Huang Haohai, Zou Ying, Chi Honggang
Department of Clinical Pharmacy, Dongguan Third People's Hospital, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan.
Department of Traditional Chinese Medicine, Scientific Research Platform, The Second Clinical Medical College, Guangdong Medical University, Dongguan.
Drug Des Devel Ther. 2017 Dec 28;12:67-75. doi: 10.2147/DDDT.S148064. eCollection 2018.
Chitosan is a popular dietary fiber often used to reduce dietary fat absorption to control weight and blood lipids. However, its effects on blood pressure (BP) have not been fully elucidated. We evaluated the effects of chitosan administration on systolic blood pressure (SBP) and diastolic blood pressure (DBP) through a pooled analysis of available randomized controlled trials (RCTs).
Electronic searches were conducted in Medline, Cochrane Library, Scopus, and EMBASE to identify relevant human placebo-control RCTs. Trials that reported BP changes from baseline to study endpoint in patients receiving treatment of chitosan were included for analysis. Weighted mean difference (WMD) and 95% CIs were pooled using fixed-effects or random-effects models. Statistical heterogeneity, prespecified subgroup, publication bias, sensitivity analysis, and meta-regression assessments were also tested.
Six hundred and seventeen participants from eight trials with 10 arms were included. Overall, chitosan administration did not significantly lower SBP (WMD: -1.41 mmHg, 95% CI: -3.29 to 0.47; =0.14) and DBP (WMD: -0.61 mmHg, 95% CI: -1.75 to 0.52; =0.29). However, our subgroup analyses indicated that chitosan consumption significantly reduced DBP in shorter-term (<12 weeks) and higher-dose (>2.4 g/day) arms. Funnel plots or Egger's tests analysis (=0.36 and 0.43 for SBP and DBP, respectively) demonstrated that there was no significant publication bias in this study.
This meta-analysis indicates that chitosan consumption significantly decreases DBP at higher dosage and in shorter-term interventions, while chitosan has no significant effects on SBP. However, these results should be interpreted cautiously because of the limited eligible RCTs included in this meta-analysis; further large-scale, well-designed RCTs on this topic are urgently needed.
壳聚糖是一种常用的膳食纤维，常用于减少膳食脂肪吸收以控制体重和血脂。然而，其对血压（BP）的影响尚未完全阐明。我们通过对现有随机对照试验（RCT）进行汇总分析，评估了壳聚糖给药对收缩压（SBP）和舒张压（DBP）的影响。
在Medline、Cochrane图书馆、Scopus和EMBASE中进行电子检索，以识别相关的人体安慰剂对照RCT。纳入报告接受壳聚糖治疗的患者从基线到研究终点血压变化的试验进行分析。使用固定效应或随机效应模型汇总加权平均差（WMD）和95%置信区间（CI）。还进行了统计异质性、预先指定的亚组、发表偏倚、敏感性分析和meta回归评估。
纳入了来自八项试验的617名参与者，共10个研究组。总体而言，壳聚糖给药并未显著降低SBP（WMD：-1.41 mmHg，95% CI：-3.29至0.47；P = 0.14）和DBP（WMD：-0.61 mmHg，95% CI：-1.75至0.52；P = 0.29）。然而，我们的亚组分析表明，在短期（<12周）和高剂量（>2.4 g/天）组中，食用壳聚糖可显著降低DBP。漏斗图或Egger检验分析（SBP和DBP的P值分别为0.36和0.43）表明，本研究中无显著的发表偏倚。
这项meta分析表明，在高剂量和短期干预中，食用壳聚糖可显著降低DBP，而壳聚糖对SBP无显著影响。然而，由于本meta分析中纳入的合格RCT有限，这些结果应谨慎解释；迫切需要就该主题进行进一步的大规模、精心设计的RCT。
