Na Takuathung Mingkwan, Aisara Jakkrit, Sawong Suphunwadee, Koonrungsesomboon Nut
Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
Clinical Research Center for Food and Herbal Product Trials and Development (CR-FAH), Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
BMC Complement Med Ther. 2025 Jul 24;25(1):286. doi: 10.1186/s12906-025-04995-8.
Maintaining bone health is vital, particularly for aging populations prone to bone disorders. Cissus quadrangularis (CQ), a traditional medicinal plant, is increasingly recognized for its potential benefits in promoting bone health, including the effects on bone-related biomarkers promoting bone healing and bone density improvement. This study aimed to evaluate the effects of CQ on bone-related biomarkers in humans as the primary objective and to assess its impact on other clinical outcomes as a secondary objective.
A systematic search of PubMed, Embase, Scopus, and the Cochrane Library databases was conducted up to April 2025. This systematic review included studies with participants receiving Cissus quadrangularis, those reporting bone biomarkers, and those with a randomized controlled design involving human participants. No restrictions were placed on age, sex, disease severity, or administration route. The quality of the studies included was assessed using the revised Cochrane risk-of-bias tool (RoB-2), while the overall strength of evidence was appraised using the GRADE approach. The summary effect measure was the standardized mean difference (SMD) with 95% confidence intervals (95% CI).
Seven studies, comprising a total of 354 participants, met the inclusion criteria for meta-analysis. The analysis revealed that CQ intervention significantly elevated serum parathyroid hormone levels (SMD = 1.23; 95% CI = 0.79 to 1.67; p < 0.0001). However, the CQ intervention did not result in significant changes in other bone-related biomarkers, including calcium, phosphorus, and serum alkaline phosphatase. The RoB-2 revealed that most studies had some concerns about bias, with two evaluated as having a high risk. The certainty of evidence was very low for all four parameters assessed by GRADE.
The CQ intervention was significantly associated with increased serum parathyroid hormone levels, with no significant effects on other bone-related biomarkers. Although there were a limited number of studies, these findings suggest its potential for modulating bone health; however, further research is needed to confirm these results and explore its clinical applications.
The study protocol was prospectively registered with PROSPERO, and the registration number is CRD42023435351.
Not applicable.
维持骨骼健康至关重要，尤其是对于易患骨骼疾病的老年人群。四角葡萄（CQ）是一种传统药用植物，其在促进骨骼健康方面的潜在益处日益受到认可，包括对促进骨愈合和改善骨密度的骨相关生物标志物的影响。本研究旨在评估CQ对人体骨相关生物标志物的影响作为主要目标，并评估其对其他临床结局的影响作为次要目标。
截至2025年4月，对PubMed、Embase、Scopus和Cochrane图书馆数据库进行了系统检索。该系统评价纳入了接受四角葡萄的参与者、报告骨生物标志物的研究以及涉及人类参与者的随机对照设计研究。对年龄、性别、疾病严重程度或给药途径没有限制。使用修订后的Cochrane偏倚风险工具（RoB-2）评估纳入研究的质量，同时使用GRADE方法评估证据的总体强度。汇总效应量为标准化均数差（SMD）及其95%置信区间（95%CI）。
七项研究，共354名参与者，符合荟萃分析的纳入标准。分析显示，CQ干预显著提高了血清甲状旁腺激素水平（SMD = 1.23；95%CI = 0.79至1.67；p < 0.0001）。然而，CQ干预并未导致其他骨相关生物标志物（包括钙、磷和血清碱性磷酸酶）发生显著变化。RoB-2显示，大多数研究存在一些偏倚问题（两项研究被评估为高风险）。GRADE评估的所有四个参数的证据确定性都非常低。
CQ干预与血清甲状旁腺激素水平升高显著相关，对其他骨相关生物标志物无显著影响。尽管研究数量有限，但这些发现表明其在调节骨骼健康方面具有潜力；然而，需要进一步研究来证实这些结果并探索其临床应用。
该研究方案已在PROSPERO上进行前瞻性注册，注册号为CRD42023435351。
不适用。
