Huang Haohai, Liao Dan, He Bin, Zhou Guanghui, Cui Yejia
Clinical Translational Medical Center, The Affiliated Dongguan Songshan Lake Central Hospital, Guangdong Medical University, Dongguan, Guangdong, China.
Department of Clinical Pharmacy, The Affiliated Dongguan Songshan Lake Central Hospital, Guangdong Medical University, Dongguan, Guangdong, China.
Curr Dev Nutr. 2023 Dec 9;8(9):102055. doi: 10.1016/j.cdnut.2023.102055. eCollection 2024 Sep.
Cardiovascular disease (CVD) is a serious public health problem worldwide. The role of citrus flavanone hesperidin consumption on cardiovascular disease risk factors (CVDRFs) has been examined in many clinical trials, but conflicting results have been found.
This study aimed to systematically evaluate the effects of hesperidin extracts or purified hesperidin on CVDRFs in humans with an updated meta-analysis of randomized controlled trials.
According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, we systematically screened and searched electronic databases from their establishment to March 2023. Reference lists and previous reviews were also searched. Intervention trials assessing hesperidin consumption on CVD outcomes were included for pooling. To assess the quality of the included articles, the tool of Cochrane risk-of-bias tool was applied. We synthesized the effect sizes with 95% CIs and weighted mean difference (WMD). The index was used to evaluate the between-study heterogeneity. To explore the heterogeneity source, we used meta-regression and subgroup analysis. Publication bias and sensitivity analysis were also performed. We used the Grading of Recommendations Assessment, Development, and Evaluation approach to evaluate the evidence quality.
We included 12 trials with 589 participants. We found evident effects of hesperidin on low-density lipoprotein cholesterol (WMD: -0.22 mmol/L; 95% CI: -0.33, -0.11 mmol/L), total cholesterol (WMD: -0.20 mmol/L; 95% CI: -0.31, -0.08 mmol/L), fasting blood glucose (WMD: -0.15 mg/dL; 95% CI: -0.29, -0.02 mg/dL), quantitative insulin-sensitivity check index (WMD 0.06, 95% CI 0.01 to 0.10), intercellular adhesion molecule 1 (WMD: -13.60 ng/mL; 95% CI: -23.72, -3.48 ng/mL), vascular cell adhesion molecule 1 (WMD: -15.60 ng/mL; 95% CI: -30.13, -1.06 ng/mL), and C-reactive protein (WMD: -0.56 mg/L; 95% CI: -1.11, -0.01 mg/L), whereas no effects were found for other CVDRFs.
Our current findings demonstrate that hesperidin might be advantageous in improving numerous CVDRFs in humans, such as blood lipid concentrations, blood glucose control, and management of inflammatory indicators.
心血管疾病（CVD）是全球严重的公共卫生问题。许多临床试验已研究了食用柑橘类黄酮橙皮苷对心血管疾病危险因素（CVDRFs）的作用，但结果相互矛盾。
本研究旨在通过对随机对照试验进行更新的荟萃分析，系统评价橙皮苷提取物或纯化橙皮苷对人类CVDRFs的影响。
根据《系统评价和荟萃分析的首选报告项目2020》指南，我们系统筛选并检索了从建库至2023年3月的电子数据库。还检索了参考文献列表和以往的综述。纳入评估食用橙皮苷对CVD结局影响的干预试验进行汇总分析。应用Cochrane偏倚风险工具评估纳入文章的质量。我们采用95%置信区间（CI）和加权均数差（WMD）综合效应量。I²指数用于评估研究间的异质性。为探究异质性来源，我们采用了meta回归和亚组分析。还进行了发表偏倚和敏感性分析。我们采用推荐分级评估、制定和评价方法评估证据质量。
我们纳入了12项试验，共589名参与者。我们发现橙皮苷对低密度脂蛋白胆固醇（WMD：-0.22 mmol/L；95% CI：-0.33，-0.11 mmol/L）、总胆固醇（WMD：-0.20 mmol/L；95% CI：-0.31，-0.08 mmol/L）、空腹血糖（WMD：-0.15 mg/dL；95% CI：-0.29，-0.02 mg/dL）、定量胰岛素敏感性检查指数（WMD 0.06，95% CI 0.01至0.10）、细胞间黏附分子1（WMD：-13.60 ng/mL；95% CI：-23.72，-3.48 ng/mL）、血管细胞黏附分子-1（WMD：-15.60 ng/mL；95% CI：-30.13，-1.06 ng/mL）和C反应蛋白（WMD：-0.56 mg/L；95% CI：-1.11，-0.01 mg/L）有显著影响，而对其他CVDRFs未发现影响。
我们目前的研究结果表明，橙皮苷可能有利于改善人类的多种CVDRFs，如血脂浓度、血糖控制和炎症指标的管理。
