Department of Orthopaedic Surgery, Wenzhou Central Hospital, Wenzhou, China.
Department of Respiratory Medicine, Wenzhou Central Hospital, Wenzhou, China.
Phytother Res. 2023 Nov;37(11):5223-5242. doi: 10.1002/ptr.7954. Epub 2023 Jul 22.
Resveratrol (RES) has extensively been utilized to treat osteoporosis (OP) in animal models. However, the anti-OP effects of RES have not been tested during clinical application due to the lack of evidence and poor knowledge of the underlying mechanisms. Moreover, there is little preclinical evidence to support the use of RES in the management of OP. In the present paper, we conducted a preclinical systematic review and meta-analysis to assess the efficacy of RES in animal OP models. The potential mechanisms underlying the efficacy of RES against OP were summarized. The online databases PubMed, CNKI, EMBASE, Wanfang, Web of Science, Chinese Biomedical Literature, Cochrane Library, and Chinese VIP were retrieved from inception to December 2021. The CAMARADES 10-item quality checklist was utilized to assess the risk of bias of the included studies. STATA 12.0 software was employed to analyze the data. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Thirteen studies containing 248 animals were included yielding a mean risk of bias score of 5.54 (range 4-7). The pooled estimates showed that the administration of RES could significantly elevate the bone mineral density (BMD) both at femur (SMD = 2.536; 95% CI = 1.950-3.122; p < 0.001) and lumbar spine (SMD = 1.363; 95% CI = 0894-1.832; p < 0.001), bone volume over total volume (BV/TV) (SMD = 2.543; 95% CI = 2.023-3.062; p < 0.001), trabecular linear density (Tb.N) (SMD = 2.724; 95% CI = 2.186-3.262; p < 0.001) and trabecular thickness (Tb.Th) (SMD = 1.745; 95% CI = 1.294-2.196; p < 0.001), while serum phosphorus (S-P) (SMD = -2.168; 95% CI = -2.753 to -1.583; p < 0.001) and trabecular separation (Tb.Sp) (SMD = -2.856; 95% CI = -4.218 to -1.494; p < 0.001) were significantly reduced in animal OP models. No significant change in serum calcium (S-Ca) (SMD = -2.448; 95% CI = -5.255-0.360; p = 0.087) was observed after RES treatment. Furthermore, RES could significantly improve the bone biomechanical indexes: bone maximum load (BML) (SMD = 2.563; 95% CI = 1.827-3.299; p < 0.001) and connectivity density (Conn.D) (SMD = 1.512; 95% CI = 0.909-2.116; p < 0.001) and decrease the structural model index (SMI) (SMD = -2.522; 95% CI = -3.243 to -1.801; p < 0.001). Overall, the present study revealed that RES has huge prospects as a medicine or dietary supplement for the clinical treatment of OP. High-quality studies with stringent designs and larger sample sizes are warranted to substantiate our conclusion.
白藜芦醇（RES）已广泛用于动物模型的骨质疏松症（OP）治疗。然而，由于缺乏证据和对潜在机制的了解不足，RES 的抗 OP 作用尚未在临床应用中得到测试。此外，几乎没有临床前证据支持 RES 用于 OP 的管理。在本文中，我们进行了一项临床前系统评价和荟萃分析，以评估 RES 在动物 OP 模型中的疗效。总结了 RES 抗 OP 的潜在机制。检索了从开始到 2021 年 12 月的 PubMed、CNKI、EMBASE、万方、Web of Science、中国生物医学文献、Cochrane 图书馆和中国 VIP 在线数据库。使用 CAMARADES 10 项质量检查表评估纳入研究的偏倚风险。使用 STATA 12.0 软件分析数据。使用 Grading of Recommendations, Assessment, Development, and Evaluation（GRADE）方法评估证据质量。纳入了 13 项包含 248 只动物的研究，平均偏倚风险评分为 5.54（范围 4-7）。汇总估计表明，RES 的给药可显著提高股骨（SMD=2.536；95%CI=1.950-3.122；p<0.001）和腰椎（SMD=1.363；95%CI=0.894-1.832；p<0.001）的骨密度（BMD），骨体积与总体积比（BV/TV）（SMD=2.543；95%CI=2.023-3.062；p<0.001），骨小梁线性密度（Tb.N）（SMD=2.724；95%CI=2.186-3.262；p<0.001）和骨小梁厚度（Tb.Th）（SMD=1.745；95%CI=1.294-2.196；p<0.001），同时血清磷（S-P）（SMD=-2.168；95%CI=-2.753 至-1.583；p<0.001）和骨小梁分离（Tb.Sp）（SMD=-2.856；95%CI=-4.218 至-1.494；p<0.001）显著降低。RES 治疗后血清钙（S-Ca）（SMD=-2.448；95%CI=-5.255-0.360；p=0.087）无显著变化。此外，RES 可显著改善骨生物力学指标：骨最大载荷（BML）（SMD=2.563；95%CI=1.827-3.299；p<0.001）和连通密度（Conn.D）（SMD=1.512；95%CI=0.909-2.116；p<0.001），并降低结构模型指数（SMI）（SMD=-2.522；95%CI=-3.243 至-1.801；p<0.001）。总的来说，本研究表明 RES 作为一种药物或膳食补充剂，具有巨大的临床治疗 OP 的前景。需要高质量的研究，设计严格，样本量大，以证实我们的结论。
