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膳食多酚姜黄素补充剂对代谢综合征患者代谢、炎症和氧化应激指标的影响:系统评价和随机对照试验的荟萃分析。

Effects of dietary polyphenol curcumin supplementation on metabolic, inflammatory, and oxidative stress indices in patients with metabolic syndrome: a systematic review and meta-analysis of randomized controlled trials.

机构信息

Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

Department of Special Needs International Medical, Peking University International Hospital, Beijing, China.

出版信息

Front Endocrinol (Lausanne). 2023 Jul 14;14:1216708. doi: 10.3389/fendo.2023.1216708. eCollection 2023.

Abstract

OBJECTIVE

The aim was to conduct a systematic review and meta-analysis for assessing the effectiveness and safety of dietary polyphenol curcumin supplement on metabolic, inflammatory, and oxidative stress indices in patients with metabolic syndrome (MetS).

METHODS

A comprehensive search for clinical trials was conducted in the following scientific databases: PubMed, SCOPUS, Cochrane Library, EMBASE, Web of Science, and China Biological Medicine. Randomized controlled trials (RCTs) evaluating the efficacy and safety of curcumin supplement for MetS were identified. A random-effects meta-analysis was performed using inverse variance, and efficacy was expressed as mean difference (MD) with 95% confidence interval (CI). The metabolic syndrome markers that were evaluated in the present study included waist circumference (WC), fasting blood sugar (FBS), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), tumor necrosis factor-a (TNF-a), interleukin 6 (IL-6), C-reactive protein (CRP), ultrasensitive c-reactive protein (hsCRP), and malondialdehyde (MDA). By employing the Cochrane tool, RCTs were assessed for bias risk.

RESULTS

A total of 785 participants from 13 RCTs were included, with intervention durations ranging from 4 to 12 weeks. Compared with the control group, the curcumin group had positive effects on WC (MD = -2.16, 95% CI: -3.78 to -0.54,  = 0.009, seven studies), FBS (MD = -8.6, 95% CI: -15.45 to -1.75, = 0.01, nine studies), DBP (MD = -2.8, 95% CI: -4.53 to - 1.06, = 0.002, five studies), HDL-C (MD = 4.98, 95% CI: 2.58 to 7.38, < 0.0001, eight studies), TNF-a (MD = -12.97, 95% CI: -18.37 to -7.57, < 0.00001, two studies), CRP (MD = - 1.24, 95% CI: -1.71 to -0.77, < 0.00001, two studies), and MDA (MD = -2.35, 95% CI: -4.47 to -0.24, = 0.03, three studies). These improvements were statistically significant. Meanwhile, there was no significant improvement in SBP (MD = -4.82, 95% CI: -9.98 to 0.35, = 0.07, six studies), TG (MD = 1.28, 95% CI: -3.75 to 6.30,  = 0.62, eight studies), IL-6 (MD = -1.5, 95% CI: -3.97 to 0.97, = 0.23, two studies), or hsCRP (MD = -1.10, 95% CI: -4.35 to 2.16, < 0.51, two studies). FBS, SBP, HDL-C, IL-6, CRP, hsCRP, and MDA had a relatively high heterogeneity.

CONCLUSION

Curcumin exhibited promising potential in enhancing markers associated with metabolic syndrome, including inflammation. However, additional studies are required to confirm such findings since the included evidence is limited and has a relatively high heterogeneity.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero, identifier CRD42022362553.

摘要

目的

系统评价和荟萃分析评估膳食多酚姜黄素补充剂对代谢综合征(MetS)患者代谢、炎症和氧化应激指标的有效性和安全性。

方法

在以下科学数据库中全面检索临床试验:PubMed、SCOPUS、Cochrane 图书馆、EMBASE、Web of Science 和中国生物医学文献数据库。确定评估姜黄素补充剂治疗 MetS 的疗效和安全性的随机对照试验(RCT)。采用逆方差法进行随机效应荟萃分析,疗效表示为均数差(MD)和 95%置信区间(CI)。本研究评估的代谢综合征标志物包括腰围(WC)、空腹血糖(FBS)、收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、肿瘤坏死因子-α(TNF-α)、白细胞介素 6(IL-6)、C 反应蛋白(CRP)、超敏 C 反应蛋白(hsCRP)和丙二醛(MDA)。采用 Cochrane 工具评估 RCT 的偏倚风险。

结果

共纳入来自 13 项 RCT 的 785 名参与者,干预时间从 4 周到 12 周不等。与对照组相比,姜黄素组在 WC(MD=-2.16,95%CI:-3.78 至-0.54, =0.009,七项研究)、FBS(MD=-8.6,95%CI:-15.45 至-1.75, =0.01,九项研究)、DBP(MD=-2.8,95%CI:-4.53 至-1.06, =0.002,五项研究)、HDL-C(MD=4.98,95%CI:2.58 至 7.38, <0.0001,八项研究)、TNF-α(MD=-12.97,95%CI:-18.37 至-7.57, <0.00001,两项研究)、CRP(MD=-1.24,95%CI:-1.71 至-0.77, <0.00001,两项研究)和 MDA(MD=-2.35,95%CI:-4.47 至-0.24, =0.03,三项研究)方面有积极影响。这些改善具有统计学意义。同时,SBP(MD=-4.82,95%CI:-9.98 至 0.35, =0.07,六项研究)、TG(MD=1.28,95%CI:-3.75 至 6.30, =0.62,八项研究)、IL-6(MD=-1.5,95%CI:-3.97 至 0.97, =0.23,两项研究)或 hsCRP(MD=-1.10,95%CI:-4.35 至 2.16, <0.51,两项研究)无明显改善。FBS、SBP、HDL-C、IL-6、CRP、hsCRP 和 MDA 具有较高的异质性。

结论

姜黄素在改善代谢综合征相关标志物方面表现出良好的潜力,包括炎症。然而,由于纳入的证据有限且具有较高的异质性,需要进一步的研究来证实这些发现。

系统评价注册

https://www.crd.york.ac.uk/prospero,标识符 CRD42022362553。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f75/10376715/7c348157932a/fendo-14-1216708-g001.jpg

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