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补充植物来源的α-亚麻酸(ALA)对慢性肾脏病患者炎症标志物和血脂谱的影响:系统评价和荟萃分析。

Effects of supplementation with vegetable sources of alpha-linolenic acid (ALA) on inflammatory markers and lipid profile in individuals with chronic kidney disease: A systematic review and meta-analysis.

机构信息

Post-Graduate Program in Nutrition, Department of Nutrition, Federal University of Santa Catarina, Florianopolis, Brazil.

Post-Graduate Program in Nutrition, Department of Nutrition, Federal University of Santa Catarina, Florianopolis, Brazil.

出版信息

Clin Nutr. 2022 Jun;41(6):1434-1444. doi: 10.1016/j.clnu.2022.02.013. Epub 2022 Feb 22.

Abstract

BACKGROUND AND AIMS

Inflammation and dyslipidemia are traditional risk factors and well-known causes of morbidity and mortality in chronic kidney disease (CKD). Alpha-linolenic acid (ALA), an essential fatty acid mainly found in vegetable sources, has been associated with anti-inflammatory effects and improving lipid profile. This systematic review and meta-analysis investigate the effects of supplementation with vegetable sources of ALA on inflammatory marker and lipid profile in individuals with CKD.

METHODS

This review included studies with adult or elderly patients with CKD, including those receiving dialysis, using oral supplementation or food or combined interventions containing vegetable sources of ALA. All studies were randomized trials and The Cochrane Collaboration's tool was use for assessing risk of bias.

RESULTS

19 studies provided data for meta-analyses. ALA had significant effect on reducing C-reactive protein (CRP) after supplementation (WMD: -1.32; 84.5% CI, -2.35 to -0.29, P = 0.012), on the other hand, had no significant effect on total cholesterol (WMD: -2.85; 90.1% CI, -14.43 to 8.73, P = 0.629), high density lipoprotein (WMD: 1.09; 92.4% CI, -1.82 to 3.99, P = 0.463), low density lipoprotein (WMD: -3.87; 86.7% CI, -12.62 to 4.89, P = 0.387) and triglycerides (WMD: -16.42; 87.7% CI, -47.83 to 14.98, P = 0.305).

CONCLUSION

Vegetables sources of ALA showed beneficial effects on reducing inflammatory marker CRP in CKD patients but had no effect on lipid profile. Future well-designed studies are needed to investigate the effectiveness of vegetables sources of ALA, particularly in CKD.

摘要

背景与目的

炎症和血脂异常是慢性肾脏病(CKD)发病和死亡的传统危险因素和已知原因。α-亚麻酸(ALA)是一种必需脂肪酸,主要存在于植物性食物中,具有抗炎作用,并能改善血脂谱。本系统评价和荟萃分析旨在研究补充植物性 ALA 对 CKD 患者炎症标志物和血脂谱的影响。

方法

本综述纳入了包括接受透析治疗的成年或老年 CKD 患者的研究,采用口服补充剂或食物或包含植物性 ALA 的联合干预措施。所有研究均为随机试验,采用 Cochrane 协作工具评估偏倚风险。

结果

19 项研究提供了 meta 分析的数据。ALA 补充后对降低 C 反应蛋白(CRP)有显著作用(WMD:-1.32;84.5% CI,-2.35 至-0.29,P=0.012),而对总胆固醇(WMD:-2.85;90.1% CI,-14.43 至 8.73,P=0.629)、高密度脂蛋白(WMD:1.09;92.4% CI,-1.82 至 3.99,P=0.463)、低密度脂蛋白(WMD:-3.87;86.7% CI,-12.62 至 4.89,P=0.387)和甘油三酯(WMD:-16.42;87.7% CI,-47.83 至 14.98,P=0.305)无显著影响。

结论

植物性 ALA 对降低 CKD 患者炎症标志物 CRP 有有益作用,但对血脂谱无影响。需要进一步开展设计良好的研究来探讨植物性 ALA 的有效性,特别是在 CKD 患者中。

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