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镁补充对血管内皮功能的影响:系统评价和随机对照试验的荟萃分析。

Effect of magnesium supplementation on endothelial function: A systematic review and meta-analysis of randomized controlled trials.

机构信息

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran; Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.

出版信息

Atherosclerosis. 2018 Jun;273:98-105. doi: 10.1016/j.atherosclerosis.2018.04.020. Epub 2018 Apr 14.

Abstract

BACKGROUND AND AIMS

Findings of past studies are inconsistent regarding the effects of magnesium (Mg) supplementation on endothelial function (EF). We performed this meta-analysis to examine the effects of magnesium supplementation on flow-mediated dilation (FMD) and carotid intima media thickness (CIMT) as markers of EF.

METHODS

Literature searches of English publications in MEDLINE and EMBASE databases were conducted up to November 2017. Results are reported as weighted mean difference (MD) with 95% confidence intervals (CI) using random effects model (DerSimonian-Laird method). Cochrane's Q test and I-squared (I) were used to determine heterogeneity among included studies. To determine potential sources of heterogeneity, subgroup analysis was conducted for pre-defined criteria. Funnel plot and Egger's regression test were used to assess publication bias.

RESULTS

Seven RCTs with 306 participants were included. Mg supplementation significantly increased FMD (MD: 2.97; 95% CI: 0.23 to 5.70%, p = 0.033). Between studies heterogeneity was high and subgroup analysis could not identify the sources of heterogeneity. Magnesium supplementation had no significant effect on CIMT (MD: -0.13 mm; 95% CI: 0.27, 0.01; p = 0.077) with high heterogeneity. Mg dose, duration of treatment, healthy status, baseline CIMT and sample size were the potential sources of heterogeneity. Mg supplementation could decrease CIMT to a greater extent in hemodialysis (HD) patients; lower doses of Mg, higher sample size and follow up duration and subjects with higher baseline CIMT also reduced the heterogeneity to some degree (p < 0.001).

CONCLUSIONS

Magnesium supplementation may improve endothelial function without affecting carotid intima media thickness.

摘要

背景与目的

过去的研究结果在镁(Mg)补充对内皮功能(EF)的影响方面不一致。我们进行了这项荟萃分析,以检查镁补充对血流介导的扩张(FMD)和颈动脉内膜中层厚度(CIMT)作为 EF 标志物的影响。

方法

对 MEDLINE 和 EMBASE 数据库中的英文文献进行了文献检索,检索截至 2017 年 11 月。结果以使用随机效应模型(DerSimonian-Laird 方法)的加权均数差(MD)和 95%置信区间(CI)表示。Cochrane's Q 检验和 I 平方(I)用于确定纳入研究之间的异质性。为确定异质性的潜在来源,进行了针对预定义标准的亚组分析。漏斗图和 Egger 回归检验用于评估发表偏倚。

结果

纳入了 7 项 RCT,共 306 名参与者。Mg 补充显著增加了 FMD(MD:2.97;95%CI:0.23 至 5.70%,p=0.033)。研究之间存在高度异质性,亚组分析无法确定异质性的来源。Mg 补充对 CIMT 没有显著影响(MD:-0.13mm;95%CI:0.27,0.01;p=0.077),异质性很高。Mg 剂量、治疗持续时间、健康状况、基线 CIMT 和样本量是异质性的潜在来源。在血液透析(HD)患者中,Mg 补充可能更能降低 CIMT;更低剂量的 Mg、更大的样本量和随访时间以及更高基线 CIMT 的受试者在一定程度上也降低了异质性(p<0.001)。

结论

镁补充可能改善内皮功能而不影响颈动脉内膜中层厚度。

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