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关于对人类健康的营养意义:一项采用GRADE评估的临床试验系统评价和荟萃分析

The Nutritional Significance of on Human Health: A GRADE-Assessed Systematic Review and Meta-Analysis of Clinical Trials.

作者信息

Jafari Ali, Mardani Helia, Mirzaei Fashtali Zahra, Arghavan Bahareh

机构信息

Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute Shahid Beheshti University of Medical Sciences Tehran Iran.

Systematic Review and Meta-Analysis Expert Group (SRMEG) Universal Scientific Education and Research Network (USERN) Tehran Iran.

出版信息

Food Sci Nutr. 2025 Jun 12;13(6):e70423. doi: 10.1002/fsn3.70423. eCollection 2025 Jun.

Abstract

This study aimed to assess the impact of supplementation (200-11,200 mg/day, 1-24 weeks) on health-related indices in populations including healthy, at-risk, and chronic disease individuals. A systematic review and meta-analysis were conducted using data from EMBASE, PubMed, Web of Science, and Scopus up to August 2024. Pooled analysis of 17 randomized controlled trials (RCTs) involving 971 participants revealed that supplementation demonstrated significant reductions in body mass index (BMI) (Weighted Mean Difference [WMD] = -0.43; 95% Confidence Interval [CI]: -0.77, -0.10;  = 0.011), creatinine (WMD = -0.14; 95% CI: -0.27, -0.02;  = 0.028), glutathione peroxidase (GPx) (WMD = 2.29; 95% CI: 1.67, 2.92;  < 0.001), and heart rate (HR) (WMD = -3.92; 95% CI: -7.45, -0.40;  = 0.029). No significant effects were observed on body fat, waist circumference, blood pressure, fasting glucose, lipid profile, inflammatory markers, or liver enzymes. Subgroup analyses indicated effects varied by health condition, dosage, duration, and age. Subgroup analyses revealed variations in the effects of supplementation based on health conditions, dosage, intervention duration, age at intervention, country, sample size, and publication year. Significant improvements were observed in BMI, TC, creatinine, and MDA in specific subgroups, such as those receiving lower doses (< 1400 mg/day) or those aged < 50 years. The GRADE profile for supplementation evaluated the certainty of the outcomes and indicated that the quality of evidence was very low across all outcomes. supplementation may have modest effects on certain health indices, but the evidence is limited by very low quality.

摘要

本研究旨在评估补充剂(200 - 11200毫克/天,1 - 24周)对包括健康人群、高危人群和慢性病患者在内的各类人群健康相关指标的影响。利用截至2024年8月从EMBASE、PubMed、科学网和Scopus获取的数据进行了系统评价和荟萃分析。对17项涉及971名参与者的随机对照试验(RCT)进行的汇总分析显示,补充剂使体重指数(BMI)显著降低(加权平均差[WMD]= -0.43;95%置信区间[CI]:-0.77,-0.10;P = 0.011)、肌酐(WMD = -0.14;95% CI:-0.27,-0.02;P = 0.028)、谷胱甘肽过氧化物酶(GPx)(WMD = 2.29;95% CI:1.67,2.92;P < 0.001)以及心率(HR)(WMD = -3.92;95% CI:-7.45,-0.40;P = 0.029)。在体脂、腰围、血压、空腹血糖、血脂谱、炎症标志物或肝酶方面未观察到显著影响。亚组分析表明,影响因健康状况、剂量、持续时间和年龄而异。亚组分析揭示了基于健康状况、剂量、干预持续时间、干预时年龄、国家、样本量和发表年份的补充剂效果差异。在特定亚组中观察到BMI、总胆固醇(TC)、肌酐和丙二醛有显著改善,例如接受较低剂量(<1400毫克/天)的人群或年龄<50岁的人群。补充剂的GRADE概况评估了结果的确定性,表明所有结果的证据质量都非常低。补充剂可能对某些健康指标有适度影响,但证据因质量极低而受限。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e890/12160064/5f3c903bf4a5/FSN3-13-e70423-g002.jpg

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