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锌补充剂与体重:随机对照试验的系统评价和剂量反应荟萃分析。

Zinc Supplementation and Body Weight: A Systematic Review and Dose-Response Meta-analysis of Randomized Controlled Trials.

机构信息

Department of Nutrition and Public Health, School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran.

Department of Nutrition, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

出版信息

Adv Nutr. 2020 Mar 1;11(2):398-411. doi: 10.1093/advances/nmz084.

Abstract

The aim of this study was to determine the effect of zinc supplementation on anthropometric measures. In this systematic review and dose-response meta-analysis, we searched PubMed, Scopus, ISI Web of Science, and the Cochrane Library from database inception to August 2018 for relevant randomized controlled trials. Mean differences and SDs for each outcome were pooled using a random-effects model. Furthermore, a dose-response analysis for zinc dosage was performed using a fractional polynomial model. Quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Twenty-seven trials (n = 1438 participants) were included in the meta-analysis. There were no significant changes in anthropometric measures after zinc supplementation in the overall analysis. However, subgroup analyses revealed that zinc supplementation increased body weight in individuals undergoing hemodialysis (HD) [3 trials, n = 154 participants; weighted mean difference (WMD) = 1.02 kg; 95% CI: 0.38, 1.65 kg; P = 0.002; I2 = 11.4%] and decreased body weight in subjects who are overweight/obese but otherwise healthy (5 trials, n = 245 participants; WMD = -0.55 kg; 95% CI: -1.06, -0.04 kg; P = 0.03; I2 = 31.5%). Dose-response analyses revealed a significant nonlinear effect of supplementation dosage on BMI (P = 0.001). Our data suggest that zinc supplementation increases body weight in patients undergoing HD and decreases body weight in individuals who are overweight/obese but otherwise healthy, although after normalization for study duration, the association observed in subjects who are overweight/obese disappeared. Although more high-quality studies are needed to reach a definitive conclusion, our study supports the view that zinc may be associated with body weight.

摘要

本研究旨在确定补锌对人体测量学指标的影响。在本系统评价和剂量-反应荟萃分析中,我们从数据库建立到 2018 年 8 月,检索了 PubMed、Scopus、ISI Web of Science 和 Cochrane 图书馆中相关的随机对照试验。使用随机效应模型汇总每个结局的均数差和标准差。此外,使用分数多项式模型对锌剂量进行了剂量-反应分析。使用推荐评估、制定与评价(GRADE)方法学评估证据质量。荟萃分析纳入了 27 项试验(n=1438 名参与者)。总体分析显示,补锌后人体测量学指标无显著变化。然而,亚组分析显示,补锌增加了接受血液透析(HD)治疗的个体的体重[3 项试验,n=154 名参与者;加权均数差(WMD)=1.02kg;95%CI:0.38,1.65kg;P=0.002;I2=11.4%],降低了超重/肥胖但其他方面健康的个体的体重[5 项试验,n=245 名参与者;WMD=-0.55kg;95%CI:-1.06,-0.04kg;P=0.03;I2=31.5%]。剂量-反应分析显示,补充剂量对 BMI 有显著的非线性影响(P=0.001)。我们的数据表明,补锌增加了 HD 患者的体重,降低了超重/肥胖但其他方面健康的个体的体重,但在根据研究持续时间进行归一化后,超重/肥胖患者的相关性消失了。尽管需要更多高质量的研究来得出明确的结论,但我们的研究支持锌可能与体重有关的观点。

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