饮食模式对肠道微生物群对心血管疾病一级和二级预防的影响:系统综述

IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS
Junwen Yu, Yue Wu, Zheng Zhu, Hongzhou Lu
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引用次数: 0

摘要

背景:以往的研究发现,通过调节肠道菌群来实现饮食模式对心血管健康的保护作用是有希望的。然而,关于饮食模式如何影响已患病或有心血管疾病(CVD)风险的个体的肠道微生物群,报道了相互矛盾的发现。我们的系统综述旨在探讨饮食模式对这些人群肠道微生物群组成和心血管疾病危险因素的影响。方法:系统检索PubMed/MEDLINE、MEDLINE (Ovid)、Embase (Ovid)、CINHAL (EBSCO)、Web of Science、中国知网(CNKI)、万方(Wanfang)等7个数据库,涵盖从建库到2024年10月的文献。如果研究集中于18岁及以上患有心血管疾病或至少两种心血管疾病危险因素的成年人,实施饮食模式干预,并纳入与微生物组分析相关的结果,则纳入研究。纳入研究的偏倚风险评估使用修订后的Cochrane随机试验偏倚风险评估工具(RoB2)和非随机研究的非随机干预研究偏倚风险评估工具(ROBINS-I)。在不同的分类水平上,包括门、纲、目、科、属和种,总结了肠道微生物组相对丰度的变化。随机效应荟萃分析分析干预前后心脏代谢参数的平均差异。结果:共纳入19项研究,包括17项随机对照试验和2项自我对照试验。这些研究的偏倚风险好坏参半,但主要确定为低且不明确。据报道,增加最多的分类群是富含植物性饮食的Faecalibacterium (N = 8),限制性饮食的Bacteroides (N = 3),以及富含多酚饮食的Ruminococcaceae ucg005和Alistipes (N = 9)。最常见的减少类群是富含植物性饮食的拟副杆菌群(N = 7),限制性饮食的Roseburia群(N = 3)和富含多酚饮食的高沃氏鲁米诺球菌群(N = 6)。富含植物的饮食显著降低了总胆固醇(TC),平均差异为-6.77 (95% CI, -12.36至-2.58;I2 = 84.7%),而限制性饮食显示甘油三酯(TG)显著降低-22.12 (95% CI, -36.05 ~ -8.19;i2 = 98.4%)。结论:不同的饮食模式对肠道菌群组成有不同的影响。富含植物性的饮食促进了丁酸产生细菌的增殖,这表明通过饮食干预调节肠道微生物群和丁酸产生以增强心血管健康的前景广阔。需要进一步研究饮食模式对临床终点的长期影响,如心血管疾病事件或死亡率。评审注册:注册号:CRD42024507660。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The impact of dietary patterns on gut microbiota for the primary and secondary prevention of cardiovascular disease: a systematic review.

Background: Previous studies found that it is promising to achieve the protective effects of dietary patterns on cardiovascular health through the modulation of gut microbiota. However, conflicting findings have been reported on how dietary patterns impact gut microbiota in individuals either established or at risk of cardiovascular disease (CVD). Our systematic review aimed to explore the effect of dietary patterns on gut microbiota composition and on risk factors for CVD in these populations.

Methods: We systematically searched seven databases, including PubMed/MEDLINE, MEDLINE (Ovid), Embase (Ovid), CINHAL (EBSCO), Web of Science, CNKI (Chinese), and Wanfang (Chinese), covering literature from inception to October 2024. Studies were included if they focused on adults aged 18 years and older with CVD or at least two CVD risk factors, implemented dietary pattern interventions, and incorporated outcomes related to microbiome analysis. The risk of bias for included studies was assessed using the revised Cochrane risk of bias tool (RoB2) for randomized trials and the Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I) for non-randomized studies. Changes in the relative abundance of the gut microbiome were summarized at various taxonomic levels, including phylum, class, order, family, genus, and species. Random-effects meta-analysis was conducted to analyze the mean difference in cardiometabolic parameters pre- and post-intervention.

Results: Nineteen studies were identified, including 17 RCT and two self-controlled trails. Risk of bias across the studies was mixed but mainly identified as low and unclear. The most frequently reported increased taxa were Faecalibacterium (N = 8) with plant-rich diets, Bacteroides (N = 3) with restrictive diets, and Ruminococcaceae UCG 005 and Alistipes (N = 9) with the polyphenol-rich diets. The most frequently reported decreased taxa were Parabacteroides (N = 7) with plant-rich diets, Roseburia (N = 3) with restrictive diets, and Ruminococcus gauvreauii group (N = 6) with the polyphenol-rich diets. Plant-rich diets showed a significant decrease in total cholesterol (TC) with a mean difference of -6.77 (95% CI, -12.36 to -2.58; I2 = 84.7%), while restrictive diets showed a significant decrease in triglycerides (TG) of -22.12 (95% CI, -36.05 to -8.19; I2 = 98.4%).

Conclusions: Different dietary patterns showed distinct impacts on gut microbiota composition. Plant-rich diets promoted the proliferation of butyrate-producing bacteria, suggesting promising prospects for modulating gut microbiota and butyrate production through dietary interventions to enhance cardiovascular health. Further research is warranted to investigate the long-term effects of dietary patterns on clinical endpoints, such as CVD events or mortality.

Review registration: Registration number: CRD42024507660.

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来源期刊
Nutrition Journal
Nutrition Journal NUTRITION & DIETETICS-
CiteScore
9.80
自引率
0.00%
发文量
68
审稿时长
4-8 weeks
期刊介绍: Nutrition Journal publishes surveillance, epidemiologic, and intervention research that sheds light on i) influences (e.g., familial, environmental) on eating patterns; ii) associations between eating patterns and health, and iii) strategies to improve eating patterns among populations. The journal also welcomes manuscripts reporting on the psychometric properties (e.g., validity, reliability) and feasibility of methods (e.g., for assessing dietary intake) for human nutrition research. In addition, study protocols for controlled trials and cohort studies, with an emphasis on methods for assessing dietary exposures and outcomes as well as intervention components, will be considered. Manuscripts that consider eating patterns holistically, as opposed to solely reductionist approaches that focus on specific dietary components in isolation, are encouraged. Also encouraged are papers that take a holistic or systems perspective in attempting to understand possible compensatory and differential effects of nutrition interventions. The journal does not consider animal studies. In addition to the influence of eating patterns for human health, we also invite research providing insights into the environmental sustainability of dietary practices. Again, a holistic perspective is encouraged, for example, through the consideration of how eating patterns might maximize both human and planetary health.
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