补充染料木黄酮对心血管危险因素的改善作用：基于不同人群的随机对照试验的系统评价和荟萃分析

Improvement of Cardiovascular Risk Factors by Genistein Supplementation: A Systematic Review and Meta-Analysis in Diverse Population-Based RCTs.

作者信息

Feng Hanxiao, Jiang Kuan, Zhang Yi-Feng, Zhuang Jinhong, Ku Cun, Yang Jinzhao, Zhang Yang

机构信息

School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong, China.

Guangdong Provincial Key Laboratory of Diabetology, Guangzhou Key Laboratory of Mechanistic and Translational Obesity Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.

出版信息

J Nutr Metab. 2025 Mar 18;2025:1827252. doi: 10.1155/jnme/1827252. eCollection 2025.

Genistein[5,7-dihydroxy-3-(4-hydroxyphenyl)chromen-4-one] is a phytoestrogens known to positively impact various cardiovascular disease (CVD) risk factors. However, not all studies have yielded consistent results, and existing meta-analyses have not comprehensively addressed all CVD risk factors. We conducted a systematic search of the PubMed, ISI Web of Science, Embase, and Cochrane Library databases up to June 2024, following PRISMA 2020 guidelines. We included adult randomized controlled trials (RCTs) that examined pure genistein supplementation without other combined interventions and reported on at least one CVD risk factor. Data extraction and quality assessment were performed independently by two authors using a standardized form and the Cochrane Collaboration Scale. A total of 21 RCTs were included, with 941 participants in the genistein supplementation group and 918 participants in the control group. Statistical analyses were conducted using R software with the meta package. The meta-analysis revealed that, compared to the placebo group, genistein supplementation significantly improved the levels of TC ([MD 95% CI: -9.38 [-14.64, -4.12]; < 0.001]), LDL-C ([MD 95% CI: -11.14 [-19.42, -2.86]; < 0.001]), Lp(a) levels ([MD 95% CI: -0.69 [-0.98, -0.41]; < 0.01), SBP ([MD 95% CI: -8.32 [-12.44, -4.20]; < 0.01), DBP ([MD 95% CI: -3.57 [-5.25, -1.89]; =0.04]), fasting blood glucose ([MD 95% CI: -3.98 [-6.79, -1.17]; < 0.001]), fasting insulin ([MD 95% CI: -1.79 [-2.05, -1.54]; < 0.01), HOMA-IR ([MD 95% CI: -0.56 [-0.64, -0.49]; < 0.01), and homocysteine levels ([MD 95% CI: -0.74 [-1.05, -0.42]; < 0.01). However, there were no significant improvements in TG, HDL-C, and CRP levels. The observed improvements align with clinically meaningful thresholds for cardiovascular risk reduction. Substantial heterogeneity observed for most outcomes was explored via subgroup analysis. Subgroup analyses were conducted based on treatment duration, geographic region, or participant health status, and heterogeneity was assessed using the statistic. Subgroup analysis did not reveal any significant differences, indicating that heterogeneity was not influenced by factors such as treatment duration, geographic region, or participant health status. Overall, this meta-analysis provides consistent evidence that genistein intake significantly reduces several important CVD risk factors, including TC, LDL-C, Lp(a), SBP, DBP, fasting blood glucose, fasting insulin, HOMA-IR, and homocysteine levels.

染料木黄酮[5,7 - 二羟基 - 3 - (4 - 羟基苯基)色原酮 - 4 - 酮]是一种已知对多种心血管疾病（CVD）风险因素有积极影响的植物雌激素。然而，并非所有研究都得出了一致的结果，并且现有的荟萃分析并未全面涉及所有CVD风险因素。我们按照PRISMA 2020指南，对截至2024年6月的PubMed、ISI科学网、Embase和Cochrane图书馆数据库进行了系统检索。我们纳入了成人随机对照试验（RCT），这些试验研究了单纯补充染料木黄酮而无其他联合干预措施，并报告了至少一种CVD风险因素。由两名作者使用标准化表格和Cochrane协作量表独立进行数据提取和质量评估。共纳入21项RCT，染料木黄酮补充组有941名参与者，对照组有918名参与者。使用带有meta包的R软件进行统计分析。荟萃分析显示，与安慰剂组相比，补充染料木黄酮显著改善了总胆固醇（TC）水平（[平均差（MD）95%置信区间： - 9.38 [- 14.64, - 4.12]；P < 0.001]）、低密度脂蛋白胆固醇（LDL - C）水平（[MD 95%置信区间： - 11.14 [- 19.42, - 2.86]；P < 0.001]）、脂蛋白（a）[Lp(a)]水平（[MD 95%置信区间： - 0.69 [- 0.98, - 0.41]；P < 0.01]）、收缩压（SBP）（[MD 95%置信区间： - 8.32 [- 12.44, - 4.20]；P < 0.01]）、舒张压（DBP）（[MD 95%置信区间： - 3.57 [- 5.25, - 1.89]；P = 0.04]）、空腹血糖（[MD 95%置信区间： - 3.98 [- 6.79, - 1.17]；P < 0.001]）、空腹胰岛素（[MD 95%置信区间： - 1.79 [- 2.05, - 1.54]；P < 0.01]）、稳态模型评估胰岛素抵抗（HOMA - IR）（[MD 95%置信区间： - 0.56 [- 0.64, - 0.49]；P < 0.01]）和同型半胱氨酸水平（[MD 95%置信区间： - 0.74 [- 1.05, - 0.42]；P < 0.01]）。然而，甘油三酯（TG）、高密度脂蛋白胆固醇（HDL - C）和C反应蛋白（CRP）水平没有显著改善。观察到的改善与心血管风险降低的临床有意义阈值相符。通过亚组分析探索了大多数结局中观察到的显著异质性。根据治疗持续时间、地理区域或参与者健康状况进行亚组分析，并使用I²统计量评估异质性。亚组分析未发现任何显著差异，表明异质性不受治疗持续时间、地理区域或参与者健康状况等因素的影响。总体而言，这项荟萃分析提供了一致的证据，即摄入染料木黄酮可显著降低多种重要的CVD风险因素，包括TC、LDL - C、Lp(a)、SBP、DBP、空腹血糖、空腹胰岛素、HOMA - IR和同型半胱氨酸水平。