Cardiovascular Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA,
Internal Medicine, Mercy Health St. Vincent Medical Center, Toledo, Ohio, USA.
Complement Med Res. 2020;27(4):272-281. doi: 10.1159/000506180. Epub 2020 Feb 26.
Endothelial dysfunction is an early marker of atherosclerosis. Flow-mediated dilation (FMD), measured by ultrasonography, is used to noninvasively assess endothelial dysfunction. Preparations of curcumin, a naturally occurring pigment found in turmeric, may improve FMD and thus endothelial dysfunction. We did a systematic review and meta-analysis to analyze the effect of curcumin preparations on endothelial dysfunction.
Five randomized clinical trials met the inclusion criteria for meta-analysis. The primary outcome was an improvement in FMD, as measured at brachial artery, after supplementations with curcumin preparations compared to the control group. Standardized mean difference and Hedges' g were used for effect size (ES) measurement. An ES of 0.2-0.5 is considered small, 0.5-0.8 is medium, and more than 0.8 is large. Publication bias was studied too.
We found supplementation with curcumin preparations had an overall ES (standard difference in means) of 1.379 (95% CI 0.485-2.274, p = 0.003) on FMD. The overall Hedges' g was 1.353 (95% CI 0.47-2.235, p = 0.03). This analysis suggests a positive and large ES of curcumin preparations on FMD using a random effect model. Smokers had a smaller increase in FMD compared to nonsmokers (ES 0.379 vs. 1.639, p = 0.034).
This meta-analysis of 5 randomized clinical trials indicates a significant effect of curcumin preparations to increase the FMD compared to placebo and thus endothelial function. This effect is not strongly noticed in smokers.
内皮功能障碍是动脉粥样硬化的早期标志物。超声测量的血流介导的扩张（FMD）用于无创评估内皮功能障碍。姜黄素是一种天然存在于姜黄中的色素，其制剂可能改善 FMD，从而改善内皮功能障碍。我们进行了系统评价和荟萃分析，以分析姜黄素制剂对内皮功能障碍的影响。
符合荟萃分析纳入标准的五项随机临床试验。主要结局是与对照组相比，姜黄素制剂补充后肱动脉 FMD 的改善。使用标准化均数差和 Hedges'g 测量效应量（ES）。0.2-0.5 被认为是小 ES，0.5-0.8 是中 ES，大于 0.8 是大 ES。还研究了发表偏倚。
我们发现，与安慰剂相比，姜黄素制剂补充剂对 FMD 的总体 ES（均数差值的标准差）为 1.379（95%CI 0.485-2.274，p=0.003）。总体 Hedges'g 为 1.353（95%CI 0.47-2.235，p=0.03）。这项分析表明，使用随机效应模型，姜黄素制剂对 FMD 的影响具有阳性和较大的 ES。与不吸烟者相比，吸烟者的 FMD 增加幅度较小（ES 0.379 与 1.639，p=0.034）。
这项对 5 项随机临床试验的荟萃分析表明，与安慰剂相比，姜黄素制剂显著增加 FMD，从而改善内皮功能。这种作用在吸烟者中并不明显。
