背景:氧化应激和炎症在许多慢性疾病的发病机制中起关键作用。黑巧克力(DC)/可可,作为类黄酮等多酚的丰富来源,具有抗炎和抗氧化特性,可能会带来健康益处,但是在这种情况下的发现是不一致的。
目的:本系统综述和剂量-反应荟萃分析旨在全面概述研究DC/可可对成人氧化应激和炎症生物标志物影响的对照试验(CT)。
方法:包括PubMed、WebofScience,还有Scopus,在2024年4月之前搜索相关研究。
方法:研究评估了C反应蛋白(CRP),白细胞介素-6(IL-6),肿瘤坏死因子-α(TNF-α),丙二醛(MDA),一氧化氮(NO),P-选择素,包括成人中的E-选择素和硫代巴比妥酸反应物质(TBARS)。
方法:基于随机效应模型,我们计算了大规模杀伤性武器,SMD和95%置信区间(CI)。灵敏度,分组,还进行了荟萃回归和剂量反应分析。
结果:纳入了33个符合条件的CTs,1379名参与者。所有研究都报告了干预类型(可可粉,饮料和巧克力棒)和剂量。然而,16项研究没有进行/报告独立组的纯度和效力测试。此外,没有一项研究提到重金属污染的风险。另一个限制是研究中缺乏盲法评估。DC/可可显着降低MDA(SMD:-0.69,95CI:-1.17,-0.2,p=0.005)并增加NO水平(SMD:2.43,95CI:1.11,3.75,p<0.001);但是,它对其他结果没有显著影响。在非健康参与者中,较高的类黄酮剂量(>450mg/天)和较短的持续时间(≤4周)出现更大的抗炎作用。观察到可可剂量与CRP水平之间以及类黄酮剂量与IL-6水平之间的非线性剂量反应关系。根据等级评估,仅CRP和MDA结果被认为是高确定性证据,其他结局结果被归类为非常低至中等确定性.
结论:DC/可可可改善成人的全身氧化状态和炎症。然而,应进行进一步研究以确定其益处.
BACKGROUND: Oxidative stress and inflammation play critical roles in the pathogenesis of many chronic diseases. Dark
chocolate (DC)/cocoa, as a rich source of polyphenols like flavonoids, has anti-inflammatory and antioxidant properties that may confer health benefits, but findings in this context are inconsistent.
OBJECTIVE: This systematic
review and dose-response meta-analysis aimed to provide a comprehensive overview of the controlled trials (CTs) that have examined the effects of DC/cocoa on oxidative stress and inflammation biomarkers in adults.
METHODS: Databases including PubMed, Web of Science, and Scopus, were searched for relevant studies through April 2024.
METHODS: Studies assessed C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), malondialdehyde (MDA), nitric oxide (NO), P-selectin, E-selectin and thiobarbituric acid reactive substances (TBARS) in adults were included.
METHODS: Based on the random-effects model, we calculated WMDs, SMDs and 95 % confidence intervals (CIs). Sensitivity, sub-group, meta-regression and dose-response analyses were also conducted.
RESULTS: Thirty-three eligible CTs with 1379 participants were included. All studies reported the intervention types (cocoa powder, beverages and
chocolate bars) and dosage. However, sixteen studies didn\'t do/report testing for purity and potency by independent groups. Also, none of the studies mentioned the risk of contamination with heavy metals. Another limitation was the lack of blinding assessment in studies. DC/cocoa significantly reduced MDA (SMD: -0.69, 95 %CI: -1.17, -0.2, p = 0.005) and increased NO levels (SMD: 2.43, 95 %CI: 1.11,3.75, p < 0.001); However, it has no significant effects on the other outcomes. Greater anti-inflammatory effects occurred at higher flavonoid doses (>450 mg/day) and for shorter durations (≤4 weeks) in the non-healthy participants. Non-linear dose-response relationships between cocoa dosage and CRP level and also between flavonoid dosage and IL-6 level were observed. Based on the GRADE evaluation, just CRP and MDA results were considered as high certainty evidence and the other outcomes results were categorized as very low to moderate certainty.
CONCLUSIONS: DC/cocoa may improve systemic oxidative status and inflammation in adults. However, further studies should be performed to determine its benefits.