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白藜芦醇可能轻微改善一般成年人群的肾功能:一项随机对照临床试验的系统评价和荟萃分析。

Resveratrol may mildly improve renal function in the general adult population: A systematic review and meta-analysis of randomized controlled clinical trials.

机构信息

Department of Nutrition, School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran.

Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Nutr Res. 2023 May;113:1-13. doi: 10.1016/j.nutres.2023.03.002. Epub 2023 Mar 9.

DOI:10.1016/j.nutres.2023.03.002
PMID:36996691
Abstract

Whether renal health biomarkers can benefit from resveratrol supplements is unknown. Thus, we conducted a systematic review and meta-analysis to summarize evidence from randomized controlled trials investigating the effect of resveratrol supplementation on renal health biomarkers. We hypothesized that resveratrol supplementation is associated with improved renal health biomarkers. Four electronic databases, including PubMed, Scopus, and Institute for Scientific Information Web of Science, and Cochrane Central, were searched for relevant articles up to February 2023. The pooled effect sizes were estimated using a random effects model and expressed as weighted mean difference (WMD) and 95% CI. In total, 32 articles were eligible for inclusion in the current meta-analysis. The pooled results indicated that resveratrol significantly decreased blood urea nitrogen (weighted mean difference [WMD]= -0.84 mg/dL; 95% CI, -1.48 to -0.20; P = .01; I = 64.4%) and creatinine levels (WMD = -1.90 µmol/L; 95% CI, -3.59 to -0.21; P = .03; I= 52.1%), and increased glomerular filtration rate (WMD = 7.58 mL/min/1.73 m; 95% CI, 5.25-9.91; P < .001; I = 0%). The favorable change of blood urea nitrogen was significant in studies with short follow-up duration (12 weeks or less), with lower doses of resveratrol (less than 500 mg/d), and those conducted in patients with diabetes. However, higher doses of resveratrol are needed to observe significant reductions in creatinine. No significant change was observed in albumin, total protein, and uric acid concentrations. This meta-analysis provides a low certainty of evidence indicating a mild renal protective effect of resveratrol in adults. Further high-quality evidence in patients with impaired renal function and estimates of mortality risk in these patients is required before resveratrol can be advocated as an adjuvant therapy.

摘要

目前尚不清楚肾脏健康生物标志物是否能从白藜芦醇补充剂中获益。因此,我们进行了系统评价和荟萃分析,以总结随机对照试验中关于白藜芦醇补充剂对肾脏健康生物标志物影响的证据。我们假设白藜芦醇补充剂与改善肾脏健康生物标志物有关。检索了包括 PubMed、Scopus、科学信息研究所 Web of Science 和 Cochrane 中心在内的 4 个电子数据库,以获取截至 2023 年 2 月的相关文章。使用随机效应模型估计汇总效应量,并表示为加权均数差(WMD)和 95%置信区间(CI)。共有 32 篇文章符合纳入本荟萃分析的标准。汇总结果表明,白藜芦醇可显著降低血尿素氮(WMD=-0.84mg/dL;95%CI,-1.48 至-0.20;P=0.01;I=64.4%)和肌酐水平(WMD=-1.90μmol/L;95%CI,-3.59 至-0.21;P=0.03;I=52.1%),并提高肾小球滤过率(WMD=7.58mL/min/1.73m;95%CI,5.25-9.91;P<0.001;I=0%)。在随访时间较短(12 周或更短)、白藜芦醇剂量较低(低于 500mg/d)和糖尿病患者中,血尿素氮的有利变化更为显著。然而,需要更高剂量的白藜芦醇才能观察到肌酐的显著降低。白蛋白、总蛋白和尿酸浓度没有明显变化。本荟萃分析提供了证据的低确定性,表明白藜芦醇对成年人有轻度的肾脏保护作用。在将白藜芦醇作为辅助治疗方法之前,还需要在肾功能受损患者中开展高质量的证据,并评估这些患者的死亡风险。

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