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补充共轭亚油酸对超重和肥胖个体循环脂蛋白(a)水平的不良影响:随机对照试验的系统评价和荟萃分析结果

Adverse effects of conjugated linoleic acids supplementation on circulating lipoprotein (a) levels in overweight and obese individuals: results of a systematic review and meta-analysis of randomized controlled trials.

作者信息

Leilami Kimia, Kohansal Atefeh, Mohammadi Sartang Mohsen, Babajafari Siavash, Sohrabi Zahra

机构信息

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

Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences Shiraz, Iran.

出版信息

Am J Cardiovasc Dis. 2021 Feb 15;11(1):124-135. eCollection 2021.

Abstract

Conjugated Linoleic Acids (CLA) may have beneficial effects on the prevention of atherosclerosis, but their net effects on circulating levels of lipoprotein (a) [Lp (a)] are unclear. The present study aimed to systematically review and analyze the Randomized Clinical Trials (RCTs) assessing the effects of CLA on circulating Lp (a) concentrations. A literature search of SCOPUS, PubMed-Medline, ISI, Web of Science, and Cochrane library databases was conducted for the relevant RCTs investigating the effects of CLA supplementation on circulating Lp (a) levels, which had been published up to 20 August 2020. Weighted Mean Difference (WMD) and 95% Confidence Intervals (CI) were reported as the summary statistics. Statistical analysis were done with Comprehensive Meta-Analysis (CMA) V2 software (Biostat, NJ). Totally, six studies with 13 treatment arms including 752 subjects were included in the meta-analysis. The results showed a significant increase in circulating Lp (a) levels after CLA supplementation (WMD: 16.68 mg/L, 95% CI: 5.43-27.93; P=0.004) with no evidence of heterogeneity across the studies. In the subgroup analysis, a more significant elevation of Lp (a) levels was observed in the trials lasting for six months or more (WMD: 21.61 mg/L, 95% CI: 9.85-33.37, P<0.001) as well as in those with a supplementation dosage of ≥3.5 g/d (WMD: 26.13 mg/L, 95% CI: 7.02-45.24, P=0.007). These findings were sensitive to one study. It can be concluded that CLA supplementation with a dose of ≥3.5 g/d over a six-month period might significantly increase the circulating Lp (a) concentrations.

摘要

共轭亚油酸(CLA)可能对预防动脉粥样硬化具有有益作用,但其对脂蛋白(a)[Lp(a)]循环水平的净影响尚不清楚。本研究旨在系统评价和分析评估CLA对循环Lp(a)浓度影响的随机临床试验(RCT)。对SCOPUS、PubMed-Medline、ISI、Web of Science和Cochrane图书馆数据库进行文献检索,以查找截至2020年8月20日发表的有关CLA补充剂对循环Lp(a)水平影响的相关RCT。加权平均差(WMD)和95%置信区间(CI)作为汇总统计量报告。使用综合Meta分析(CMA)V2软件(Biostat,新泽西州)进行统计分析。共有六项研究,包括13个治疗组,752名受试者被纳入荟萃分析。结果显示,补充CLA后循环Lp(a)水平显著升高(WMD:16.68 mg/L,95%CI:5.43 - 27.93;P = 0.004),且各研究之间无异质性证据。在亚组分析中,持续六个月或更长时间的试验(WMD:21.61 mg/L,95%CI:9.85 - 33.37,P < 0.001)以及补充剂量≥3.5 g/d的试验(WMD:26.13 mg/L,95%CI:7.02 - 45.24,P = 0.007)中观察到Lp(a)水平有更显著的升高。这些发现对一项研究敏感。可以得出结论,在六个月期间补充剂量≥3.5 g/d的CLA可能会显著增加循环Lp(a)浓度。

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