姜黄素补充剂对非酒精性脂肪肝患者肝酶的影响:随机对照试验的 GRADE 评估系统综述和剂量反应荟萃分析。

IF 5.9 2区 医学 Q1 NUTRITION & DIETETICS
Mahdi Vajdi, Shirin Hassanizadeh, Reza Hassanizadeh, Mohammad Bagherniya
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引用次数: 0

摘要

背景:姜黄素对非酒精性脂肪肝(NAFLD)患者肝酶影响的临床研究结果并不一致:本系统综述和荟萃分析旨在研究姜黄素和姜黄素加胡椒碱补充剂对非酒精性脂肪肝患者的丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)和天冬氨酸氨基转移酶(AST)等肝酶的总体影响:使用代表非酒精性脂肪肝和肝酶的检索词对 Scopus、Web of Science、PubMed 和 Cochrane Library 数据库进行了检索,检索期从开始到 2023 年 7 月。文章由两名研究人员根据 PICOS 纳入标准独立筛选:提取以下数据:第一作者姓名、研究地点、发表年份、平均年龄、研究持续时间、研究设计、参与者性别、每组参与者人数、姜黄素补充剂剂量以及ALT、ALP和AST浓度。数据分析采用 Cochrane 协作组织的修正偏倚风险工具评估偏倚风险:考虑到各研究间的异质性,进行了固定效应或随机效应荟萃分析,以估计姜黄素对肝酶的影响。I2和Cochran's Q检验用于评估研究间的异质性:共有 15 项随机对照试验、905 名参与者符合荟萃分析的条件。姜黄素补充剂能明显降低谷丙转氨酶(ALT)(加权平均差 [WMD],-4.10,95%CI,-7.16 至-1.04)和谷草转氨酶(AST)(WMD,-3.27;95%CI,-5.16 至-1.39),但不能降低谷草转氨酶(ALP)(WMD,-0.49;95%CI,-1.79 至 0.82)。姜黄素加胡椒碱对谷丙转氨酶(WMD,-3.79;95%CI,-13.30 至 5.72)和谷草转氨酶(WMD,-1.1;95%CI,-3.32 至 1.09)没有明显影响:与对照组相比,姜黄素补充剂可改善 AST 和 ALT 水平。结论:与对照组相比,姜黄素补充剂可改善AST和ALT水平。然而,要评估姜黄素对ALP的影响,还需要设计更好、样本量更大、质量更高的随机对照试验:系统综述注册:PROSPERO 注册编号CRD42023448231。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Curcumin supplementation effect on liver enzymes in patients with nonalcoholic fatty liver disease: a GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials.

Context: Clinical evidence from investigations of the effects of curcumin on liver enzymes in patients with nonalcoholic fatty liver disease (NAFLD) have led to inconsistent results.

Objective: The aim of this systematic review and meta-analysis was to investigate the overall effects of curcumin and curcumin plus piperine supplementation on liver enzymes such as alanine aminotransferase (ALT), alkaline phosphatase (ALP), and aspartate aminotransferase (AST) in patients with NAFLD.

Data sources: The Scopus, Web of Science, PubMed, and Cochrane Library databases were searched from inception through July 2023, using search terms representing NAFLD and liver enzymes. Articles were screened independently by 2 researchers based on PICOS inclusion criteria.

Data extraction: The following data were extracted: first author's name, study location, year of publication, mean age, study duration, study design, participants' sex, number of participants in each group, dose of curcumin supplementation, and ALT, ALP, and AST concentrations. Risk of bias was assessed using the Cochrane Collaboration's modified risk-of-bias tool.

Data analysis: Fixed- or random-effects meta-analysis was performed to estimate the effects of curcumin on liver enzymes, considering heterogeneity across studies. The I2 and Cochran's Q tests were used to assess heterogeneity between studies.

Results: Overall, 15 randomized controlled trials comprising 905 participants were eligible for this meta-analysis. Curcumin supplementation significantly reduced ALT (weighted mean difference [WMD], -4.10, 95%CI, -7.16 to -1.04) and AST (WMD, -3.27; 95%CI, -5.16 to -1.39), but not ALP (WMD, -0.49; 95%CI, -1.79 to 0.82). Curcumin plus piperine supplementation had no significant effect on ALT (WMD, -3.79; 95%CI, -13.30 to 5.72), and AST (WMD, -1.1; 95%CI, -3.32 to 1.09).

Conclusions: Curcumin supplementation improved AST and ALT levels compared with the control group. However, better-designed randomized controlled trials with larger sample sizes and of higher quality are needed to assess the effects of curcumin on ALP.

Systematic review registration: PROSPERO registration no. CRD42023448231.

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来源期刊
Nutrition reviews
Nutrition reviews 医学-营养学
CiteScore
12.20
自引率
1.60%
发文量
121
审稿时长
6-12 weeks
期刊介绍: Nutrition Reviews is a highly cited, monthly, international, peer-reviewed journal that specializes in the publication of authoritative and critical literature reviews on current and emerging topics in nutrition science, food science, clinical nutrition, and nutrition policy. Readers of Nutrition Reviews include nutrition scientists, biomedical researchers, clinical and dietetic practitioners, and advanced students of nutrition.
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