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Abstract：
BACKGROUND: Patients with a low serum blood hemoglobin concentration suffer from a pathologic state that contributes significantly to morbidity and mortality figures worldwide. Oral iron supplementation, the most common method of treatment, is reported to have poor patient adherence, due to its unwanted side effects. Lactoferrin is a globular glycoprotein of the transferrin family that has shown promising results in patients with a low hemoglobin profile. This systematic review and meta-analysis of randomized clinical trials explore its effect on blood hemoglobin compared to conventional iron preparations.
METHODS: We followed the PRISMA Guidelines for reporting systematic reviews and meta-analyses. A systematic search was conducted in electronic databases (PubMed, CINAHL, Scopus, and Cochrane) from inception to June 2022. Meta-analysis was performed on studies where the primary outcome was the mean Hb concentration, comparing lactoferrin to ferrous sulfate subgroups. We assessed the methodological quality of the trials using the Jadad scoring scale.
RESULTS: Nineteen trials published between 2006 and 2022 met the eligibility criteria. It has been found that the levels of Hb concentration in different populations with varying health conditions undergo a moderate to significant change after treatment with all types of trialed interventions, including both iron and lactoferrin treatment, in both the intervention group and the comparison group. Most of the studies report that LF showed a statistically significant increase in Hb concentration levels, compared to those in the iron group. The meta-analysis included seven trials comparing the effectiveness of lactoferrin to ferrous sulfate for patients with low Hb concentration. The analysis showed a statistically significant increase in Hb levels in the oral bovine lactoferrin group compared to ferrous sulfate (SMD -0.81, 95% CI: -1.21, -0.42, p < 0.0001, I2 = 95.8%, P heterogeneity < 0.001).
CONCLUSIONS: Lactoferrin is an effective intervention at doses of 100-250 ng/day, for patients with a low Hb concentration. As a safer option and with high compliance evidence, lactoferrin can serve as an iron replacement treatment for patients who may be experiencing adverse side effects due to iron intake.
METHODS: We followed the PRISMA Guidelines for reporting systematic reviews and meta-analyses. A systematic search was conducted in electronic databases (PubMed, CINAHL, Scopus, and Cochrane) from inception to June 2022. Meta-analysis was performed on studies where the primary outcome was the mean Hb concentration, comparing lactoferrin to ferrous sulfate subgroups. We assessed the methodological quality of the trials using the Jadad scoring scale.
RESULTS: Nineteen trials published between 2006 and 2022 met the eligibility criteria. It has been found that the levels of Hb concentration in different populations with varying health conditions undergo a moderate to significant change after treatment with all types of trialed interventions, including both iron and lactoferrin treatment, in both the intervention group and the comparison group. Most of the studies report that LF showed a statistically significant increase in Hb concentration levels, compared to those in the iron group. The meta-analysis included seven trials comparing the effectiveness of lactoferrin to ferrous sulfate for patients with low Hb concentration. The analysis showed a statistically significant increase in Hb levels in the oral bovine lactoferrin group compared to ferrous sulfate (SMD -0.81, 95% CI: -1.21, -0.42, p < 0.0001, I2 = 95.8%, P heterogeneity < 0.001).
CONCLUSIONS: Lactoferrin is an effective intervention at doses of 100-250 ng/day, for patients with a low Hb concentration. As a safer option and with high compliance evidence, lactoferrin can serve as an iron replacement treatment for patients who may be experiencing adverse side effects due to iron intake.
摘要：
背景：血清血红蛋白浓度低的患者患有一种病理状态，这种病理状态对全世界的发病率和死亡率数字有显著影响。口服补铁,最常见的治疗方法，据报道患者依从性差，由于其不必要的副作用。乳铁蛋白是转铁蛋白家族的球状糖蛋白,其在具有低血红蛋白谱的患者中显示出有希望的结果。这项对随机临床试验的系统评价和荟萃分析探讨了与常规铁制剂相比，其对血液血红蛋白的影响。
方法：我们遵循PRISMA指南报告系统评价和荟萃分析。在电子数据库(PubMed，CINAHL,Scopus,和Cochrane）从成立到2022年6月。对主要结局为平均Hb浓度的研究进行了荟萃分析，比较乳铁蛋白和硫酸亚铁亚组。我们使用Jadad评分量表评估试验的方法学质量。
结果：2006年至2022年间发表的19项试验符合资格标准。已经发现，在不同健康状况的不同人群中，Hb浓度水平在使用所有类型的试验干预措施进行治疗后发生中度到显着的变化。包括铁和乳铁蛋白治疗，在干预组和对照组中。大多数研究报告称，LF显示Hb浓度水平有统计学意义的增加，与铁族相比。荟萃分析包括7项试验，比较乳铁蛋白与硫酸亚铁对低Hb浓度患者的有效性。分析显示，与硫酸亚铁相比，口服牛乳铁蛋白组的Hb水平具有统计学意义（SMD-0.81，95％CI：-1.21，-0.42，p<0.0001，I2=95.8％，P异质性<0.001)。
结论：乳铁蛋白在100-250ng/天的剂量下是有效的干预措施，Hb浓度低的患者。作为一种更安全的选择，并且有很高的合规性证据，乳铁蛋白可以作为铁的替代疗法，用于可能由于铁摄入而产生不良副作用的患者。
方法：我们遵循PRISMA指南报告系统评价和荟萃分析。在电子数据库(PubMed，CINAHL,Scopus,和Cochrane）从成立到2022年6月。对主要结局为平均Hb浓度的研究进行了荟萃分析，比较乳铁蛋白和硫酸亚铁亚组。我们使用Jadad评分量表评估试验的方法学质量。
结果：2006年至2022年间发表的19项试验符合资格标准。已经发现，在不同健康状况的不同人群中，Hb浓度水平在使用所有类型的试验干预措施进行治疗后发生中度到显着的变化。包括铁和乳铁蛋白治疗，在干预组和对照组中。大多数研究报告称，LF显示Hb浓度水平有统计学意义的增加，与铁族相比。荟萃分析包括7项试验，比较乳铁蛋白与硫酸亚铁对低Hb浓度患者的有效性。分析显示，与硫酸亚铁相比，口服牛乳铁蛋白组的Hb水平具有统计学意义（SMD-0.81，95％CI：-1.21，-0.42，p<0.0001，I2=95.8％，P异质性<0.001)。
结论：乳铁蛋白在100-250ng/天的剂量下是有效的干预措施，Hb浓度低的患者。作为一种更安全的选择，并且有很高的合规性证据，乳铁蛋白可以作为铁的替代疗法，用于可能由于铁摄入而产生不良副作用的患者。
