). Pooled standardized mean difference (SMD) with 95% confidence interval (CI) was used to assess the effect.
RESULTS
The analysis included 7 eligible studies (649 patients). Turmeric and curcumin significantly reduced serum LDL-C (SMD = -0.340, 95% confidence interval [CI]: -0.530 to -0.150, P < 0.0001) and TG (SMD = -0.214, 95% CI: -0.369 to -0.059, P = 0.007) levels as compared to those in the control group. These may be effective in lowering serum TC levels in patients with metabolic syndrome (MetS, SMD = -0.934, 95% CI: -1.289 to -0.579, P < 0.0001), and turmeric extract could possibly have a greater effect on reducing serum TC levels (SMD = -0.584, 95% CI: -0.980 to -0.188, P = 0.004); however, the efficacy is yet to be confirmed. Serum HDL-C levels were not obviously improved. Turmeric and curcumin appeared safe, and no serious adverse events were reported in any of the included studies.
CONCLUSIONS
Turmeric and curcumin may protect patients at risk of CVD through improving serum lipid levels. Curcumin may be used as a well-tolerated dietary adjunct to conventional drugs. Further research is required to resolve uncertainties related to dosage form, dose and medication frequency of curcumin.
背景
血脂异常是普通人群中一个重要且常见的心血管危险因素。姜黄和姜黄素降低血脂的作用尚未得到证实。我们进行了一项荟萃分析，以评估姜黄和姜黄素在降低心血管疾病（CVD）风险患者的血脂方面的疗效和安全性。
方法
对 PubMed、Embase、Ovid、Medline 和 Cochrane Library 数据库进行了全面的文献检索，以确定评估姜黄和姜黄素对包括总胆固醇（TC）、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（TG）在内的血脂水平影响的随机对照试验（截至 2016 年 11 月发表）。使用标准化均数差值（SMD）和 95%置信区间（CI）评估疗效。
结果
分析纳入了 7 项符合条件的研究（649 名患者）。与对照组相比，姜黄和姜黄素可显著降低血清 LDL-C（SMD=-0.340，95%CI：-0.530 至-0.150，P<0.0001）和 TG（SMD=-0.214，95%CI：-0.369 至-0.059，P=0.007）水平。这些可能有助于降低代谢综合征（MetS）患者的血清 TC 水平（SMD=-0.934，95%CI：-1.289 至-0.579，P<0.0001），并且姜黄提取物可能对降低血清 TC 水平具有更大的作用（SMD=-0.584，95%CI：-0.980 至-0.188，P=0.004）；然而，疗效尚待证实。血清 HDL-C 水平没有明显改善。姜黄和姜黄素似乎是安全的，在纳入的任何研究中都没有报告严重不良事件。
结论
姜黄和姜黄素可通过改善血清脂质水平来保护心血管疾病风险患者。姜黄素可作为一种耐受良好的膳食补充剂，与常规药物联合使用。需要进一步的研究来解决有关姜黄素剂型、剂量和用药频率的不确定问题。
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