苹果及其衍生产品对代谢和心血管的益处：随机对照试验的系统评价和荟萃分析
Metabolic and Cardiovascular Benefits of Apple and Apple-Derived Products: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
作者信息
Kim Sun Jo, Anh Nguyen Hoang, Jung Cheol Woon, Long Nguyen Phuoc, Park Seongoh, Cho Young Hyun, Yoon Young Cheol, Lee Eun Goo, Kim Mina, Son Eui Young, Kim Tae Ha, Deng Yingqian, Lim Johan, Kwon Sung Won
机构信息
College of Pharmacy, Seoul National University, Seoul, South Korea.
Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, South Korea.
出版信息
Front Nutr. 2022 Apr 5;9:766155. doi: 10.3389/fnut.2022.766155. eCollection 2022.
BACKGROUND
Quantitative evidence of the metabolic and cardiovascular effects of apples () is lacking in interventional studies. This study aimed to summarize the available evidence of the beneficial effects of apples and apple-derived products (ADPs) on metabolic and cardiovascular markers.
METHODS
Peer-reviewed randomized controlled trials (RCTs) were identified from four databases on May 3, 2021 and regularly updated until the end of May 2021. Demographic characteristics, intervention types, and evaluation parameters were extracted. A meta-analysis on the mean difference of change scores was conducted on commonly presented outcomes in the RCTs.
RESULTS
The metabolic and cardiovascular effects of diverse regimens, including whole apple, apple extract, and apple juice, were examined in 18 eligible RCTs. Nine common evaluation outcomes were eventually introduced to the meta-analysis, including total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride, glucose, insulin, C-reactive protein, and systolic/diastolic blood pressures. The levels of TC (-2.69 mg/dL; 95% CI: -5.43, 0.04 mg/dL) and LDL (-2.80 mg/dL; 95% CI: -5.78, 0.17 mg/dL) showed a non-significant decreasing tendency after at least a week of apple consumption. Further subgroup analysis, particularly, a comparison with placebo as a control, showed a significant reduction in TC and LDL levels. When stratified by the baseline level, subjects with high TC and LDL level were shown to have more benefits from the apple intake. Intriguingly, apple and ADPs significantly reduced HDL levels to a small extent (-1.04 mg/dL; 95% CI: -1.79, -0.29 mg/dL). The other markers were mostly unaffected by the intervention.
CONCLUSION
Our investigation revealed that apples could improve blood cholesterol levels.
SYSTEMATIC REVIEW REGISTRATION
[https://www.crd.york.ac.uk/prospero/], identifier [CRD42020215977].
背景
在干预性研究中，缺乏苹果对代谢和心血管影响的定量证据。本研究旨在总结苹果及苹果衍生产品（ADPs）对代谢和心血管标志物有益作用的现有证据。
方法
于2021年5月3日从四个数据库中识别出经过同行评审的随机对照试验（RCTs），并定期更新至2021年5月底。提取人口统计学特征、干预类型和评估参数。对RCTs中常见结局的变化分数均值差异进行荟萃分析。
结果
在18项符合条件的RCTs中，研究了包括整个苹果、苹果提取物和苹果汁在内的多种方案对代谢和心血管的影响。最终将9项常见评估结局纳入荟萃分析，包括总胆固醇（TC）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、甘油三酯、葡萄糖、胰岛素、C反应蛋白以及收缩压/舒张压。食用苹果至少一周后，TC水平（-2.69mg/dL；95%CI：-5.43，0.04mg/dL）和LDL水平（-2.80mg/dL；95%CI：-5.78，0.17mg/dL）呈现出不显著的下降趋势。进一步的亚组分析，特别是与安慰剂作为对照的比较，显示TC和LDL水平显著降低。按基线水平分层时，TC和LDL水平高的受试者从苹果摄入中获益更多。有趣的是，苹果和ADPs在一定程度上显著降低了HDL水平（-1.04mg/dL；95%CI：-1.79，-0.29mg/dL）。其他标志物大多不受干预影响。
结论
我们的调查显示，苹果可以改善血液胆固醇水平。
系统评价注册
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