花青素、富含花青素的浆果和心血管风险：44 项随机对照试验和 15 项前瞻性队列研究的系统评价和荟萃分析,Frontiers in Nutrition

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花青素、富含花青素的浆果和心血管风险：44 项随机对照试验和 15 项前瞻性队列研究的系统评价和荟萃分析
Frontiers in Nutrition ( IF 5 ) Pub Date : 2021-12-15 , DOI: 10.3389/fnut.2021.747884
Lin Xu _{1,

2,

3,

4} , Zezhong Tian _{1,

2,

3,

4} , Hong Chen _{1,

2,

3,

4} , Yimin Zhao _{1,

2,

3,

4} , Yan Yang _{1,

2,

3,

4}

Affiliation

客观的：花青素和富含花青素的浆果的摄入量与心血管风险之间的关联仍有待确定。我们旨在定量总结纯化的花青素和富含花青素的浆果对心血管疾病 (CVD) 的主要替代标志物的影响以及膳食花青素与 CVD 事件之间的纵向关联。

方法：随机对照试验 (RCT) 和前瞻性队列研究的荟萃分析。

结果：我们在这项研究中纳入了 44 项符合条件的 RCT 和 15 项前瞻性队列研究。RCT 的汇总分析表明，补充纯化的花青素可以显着降低血液 LDL 胆固醇（加权平均差（WMD）：-5.43 mg/dL，95% CI：-8.96，-1.90 mg/dL；p = 0.003) 和甘油三酯（WMD：-6.18 mg/dL，95% CI：-11.67，-0.69 mg/dL； p = 0.027) 同时增加 HDL 胆固醇（WMD：11.49 mg/dL，95% CI：7.43, 15.55 mg/dL； p< 0.001) 浓度。纯化的花青素还显着降低了循环肿瘤坏死因子 α（WMD：-1.62 pg/mL，95% CI：-2.76，-0.48 pg/mL；p = 0.005) 和 C 反应蛋白（WMD：-0.028 mg/dL，95% CI：-0.050，-0.005 mg/dL； p= 0.014）。此外，服用富含花青素的浆果可以显着降低血液总胆固醇（WMD：-4.48 mg/dL，95% CI：-8.94，-0.02 mg/dL；p = 0.049) 和 C 反应蛋白（WMD：-0.046 mg/dL，95% CI：-0.070，-0.022 mg/dL； p< 0.001)。纯化的花青素和富含花青素的浆果都不能显着改善 BMI、血压或流量介导的扩张。此外，前瞻性队列研究的荟萃分析表明，高膳食花青素与较低的冠心病 (CHD) 风险有关（相对风险。RR): 0.83, 95% CI: 0.72, 0.95; p = 0.009)，总 CVD 发病率 (RR: 0.73, 95% CI: 0.55, 0.97; p = 0.030) 和 CVD 总死亡人数 (RR: 0.91, 95% CI: 0.87, 0.96; p < 0.001)。

结论：习惯性摄入花青素和富含花青素的浆果可预防心血管疾病通过改善血脂谱和减少循环促炎细胞因子。

系统审核注册：https://www.crd.york.ac.uk/PROSPERO，标识符：CRD42020208782。

"点击查看英文标题和摘要"

Anthocyanins, Anthocyanin-Rich Berries, and Cardiovascular Risks: Systematic Review and Meta-Analysis of 44 Randomized Controlled Trials and 15 Prospective Cohort Studies

Objective: The associations between intake of anthocyanins and anthocyanin-rich berries and cardiovascular risks remained to be established. We aimed to quantitatively summarize the effects of purified anthocyanins and anthocyanin-rich berries on major surrogate markers of cardiovascular diseases (CVDs) and the longitudinal associations between dietary anthocyanins and CVD events.

Methods: Meta-analysis of randomized controlled trials (RCTs) and prospective cohort studies.

Results: We included 44 eligible RCTs and 15 prospective cohort studies in this study. Pooled analysis of RCTs showed that purified anthocyanin supplementation could significantly reduce blood LDL cholesterol (weighted mean difference (WMD): −5.43 mg/dL, 95% CI: −8.96, −1.90 mg/dL; p = 0.003) and triglyceride (WMD: −6.18 mg/dL, 95% CI: −11.67, −0.69 mg/dL; p = 0.027) while increase HDL cholesterol (WMD: 11.49 mg/dL, 95% CI: 7.43, 15.55 mg/dL; p < 0.001) concentrations. Purified anthocyanins also markedly decreased circulating tumor necrosis factor alpha (WMD: −1.62 pg/mL, 95% CI: −2.76, −0.48 pg/mL; p = 0.005) and C-reactive protein (WMD: −0.028 mg/dL, 95% CI: −0.050, −0.005 mg/dL; p = 0.014). Besides, administration of anthocyanin-rich berries could significantly lower blood total cholesterol (WMD: −4.48 mg/dL, 95% CI: −8.94, −0.02 mg/dL; p = 0.049) and C-reactive protein (WMD: −0.046 mg/dL, 95% CI: −0.070, −0.022 mg/dL; p < 0.001). Neither purified anthocyanins nor anthocyanin-rich berries could cause any substantial improvements in BMI, blood pressure, or flow-mediated dilation. In addition, meta-analysis of prospective cohort studies suggested that high dietary anthocyanins were related to lower risk of coronary heart disease (CHD) (relative risk (RR): 0.83, 95% CI: 0.72, 0.95; p = 0.009), total CVD incidence (RR: 0.73, 95% CI: 0.55, 0.97; p = 0.030), and total CVD deaths (RR: 0.91, 95% CI: 0.87, 0.96; p < 0.001).

Conclusion: Habitual intake of anthocyanins and anthocyanin-rich berries could protect against CVDs possibly via improving blood lipid profiles and decreasing circulating proinflammatory cytokines.

Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42020208782.

更新日期：2021-12-15

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