血浆硝酸盐、膳食硝酸盐、血压和血管健康生物标志物：一项grade评价的系统评价和随机对照试验的剂量反应荟萃分析

IF 4.4 2区医学 Q1 NUTRITION & DIETETICS

Nutrition Journal Pub Date : 2025-03-24 DOI:10.1186/s12937-025-01114-8

Mostafa Norouzzadeh, Minoo Hasan Rashedi, Shadi Ghaemi, Niloufar Saber, Artemiss Mirdar Harijani, Hamzeh Habibi, Soroush Mostafavi, Fatemeh Sarv, Hossein Farhadnejad, Farshad Teymoori, Mohsen Khaleghian, Parvin Mirmiran

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引用次数: 0

摘要

背景：高血压和血管功能障碍是主要的健康问题，研究表明不同的干预措施，包括膳食硝酸盐（NO3），可以改善高血压和血管功能障碍。我们试图阐明膳食NO3对血浆NO3和亚硝酸盐（NO2）水平的影响，并确定膳食NO3对血压（BP）和血管健康生物标志物的影响形式。方法：检索截至2024年2月的PubMed、Scopus和Web of Science中符合条件的随机对照试验（rct）。合并结果以加权平均差（WMD）和95%置信区间（ci）报告。结果：我们对涉及1823名参与者的75项随机对照试验的分析显示，每增加毫摩尔（mmol）施用NO3剂量，急性(WMD: 32.7µmol/L；95%CI: 26.1, 39.4)和慢性(WMD: 19.6µmol/L；95%CI: 9.95, 29.3)血浆NO3水平升高。一氧化氮摄入量每增加一mmol，急性期的收缩压水平就会降低(WMD: -0.28mmHg；95%置信区间:-0.40、-0.17)、短期(大规模杀伤性武器:-0.24毫米汞柱;95%CI: -0.40, -0.07)和中期(WMD: -0.48mmHg；95%CI: -0.71, -0.25)周期。此外，NO3摄入量每增加mmol，舒张压降低(WMD: -0.12 mmHg；95% CI: -0.21, -0.03)。此外，每mmol NO3摄入量与中期脉冲波速呈线性剂量-响应关系(WMD: -0.07 m/s；95%CI: -0.11, -0.03)，中期血流介导的扩张(WMD: 0.30%；95%CI: 0.15, 0.46)和中期增强指数(WMD: -0.57%；95%ci: -0.98, -0.15)。结论：我们观察到在饮食中补充NO3后，血浆NO3和NO2水平呈剂量依赖性增加，随之而来的是血压降低和血管健康增强。未来需要进行高质量的人群特异性研究，优化膳食NO3剂量，以加强证据的确定性。注册：本系统评价的方案已在PROSPERO注册，注册号为CRD42024535335。

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Plasma nitrate, dietary nitrate, blood pressure, and vascular health biomarkers: a GRADE-Assessed systematic review and dose-response meta-analysis of randomized controlled trials.

Background: Hypertension and vascular dysfunction are major health concerns, and studies have suggested different interventions, including dietary nitrate (NO3), to improve it. We sought to elucidate the effects of dietary NO3 on plasma NO3 and nitrite (NO2) levels and to determine the shape of the effect of dietary NO3 on blood pressure (BP) and vascular health biomarkers.

Methods: PubMed, Scopus, and Web of Science were searched up to February 2024 for eligible randomized controlled trials (RCTs). The pooled results were reported as weighted mean differences (WMD) and 95% confidence intervals (CIs).

Results: Our analysis of 75 RCTs involving 1823 participants revealed that per each millimole (mmol) increase in the administered NO3 dose, both acute (WMD: 32.7µmol/L; 95%CI: 26.1, 39.4) and chronic-term (WMD: 19.6µmol/L; 95%CI: 9.95, 29.3) plasma NO3 levels increased. Per each mmol increase in NO3 intake, a reduction in systolic BP levels was observed in the acute (WMD: -0.28mmHg; 95%CI: -0.40, -0.17), short-term (WMD: -0.24mmHg; 95%CI: -0.40, -0.07), and medium-term (WMD: -0.48mmHg; 95%CI: -0.71, -0.25) periods. Furthermore, a decrease in diastolic BP for each mmol increase in NO3 intake (WMD: -0.12 mmHg; 95% CI: -0.21, -0.03) was shown. Moreover, a linear dose-response relationship was indicated between each mmol of NO3 intake and medium-term pulse wave velocity (WMD: -0.07 m/s; 95%CI: -0.11, -0.03), medium-term flow-mediated dilation (WMD: 0.30%; 95%CI: 0.15, 0.46), and medium-term augmentation index (WMD: -0.57%; 95%CI: -0.98, -0.15).

Conclusion: We observed dose-dependent increases in plasma NO3 and NO2 levels, along with consequent reductions in BP and enhancements in vascular health following dietary NO3 supplementation. Future high-quality, population-specific studies with optimized dietary NO3 dosages are needed to strengthen the certainty of the evidence.

Registration: The protocol for this systematic review was registered in PROSPERO under the registration number CRD42024535335.

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来源期刊

Nutrition Journal NUTRITION & DIETETICS-

CiteScore

9.80

自引率

0.00%

发文量

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.