抗氧化补充剂对随机临床对照肥胖患者代谢紊乱的影响：荟萃分析和系统评价。
Effects of Antioxidant Supplementation on Metabolic Disorders in Obese Patients from Randomized Clinical Controls: A Meta-Analysis and Systematic Review.
机构信息
Hengyang Maternal and Childe Health Hospital, Hengyang, Hunan 421001, China.
Clinical Antatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyan, Hunan 421001, China.
出版信息
Oxid Med Cell Longev. 2022 Sep 1;2022:7255413. doi: 10.1155/2022/7255413. eCollection 2022.
PURPOSE
This systematic review and meta-analysis aim at elucidating the heterogeneity in beneficial effects of antioxidant supplementation in obese adults by exploring the differential effects of antioxidant supplementation on basic indicators of obesity, lipid metabolism, systemic antioxidant capacity, inflammatory biomarkers, and liver function.
METHODS
The inclusion criteria specified randomized controlled trials with antioxidant intervention for adults (mean body mass index (BMI) > 30), from inception to Aug. 8, 2021, in the PubMed, Embase, The Cochrane Library, Web of Science, and Scopus databases. Meta-analysis and publication bias were performed using RevMan 5.4 software. Stata16 software was used to detect publication bias with Egger's and Begg's methods being mainly used. The data of basic indicators of obesity, lipid metabolism index, oxidative stress index, inflammatory biomarkers, and liver function index were collected to analyze the beneficial effects of antioxidant supplementation in obese patients.
RESULTS
A total of 30 studies were included in this study with a sample of 845 obese patients from the antioxidant supplementation group and 766 obese patients from the placebo control group. The meta-analysis showed that obese patients with antioxidant supplementation had lower BMI (mean difference (MD): - 0.44 [95%confidence interval (CI): - 0.84, -0.04], = 0.03), waist circumference (MD : -0.78 [95%CI:-1.45, -0.11], = 0.02), fasting blood glucose (FBG) level (standardized mean difference (SMD): - 4.92 [95%CI:-6.87, -2.98], < 0.001) and homeostasis model assessment of insulin resistance (MD : -0.45 [95%CI:-0.61, -0.3], < 0.001) when compared to the placebo group. Obese patients on antioxidant supplementation had lower levels of total cholesterol (SMD : -0.43 [95%CI:-0.84, -0.02], = 0.04), triglycerides (SMD : -0.17 [95%CI:-0.31, -0.04], = 0.01), low-density lipoprotein (SMD : -0.15 [95%CI:-0.29, -0.01], = 0.03), malondialdehyde (SMD : -1.67 [95%CI:-2.69, -0.65], = 0.001), and tumor necrosis factor-alpha (SMD : -0.29 [95%CI:-0.56, -0.02], = 0.03), respectively, when compared to the placebo group. In addition, obese patients with antioxidant supplementation had higher levels of high-density lipoprotein (SMD : 0.25 [95%CI : 0.03, 0.46], = 0.03) and superoxide dismutase (SMD : 1.09 [95%CI : 0.52, 1.65], < 0.001) when compared to the placebo group. Antioxidant supplementation had no effects on other analyzed parameters including waist-hip ratio, leptin, fat mass, interleukin-6, C-reactive protein, alanine transaminase, and aspartate transaminase in obese patients.
CONCLUSION
The meta-analysis results indicated that antioxidant supplementation exerted potential beneficial effects in obese patients by regulating FBG, oxidative stress, and inflammation, whilst more high-quality studies are required to confirm these effects. The present study may provide important insights for the treatment of clinical obesity and obesity-associated complications.
目的
本系统评价和荟萃分析旨在通过探讨抗氧化剂补充对肥胖成年人基本肥胖指标、脂质代谢、全身抗氧化能力、炎症生物标志物和肝功能的差异影响，阐明抗氧化剂补充在肥胖成年人中的有益效果的异质性。
方法
纳入标准为从研究开始到 2021 年 8 月 8 日在 PubMed、Embase、The Cochrane Library、Web of Science 和 Scopus 数据库中进行的、针对成年人（平均体重指数（BMI）>30）的抗氧化剂干预的随机对照试验。使用 RevMan 5.4 软件进行荟萃分析和发表偏倚。使用 Stata16 软件使用 Egger 和 Begg 方法主要检测发表偏倚。收集基本肥胖指标、脂质代谢指标、氧化应激指标、炎症生物标志物和肝功能指标的数据，以分析抗氧化剂补充对肥胖患者的有益效果。
结果
本研究共纳入 30 项研究，共 845 名接受抗氧化剂补充的肥胖患者和 766 名接受安慰剂对照的肥胖患者。荟萃分析表明，与安慰剂组相比，接受抗氧化剂补充的肥胖患者的 BMI（平均差异（MD）：-0.44 [95%置信区间（CI）：-0.84，-0.04]， = 0.03）、腰围（MD：-0.78 [95%CI：-1.45，-0.11]， = 0.02）、空腹血糖（FBG）水平（标准化均数差（SMD）：-4.92 [95%CI：-6.87，-2.98]， < 0.001）和胰岛素抵抗的稳态模型评估（MD：-0.45 [95%CI：-0.61，-0.3]， < 0.001）更低。与安慰剂组相比，接受抗氧化剂补充的肥胖患者的总胆固醇（SMD：-0.43 [95%CI：-0.84，-0.02]， = 0.04）、甘油三酯（SMD：-0.17 [95%CI：-0.31，-0.04]， = 0.01）、低密度脂蛋白（SMD：-0.15 [95%CI：-0.29，-0.01]， = 0.03）、丙二醛（SMD：-1.67 [95%CI：-2.69，-0.65]， = 0.001）和肿瘤坏死因子-α（SMD：-0.29 [95%CI：-0.56，-0.02]， = 0.03）水平更低。此外，与安慰剂组相比，接受抗氧化剂补充的肥胖患者的高密度脂蛋白（SMD：0.25 [95%CI：0.03，0.46]， = 0.03）和超氧化物歧化酶（SMD：1.09 [95%CI：0.52，1.65]， < 0.001）水平更高。抗氧化剂补充对肥胖患者的其他分析参数，包括腰臀比、瘦素、脂肪量、白细胞介素-6、C 反应蛋白、丙氨酸氨基转移酶和天冬氨酸氨基转移酶，没有影响。
结论
荟萃分析结果表明，抗氧化剂补充通过调节 FBG、氧化应激和炎症对肥胖患者具有潜在的有益效果，而需要更多高质量的研究来证实这些效果。本研究可能为肥胖症的临床治疗和肥胖症相关并发症的治疗提供重要的见解。
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