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辅酶 Q10 补充剂对冠心病患者血脂谱的影响:系统评价和随机对照试验的荟萃分析。

The effects of coenzyme Q10 supplementation on lipid profiles among patients with coronary artery disease: a systematic review and meta-analysis of randomized controlled trials.

机构信息

Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Health Policy Research Center, Institute of Health, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Lipids Health Dis. 2018 Oct 9;17(1):230. doi: 10.1186/s12944-018-0876-4.

Abstract

BACKGROUND

Chronic inflammation and increased oxidative stress significantly contribute in developing coronary artery disease (CAD). Hence, antioxidant supplementation might be an appropriate approach to decrease the incidence of CAD. This systematic review and meta-analysis was aimed to determine the effects of coenzyme Q10 (CoQ10) supplementation on lipid profile, as one of the major triggers for CAD, among patients diagnosed with coronary artery disease.

METHODS

EMBASE, Scopus, PubMed, Cochrane Library, and Web of Science were searched for studies prior to May 20th, 2018. Cochrane Collaboration risk of bias tool was applied to assess the methodological quality of included trials. I-square and Q-tests were used to measure the existing heterogeneity across included studies. Considering heterogeneity among studies, fixed- or random-effect models were applied to pool standardized mean differences (SMD) as overall effect size.

RESULTS

A total of eight trials (267 participants in the intervention group and 259 in placebo group) were included in the current meta-analysis. The findings showed that taking CoQ10 by patients with CAD significantly decreased total-cholesterol (SMD -1.07; 95% CI, - 1.94, - 0.21, P = 0.01) and increased HDL-cholesterol levels (SMD 1.30; 95% CI, 0.20, 2.41, P = 0.02). We found no significant effects of CoQ10 supplementation on LDL-cholesterol (SMD -0.37; 95% CI, - 0.87, 0.13, P = 0.14), lipoprotein (a) [Lp(a)] levels (SMD -1.12; 95% CI, - 2.84, 0.61, P = 0.20) and triglycerides levels (SMD 0.01; 95% CI, - 0.22, 0.24, P = 0.94).

CONCLUSIONS

This meta-analysis demonstrated the promising effects of CoQ10 supplementation on lowering lipid levels among patients with CAD, though it did not affect triglycerides, LDL-cholesterol and Lp(a) levels.

摘要

背景

慢性炎症和氧化应激增加是导致冠心病(CAD)的主要原因。因此,抗氧化剂的补充可能是降低 CAD 发病率的一种合适方法。本系统评价和荟萃分析旨在确定辅酶 Q10(CoQ10)补充剂对脂质谱的影响,脂质谱是 CAD 的主要诱因之一,研究对象为确诊为冠心病的患者。

方法

在 2018 年 5 月 20 日之前,检索了 EMBASE、Scopus、PubMed、Cochrane 图书馆和 Web of Science 中的研究。采用 Cochrane 协作风险偏倚工具评估纳入试验的方法学质量。应用 I 平方和 Q 检验来衡量纳入研究之间的异质性。考虑到研究之间的异质性,应用固定效应或随机效应模型来汇总标准化均数差(SMD)作为总体效应量。

结果

共有八项试验(干预组 267 例,安慰剂组 259 例)纳入本次荟萃分析。结果表明,CAD 患者服用 CoQ10 后,总胆固醇水平显著降低(SMD-1.07;95%CI,-1.94,-0.21,P=0.01),高密度脂蛋白胆固醇水平升高(SMD 1.30;95%CI,0.20,2.41,P=0.02)。我们发现 CoQ10 补充剂对 LDL-胆固醇(SMD-0.37;95%CI,-0.87,0.13,P=0.14)、脂蛋白(a)[Lp(a)]水平(SMD-1.12;95%CI,-2.84,0.61,P=0.20)和甘油三酯水平(SMD 0.01;95%CI,-0.22,0.24,P=0.94)没有显著影响。

结论

本荟萃分析表明,CoQ10 补充剂对 CAD 患者降低血脂水平具有良好的效果,但对甘油三酯、LDL-胆固醇和 Lp(a)水平没有影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a56/6176512/484c75077b31/12944_2018_876_Fig1_HTML.jpg

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