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一项随机对照试验的荟萃分析:维生素 C 补充对血清 CRP 和血清 hs-CRP 浓度的影响。

A Meta-analysis of Randomized Control Trials: The Impact of Vitamin C Supplementation on Serum CRP and Serum hs-CRP Concentrations.

机构信息

Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran.

Section of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy.

出版信息

Curr Pharm Des. 2018;24(30):3520-3528. doi: 10.2174/1381612824666181017101810.

Abstract

OBJECTIVE

The present meta-analysis was designed to assess the effects of vitamin C supplementation on serum C-reactive Protein (CRP) levels.

METHODS

We conducted a comprehensive systematic search of the literature in Scopus, PubMed and Google Scholar until May 2018. The pooled Weighted Mean Difference (WMD) and its 95% Confidence Interval (CI) in baseline and at the end of the trial were calculated to assess the net change in serum CRP by using random-effects model. The heterogeneity was assessed by I2 test. Combined and stratified analyses were used in the metaanalysis.

RESULTS

From 306 articles found and screened in our initial search, 12 studies were included with 446 participants in supplementation groups and 447 in control groups. The pooled effect size analysis showed a significant reducing effect of vitamin C supplementation on circulating CRP level (-0.23 mg/L, 95% CI, -0.44, -0.03, p=0.02), with a significant heterogeneity effect across the studies involved. Subgroup analyses showed that vitamin C supplementation significantly lowered CRP among trials. The most significant effect was found 1) on hs- CRP as the representative inflammatory marker (-0.43 mg/L, 95% CI -0.76, -0.1) 2) in subjects with a baseline CRP≥3 (-1.48 mg/L, 95% CI -2.84, -0.11) 3) in subjects under <60 years old of age (-0.23 mg/L, 95% CI -0.44,- 0.01) 4) or using intravenous administration of vitamin C (-0.89 mg/L, 95% CI -1.49,-0.3).

CONCLUSION

The present meta-analysis shows that vitamin C supplementation reduces serum CRP level, particularly in younger subjects, with higher CRP baseline level, at a lower dosage and intravenous administration.

摘要

目的

本荟萃分析旨在评估维生素 C 补充对血清 C 反应蛋白(CRP)水平的影响。

方法

我们在 Scopus、PubMed 和 Google Scholar 中进行了全面的文献系统搜索,截至 2018 年 5 月。使用随机效应模型计算基线和试验结束时的加权均数差(WMD)及其 95%置信区间(CI),以评估血清 CRP 的净变化。采用 I2 检验评估异质性。荟萃分析采用合并和分层分析。

结果

从我们最初的搜索中找到并筛选出的 306 篇文章中,有 12 项研究纳入了 446 名补充组和 447 名对照组的参与者。汇总效应大小分析显示,维生素 C 补充对循环 CRP 水平有显著降低作用(-0.23mg/L,95%CI,-0.44,-0.03,p=0.02),且研究间存在显著的异质性效应。亚组分析显示,维生素 C 补充可显著降低 CRP。最显著的效果是 1)在 hs-CRP 作为代表性炎症标志物中(-0.43mg/L,95%CI-0.76,-0.1),2)在基线 CRP≥3 的患者中(-1.48mg/L,95%CI-2.84,-0.11),3)在年龄小于 60 岁的患者中(-0.23mg/L,95%CI-0.44,-0.01),4)或使用静脉注射维生素 C 时(-0.89mg/L,95%CI-1.49,-0.3)。

结论

本荟萃分析表明,维生素 C 补充可降低血清 CRP 水平,尤其是在年轻患者、较高 CRP 基线水平、较低剂量和静脉内给药时。

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