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白藜芦醇对糖尿病性心肌病心脏保护作用的临床前证据及可能机制:一项系统评价和荟萃分析

Preclinical evidence and possible mechanisms of cardioprotective effects of resveratrol in diabetic cardiomyopathy: a systematic review and meta-analysis.

作者信息

Yan Xiaodan, Hu Youjia, Zhao Shuyuan, Zhou Qian, Chen Qiu

机构信息

Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.

Chengdu University of Traditional Chinese Medicine, Chengdu, China.

出版信息

Diabetol Metab Syndr. 2024 Nov 17;16(1):275. doi: 10.1186/s13098-024-01512-8.

Abstract

INTRODUCTION

Diabetic cardiomyopathy (DCM) is a significant complication of diabetes, characterized primarily by the development of heart failure in individuals with diabetes. Numerous animal studies have indicated that resveratrol enhances cardiac function in diabetic cardiomyopathy; however, its reliability and underlying mechanism remain unclear. This study aims to assess the cardioprotective effects of resveratrol on DCM and explore its potential mechanism.

METHODS

We searched PubMed, EMBASE, WOS, Cochrane Library, CNKI, CBM, Chinese VIP, and Wan Fang Database until March 31st, 2024, without language restrictions. Continuous outcome measures were analyzed using weighted mean difference or standardized mean difference, and heterogeneity was assessed with I. The risk of bias in animal experiments was evaluated using the SYRCLE tool, and evidence reliability was determined with the GRADE tool. All data were analyzed using Review Manager 5.4.1 and Stata 17. This study has been registered on the PROSPERO (CRD42024523944).

RESULTS

A total of 18 studies meeting the criteria were identified. The analysis revealed that the resveratrol intervention group exhibited significant improvements in LVEF (WMD = 17.88), LVFS (WMD = 8.77), HW/BW (SMD=-2.92), SOD (SMD = 4.53), and MDA (SMD=-5.07) compared to the control group. The GRADE grading assessment indicated moderate certainty for LVEF, HW/BW, and MDA, while certainty for other factors was considered low.

CONCLUSION

Our research suggests that resveratrol may protect cardiac function in DCM through anti-inflammatory and anti-oxidative stress effects. However, these findings are based on preclinical data, and further extensive trials are needed to confirm their effectiveness and safety before clinical application.

摘要

引言

糖尿病性心肌病(DCM)是糖尿病的一种重要并发症,主要特征是糖尿病患者出现心力衰竭。大量动物研究表明,白藜芦醇可改善糖尿病性心肌病的心脏功能;然而,其可靠性及潜在机制仍不明确。本研究旨在评估白藜芦醇对DCM的心脏保护作用,并探讨其潜在机制。

方法

我们检索了截至2024年3月31日的PubMed、EMBASE、WOS、Cochrane图书馆、CNKI、CBM、中国知网和万方数据库,无语言限制。采用加权均数差或标准化均数差分析连续结局指标,并使用I统计量评估异质性。使用SYRCLE工具评估动物实验的偏倚风险,并用GRADE工具确定证据可靠性。所有数据均使用Review Manager 5.4.1和Stata 17进行分析。本研究已在PROSPERO(CRD42024523944)上注册。

结果

共纳入18项符合标准的研究。分析显示,与对照组相比,白藜芦醇干预组的左心室射血分数(WMD = 17.88)、左心室短轴缩短率(WMD = 8.77)、心脏重量/体重(SMD = -2.92)、超氧化物歧化酶(SMD = 4.53)和丙二醛(SMD = -5.07)均有显著改善。GRADE分级评估表明,左心室射血分数、心脏重量/体重和丙二醛的证据确定性为中等,而其他因素的确定性较低。

结论

我们的研究表明,白藜芦醇可能通过抗炎和抗氧化应激作用保护DCM患者的心脏功能。然而,这些发现基于临床前数据,在临床应用前还需要进一步的广泛试验来证实其有效性和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/384e/11572515/b98976b516dc/13098_2024_1512_Fig1_HTML.jpg

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