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辅酶 Q10 治疗慢性肾脏病患者的疗效的系统评价。

A systematic review for the efficacy of coenzyme Q10 in patients with chronic kidney disease.

机构信息

Department of Nephrology, Chinese PLA Strategic Support Force Characteristic Medical Center (The 306th Hospital of Chinese PLA), 9 AnXiangBeiLi Road, Beijing, 100101, China.

Institute of Food Industrial Technology and Economic, Academy of National Food and Strategic Reserves Administration, No. 11 Baiwanzhuang Street, Beijing, 100037, China.

出版信息

Int Urol Nephrol. 2022 Jan;54(1):173-184. doi: 10.1007/s11255-021-02838-2. Epub 2021 Mar 29.

Abstract

BACKGROUND

The effects of coenzyme Q10 (CoQ10) supplementation in chronic kidney disease (CKD) patients remain controversial.

OBJECTIVE

A systematic review of current evidence was performed to systematically and comprehensively summarize the effects of CoQ10 on cardiovascular outcomes, oxidative stress, inflammation, lipid profiles, and glucose metabolism.

METHODS

MEDLINE, EMBASE, and the Cochrane Library database (Cochrane Central Register of Controlled Trials) were searched to identify eligible studies investigating the effects of CoQ10 supplementation on patients with CKD.

RESULTS

Twelve independent studies (including seventeen publications) were included in this systematic review. For CKD patients, six studies reported variable cardiovascular outcomes, which yielded inconsistent results. Regarding oxidative stress and inflammation, pooled analysis showed that CoQ10 supplementation significantly reduced malonaldehyde (WMD: - 1.15 95% CI - 1.48 to - 0.81) and high-sensitivity C reactive protein levels (WMD: - 1.18 95% CI - 2.21 to - 0.15). Regarding glucose metabolism, we found that CoQ10 supplementation resulted in significant improvements in HbA1c (WMD: - 0.80; 95% CI: - 1.35 to - 0.24) and QUICKI (WMD: 0.02; 95% CI: 0.01 to 0.03). The pooled results indicated that CoQ10 supplementation had no effects on total cholesterol, or LDL-cholesterol, or on HDL-cholesterol, and triglycerides.

CONCLUSIONS

Our systematic review demonstrated that CoQ10 supplementation might have promising effects on oxidative stress. This work provided some clues that CoQ10 supplementation might have the potential to improve inflammation levels, glucose metabolism, cardiac structure, and cardiac biomarkers. However, the effects of CoQ10 supplementation should be confirmed in larger high-quality studies.

摘要

背景

辅酶 Q10(CoQ10)补充剂对慢性肾脏病(CKD)患者的影响仍存在争议。

目的

对现有证据进行系统评价,以系统全面地总结 CoQ10 对心血管结局、氧化应激、炎症、血脂谱和葡萄糖代谢的影响。

方法

检索 MEDLINE、EMBASE 和 Cochrane 图书馆数据库(Cochrane 中央对照试验注册库),以确定评估 CoQ10 补充剂对 CKD 患者影响的合格研究。

结果

本系统评价纳入了 12 项独立研究(包括 17 项研究)。对于 CKD 患者,6 项研究报告了不同的心血管结局,结果不一致。关于氧化应激和炎症,汇总分析显示 CoQ10 补充剂显著降低了丙二醛(WMD:-1.15,95%CI:-1.48 至-0.81)和高敏 C 反应蛋白水平(WMD:-1.18,95%CI:-2.21 至-0.15)。关于葡萄糖代谢,我们发现 CoQ10 补充剂可显著改善 HbA1c(WMD:-0.80;95%CI:-1.35 至-0.24)和 QUICKI(WMD:0.02;95%CI:0.01 至 0.03)。汇总结果表明,CoQ10 补充剂对总胆固醇、LDL-胆固醇或 HDL-胆固醇或甘油三酯没有影响。

结论

本系统评价表明,CoQ10 补充剂可能对氧化应激有良好的作用。本研究提供了一些线索,表明 CoQ10 补充剂可能有改善炎症水平、葡萄糖代谢、心脏结构和心脏生物标志物的潜力。然而,CoQ10 补充剂的效果需要在更大的高质量研究中加以证实。

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