Quercetin

槲皮素
  • 文章类型: Journal Article
    槲皮素及其糖苷(QG),至关重要的天然类黄酮,因健康益处而受欢迎。然而,吸收和代谢会影响它们的生物利用度,代谢转化改变了它们的生物活性。本文系统总结了槲皮素/QG在体内和体外的生物利用度和吸收代谢途径。讨论了槲皮素/QG及其代谢产物治疗糖脂代谢的生物学活性和作用机制。口服后,槲皮素/QG主要被肠道吸收,在小肠和肝脏中经历II期代谢以形成缀合物,并被肠道微生物群代谢为小酚酸。槲皮素/QG及其代谢物对调节糖脂代谢紊乱发挥有益作用,包括改善胰岛素抵抗,抑制脂肪生成,增强产热,调节肠道微生物群,缓解氧化应激,减轻炎症。本文旨在加深对槲皮素/QG调节糖脂代谢机制的认识,为功能性食品的开发提供科学依据。
    Quercetin and its glycosides (QG), vitally natural flavonoid, have been popular for health benefits. However, the absorption and metabolism affect their bioavailability, and the metabolic transformation alters their biological activities. This review systematically summarizes the bioavailability and pathways for the absorption and metabolism of quercetin/QG in vivo and in vitro, the biological activities and mechanism of quercetin/QG and their metabolites in treating glucolipid metabolism are discussed. After oral administration, quercetin/QG are mainly absorbed by the intestine, undergo phase II metabolism in the small intestine and liver to form conjugates and are metabolized into small phenolic acids by intestinal microbiota. Quercetin/QG and their metabolites exert beneficial effects on regulating glucolipid metabolism disorders, including improving insulin resistance, inhibiting lipogenesis, enhancing thermogenesis, modulating intestinal microbiota, relieving oxidative stress, and attenuating inflammation. This review enhances understanding of the mechanism of quercetin/QG regulate glucolipid metabolism and provides scientific support for the development of functional foods.
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  • 文章类型: Journal Article
    天然化合物如多酚在维持细胞的氧化和炎症能力方面发挥着积极作用。这导致了它们作为抗癌疗法的潜在用途。有许多多酚的体外和体内抗癌活性的有希望的证据,包括白藜芦醇和槲皮素,特别是在结直肠癌(CRC)的治疗中。白藜芦醇和槲皮素在干扰涉及CRC的机制途径中存在明显的关联,比如Wnt,P13K/AKT,caspase-3,MAPK,NF-κB,等。这些分子途径确立了白藜芦醇和槲皮素在控制癌细胞生长中的作用,诱导细胞凋亡,并抑制转移。白藜芦醇和槲皮素用作抗癌治疗剂的进展中的主要瓶颈是它们在体内的生物利用度降低,这是因为它们在人体内的快速代谢。各种纳米技术制剂的最新进展有望克服这些生物利用度问题。白藜芦醇和槲皮素的各种纳米制剂对降低白藜芦醇和槲皮素在体内的溶解度和改善稳定性显示出乐观的影响。使用白藜芦醇与槲皮素的纳米制剂的组合方法可能潜在地增加白藜芦醇在控制CRC细胞增殖中的影响。本文综述了白藜芦醇和槲皮素的作用机制,两种生物活性多酚,在结肠癌中,重点是针对结肠癌的两种分子的各种类型的纳米制剂。它还探讨了白藜芦醇和槲皮素在各种纳米制剂中的协同作用,靶向结肠癌。这项研究探讨了这些生物活性多酚以创新方式一起使用时增强的药代动力学和潜在的化疗益处。
    Natural compounds such as polyphenols play several positive roles in maintaining the oxidative and inflammatory capacity of cells, which leads to their potential use as anticancer therapeutics. There is promising evidence for the in vitro and in vivo anticancer activity of many polyphenols, including resveratrol and quercetin, specifically in the treatment of colorectal cancer (CRC). There is a clear association between resveratrol and quercetin in interfering with the mechanistic pathways involved in CRC, such as Wnt, P13K/AKT, caspase-3, MAPK, NF-κB, etc. These molecular pathways establish the role of resveratrol and quercetin in controlling cancer cell growth, inducing apoptosis, and inhibiting metastasis. The major bottleneck in the progression of the use of resveratrol and quercetin as anticancer therapeutics is their reduced bioavailability in vivo because of their rapid metabolism in humans. Recent advancements in various nanotechnological formulations are promising for overcoming these bioavailability issues. Various nanoformulations of resveratrol and quercetin have shown an optimistic impact on reducing the solubility and improving the stability of resveratrol and quercetin in vivo. A combinatorial approach using nanoformulations of resveratrol with quercetin could potentially increase the impact of resveratrol in controlling CRC cell proliferation. This review discusses the mechanism of resveratrol and quercetin, the two bioactive polyphenolics, in colon cancer, with an emphasis on various types of nanoformulations of the two molecules targeting colon cancer. It also explores the synergistic effect of combining resveratrol and quercetin in various nanoformulations, targeting colon cancer. This research delves into the enhanced pharmacokinetics and potential chemotherapeutic benefits of these bioactive polyphenolics when used together in innovative ways.
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  • 文章类型: Journal Article
    这种全面的探索,深入研究槲皮素的多方面属性,一种具有广泛促进健康潜力的类黄酮。这篇评论浏览了它的基本属性,包括它的化学结构,分类为类黄酮,以及它在各种来源的自然流行。解决溶解度,稳定性,和生物利用度挑战,调查深入研究了创新的隔离技术,包括溶剂萃取,固相萃取,天然的低共熔溶剂,超临界流体萃取,微波辅助提取,柱层析,和高效薄层色谱。过渡到药理意义,这项研究揭示了槲皮素在抗炎途径中的作用,抗氧化作用,和免疫调节,体现了其在健康管理中的多才多艺意义。该综述强调了其对伤口愈合过程的影响及其减轻关节炎的潜力,阐明其整体贡献。在最近研究的探索中,该分析强调槲皮素具有显著的抗炎和抗关节炎活性,反映了它在各种疾病中的巨大潜力。审查的结论是预测未来的轨迹,强调对槲皮素机制的深入理解的前景,可持续提取技术,临床整合,并探索协同组合。总的来说,本综述研究强调槲皮素在天然化合物和药物应用的交汇处的动态作用,为福祉和健康增强提供了深远的影响。
    This comprehensive exploration delves into the multifaceted attributes of quercetin, a flavonoid with extensive health-promoting potential. The review navigates through its fundamental properties, encompassing its chemical structure, classification as a flavonoid, and its natural prevalence in various sources. Addressing solubility, stability, and bioavailability challenges, the investigation delves into innovative isolation techniques, including solvent extraction, solid-phase extraction, natural deep eutectic solvents, supercritical fluid extraction, microwave-assisted extraction, column chromatography, and high-performance thin-layer chromatography. Transitioning into pharmacological implications, the study unveils quercetin\'s roles in anti-inflammatory pathways, antioxidant effects, and immune modulation, reflecting its versatile significance in health management. The review highlights its impact on wound healing processes and its potential to mitigate arthritis, elucidating its holistic contributions. Culminating in an exploration of recent studies, the analysis underscores quercetin\'s remarkable anti-inflammatory and anti-arthritis activities, reflecting its substantial potential across various ailments. The review concludes by projecting future trajectories, emphasizing prospects for an advanced understanding of quercetin\'s mechanisms, sustainable extraction techniques, clinical integration, and exploration of synergistic combinations. Collectively, this review investigation underscores quercetin\'s dynamic role at the intersection of natural compounds and medicinal applications, offering profound implications for well- being and health enhancement.
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  • 文章类型: Journal Article
    创伤性脑损伤(TBI)是全球残疾的主要原因,估计年发病率为27-69百万。TBI是一种严重的疾病,可能导致高死亡率和长期认知,行为,和年轻人的身体损伤。由于缺乏有效的治疗方法,这是一个重大的公共卫生问题。槲皮素,一种在各种水果和蔬菜中发现的天然类黄酮,已经证明了抗炎的治疗潜力,抗氧化剂,和神经保护特性。最近,一些证据强调了槲皮素对TBI的改善作用。本文综述了槲皮素通过调节多种细胞和分子途径减轻TBI相关损伤的能力。槲皮素的体外和体内研究显示出减少炎症的希望,氧化应激,凋亡,增强TBI后的认知功能。鉴于这些发现,有必要进一步临床研究槲皮素作为TBI治疗中一种现成的佐剂的治疗潜力。这篇综述通过阐明槲皮素的作用机制,增加了我们对槲皮素治疗TBI潜力的认识。
    Traumatic brain injury (TBI) is a leading cause of disability worldwide, with an estimated annual incidence of 27-69 million. TBI is a severe condition that can lead to high mortality rates and long-term cognitive, behavioral, and physical impairments in young adults. It is a significant public health concern due to the lack of effective treatments available. Quercetin, a natural flavonoid found in various fruits and vegetables, has demonstrated therapeutic potential with anti-inflammatory, antioxidant, and neuroprotective properties. Recently, some evidence has accentuated the ameliorating effects of quercetin on TBI. This review discusses quercetin\'s ability to reduce TBI-related damage by regulating many cellular and molecular pathways. Quercetin in vitro and in vivo studies exhibit promise in reducing inflammation, oxidative stress, apoptosis, and enhancing cognitive function post-TBI. Further clinical investigation into quercetin\'s therapeutic potential as a readily available adjuvant in the treatment of TBI is warranted in light of these findings. This review adds to our knowledge of quercetin\'s potential in treating TBI by clarifying its mechanisms of action.
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  • 文章类型: Journal Article
    帕金森病(PD)是一种影响多巴胺能神经元的神经退行性疾病,从而损害多巴胺能信号。槲皮素(QUE)具有抗氧化和神经保护特性,有望用于治疗PD。本系统综述旨在研究QUE在临床前模型中对PD的治疗效果。系统搜索在PubMed中进行,Scopus和WebofScience在最后的筛选阶段,根据预先建立的标准选择了26篇文章。选定的研究使用不同的PD诱导方法,以及动物模型。大多数研究使用大鼠(73.08%)和小鼠(23.08%),以6-OHDA为PD诱导的主要策略(38.6%),其次是鱼藤酮(30.8%)。将QUE浸入油中进行测试,纳米系统或自由配方,在不同的给药途径和剂量中,口服和腹膜内给药范围为10至400mg/kg和5至200mg/kg,分别。总的来说,来自已发表数据的证据表明,QUE可能用作PD的治疗方法,主要通过抑制氧化应激,神经炎症反应和凋亡途径。
    Parkinson\'s disease (PD) is a neurodegenerative disease that affects dopaminergic neurons, thus impairing dopaminergic signalling. Quercetin (QUE) has antioxidant and neuroprotective properties that are promising for the treatment of PD. This systematic review aimed to investigate the therapeutic effects of QUE against PD in preclinical models. The systematic search was performed in PubMed, Scopus and Web of Science. At the final screening stage, 26 articles were selected according to pre-established criteria. Selected studies used different methods for PD induction, as well as animal models. Most studies used rats (73.08%) and mice (23.08%), with 6-OHDA as the main strategy for PD induction (38.6%), followed by rotenone (30.8%). QUE was tested immersed in oil, nanosystems or in free formulations, in varied routes of administration and doses, ranging from 10 to 400 mg/kg and from 5 to 200 mg/kg in oral and intraperitoneal administrations, respectively. Overall, evidence from published data suggests a potential use of QUE as a treatment for PD, mainly through the inhibition of oxidative stress, neuroinflammatory response and apoptotic pathways.
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  • 文章类型: Journal Article
    脂肪合成和脂肪分解是生长的自然过程,与健康密切相关。脂肪提供能量,维持生理功能,等等,因此在身体中起着重要的作用。然而,过度/异常脂肪积累导致肥胖和脂质代谢紊乱,这会对生长产生有害影响,甚至损害人的健康。除了遗传影响,有一系列与肥胖有关的因素,如过量的营养摄入,炎症,糖代谢疾病,等等。这些因素可以作为抗肥胖治疗的潜在目标。槲皮素是一种黄酮醇,由于其在抗肥胖中的作用,最近受到了很多关注。它被认为具有调节脂质代谢的能力,并对抗肥胖有积极作用,但是过程仍然未知。最近的研究表明槲皮素在脂质代谢中的作用可能与其对炎症反应和糖代谢的影响有关。本次审查选择了参考文献,但没有根据它们所涉及的主题应用日期限制,并利用PubMed和SicenceWeb数据库进行了参考研究,使用以下搜索词:\"quercetin\",“肥胖”,\"炎症\",“糖代谢”,“胰岛素敏感性”,等。本文综述了槲皮素通过抗炎和降糖信号通路缓解脂质代谢的潜在机制。并描述了炎症和糖代谢相互作用中可能的信号通路,以期为未来槲皮素在脂质代谢调控中的研究和应用提供参考。
    Fat synthesis and lipolysis are natural processes in growth and have a close association with health. Fat provides energy, maintains physiological function, and so on, and thus plays a significant role in the body. However, excessive/abnormal fat accumulation leads to obesity and lipid metabolism disorder, which can have a detrimental impact on growth and even harm one\'s health. Aside from genetic effects, there are a range of factors related to obesity, such as excessive nutrient intake, inflammation, glycometabolism disease, and so on. These factors could serve as potential targets for anti-obesity therapy. Quercetin is a flavonol that has received a lot of attention recently because of its role in anti-obesity. It was thought to have the ability to regulate lipid metabolism and have a positive effect on anti-obesity, but the processes are still unknown. Recent studies have shown the role of quercetin in lipid metabolism might be related to its effects on inflammatory responses and glycometabolism. The references were chosen for this review with no date restrictions applied based on the topics they addressed, and the databases PubMed and Web of Sicence was used to conduct the references research, using the following search terms: \"quercetin\", \"obesity\", \"inflammation\", \"glycometabolism\", \"insulin sensitivity\", etc. This review summarizes the potential mechanisms of quercetin in alleviating lipid metabolism through anti-inflammatory and hypoglycemic signaling pathways, and describes the possible signaling pathways in the interaction of inflammation and glycometabolism, with the goal of providing references for future research and application of quercetin in the regulation of lipid metabolism.
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  • 文章类型: Journal Article
    恶性肿瘤是全球第二大常见死亡原因。人们越来越关注人体氧化还原平衡受损与癌症发病率之间的联系。来自植物的多酚受到了很多关注,因为它们的特性之一是抗氧化特性:消除活性氧和氮的能力,螯合特定的金属离子,调节影响炎症的信号通路,并提高抗氧化酶的水平和活性,同时降低具有氧化作用的酶。以下三种化合物,白藜芦醇,槲皮素,还有姜黄素,是多酚调节多个分子靶标,或增加促凋亡蛋白表达水平和降低抗凋亡蛋白表达水平。在动物和人体内进行的体外和体内实验表明,基于抗氧化特性,将它们用作化学预防剂。这些天然多酚的优点是低毒性和较高剂量的弱副作用。然而,所讨论的化合物的特点是生物利用度和溶解度低,这可能使实现所需效果所需的血液浓度具有挑战性。该溶液可能存在于天然存在的多酚的衍生物中,这些衍生物经过了结构修饰,从而增强了它们的有益效果,或者致力于实现递送抗氧化剂的新方法,从而改善了它们的溶解度和生物利用度。
    Malignant tumors are the second most common cause of death worldwide. More attention is being paid to the link between the body\'s impaired oxidoreductive balance and cancer incidence. Much attention is being paid to polyphenols derived from plants, as one of their properties is an antioxidant character: the ability to eliminate reactive oxygen and nitrogen species, chelate specific metal ions, modulate signaling pathways affecting inflammation, and raise the level and activity of antioxidant enzymes while lowering those with oxidative effects. The following three compounds, resveratrol, quercetin, and curcumin, are polyphenols modulating multiple molecular targets, or increasing pro-apoptotic protein expression levels and decreasing anti-apoptotic protein expression levels. Experiments conducted in vitro and in vivo on animals and humans suggest using them as chemopreventive agents based on antioxidant properties. The advantage of these natural polyphenols is low toxicity and weak adverse effects at higher doses. However, the compounds discussed are characterized by low bioavailability and solubility, which may make achieving the blood concentrations needed for the desired effect challenging. The solution may lie in derivatives of naturally occurring polyphenols subjected to structural modifications that enhance their beneficial effects or work on implementing new ways of delivering antioxidants that improve their solubility and bioavailability.
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  • 文章类型: Journal Article
    目的:本文旨在为槲皮素在骨质疏松症(OP)防治中的临床应用提供理论依据和见解。分析其在骨形成促进中的作用,骨吸收抑制,抗炎,抗氧化作用,和潜在的机制。
    结果:OP,一种普遍的骨骼疾病,以骨矿物质密度降低和骨骼结构受损为特征,增加患者骨折的风险。OP管理的主要方法是药物治疗,槲皮素,一种植物化学化合物,成为最近关注的焦点。这种天然黄酮类化合物对骨髓间充质干细胞具有调节作用,成骨细胞,和破骨细胞,并通过抗炎和抗氧化途径促进骨骼健康和代谢平衡。虽然槲皮素在调节骨代谢方面表现出显著的潜力,有必要进一步开展高质量的临床研究,重点是药用槲皮素.
    OBJECTIVE: This review aims to provide a theoretical basis and insights for quercetin\'s clinical application in the prevention and treatment of osteoporosis (OP), analyzing its roles in bone formation promotion, bone resorption inhibition, anti-inflammation, antioxidant effects, and potential mechanisms.
    RESULTS: OP, a prevalent bone disorder, is marked by reduced bone mineral density and impaired bone architecture, elevating the risk of fractures in patients. The primary approach to OP management is pharmacotherapy, with quercetin, a phytochemical compound, emerging as a focus of recent interest. This natural flavonoid exerts regulatory effects on bone marrow mesenchymal stem cells, osteoblasts, and osteoclasts and promotes bone health and metabolic equilibrium via anti-inflammatory and antioxidative pathways. Although quercetin has demonstrated significant potential in regulating bone metabolism, there is a need for further high-quality clinical studies focused on medicinal quercetin.
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  • 文章类型: Meta-Analysis
    背景:二甲双胍是一种胰岛素增敏剂,广泛用于治疗多囊卵巢综合征患者的胰岛素抵抗。然而,二甲双胍可引起胃肠道副作用。
    目的:本研究表明槲皮素的作用与二甲双胍相当。因此,本研究旨在系统评价槲皮素治疗PCOS的疗效。
    方法:当前对中国国家知识基础设施的系统搜索(CNKI),万方数据信息网站,中国科技期刊数据库(VIP),SinoMed,WebofScience,和PubMed数据库从开始到2024年2月进行。然后通过SYRCLE的偏倚风险工具评估方法学质量,数据采用RevMan5.3软件进行分析。
    结果:10项研究纳入荟萃分析。与模型组相比,PCOS组有显著降低空腹胰岛素(FIS)水平的作用(P=0.0004),空腹血糖(FBG)水平(P=0.01),HOMA-IR水平(P<0.00001),胆固醇水平(P<0.0001),甘油三酯水平(P=0.001),睾酮(T)水平(P<0.00001),黄体生成素(LH)水平(P=0.0003),黄体生成素/卵泡刺激素(LH/FSH)比值(P=0.01),血管内皮生长因子(VEGF)水平(P<0.00001),丙二醛(MDA)水平(P=0.03),超氧化物歧化酶(SOD)水平(P=0.01)和GLUT4mRNA表达(P<0.00001)。
    结论:这项荟萃分析提示槲皮素对PCOS治疗有积极作用。槲皮素可以系统地减少胰岛素,血糖,胆固醇,和代谢途径中的甘油三酯水平。在内分泌通路中,槲皮素可以调节垂体-卵巢轴的功能,降低睾酮和黄体生成素(LH)水平,并降低LH与卵泡刺激素(FSH)的比例。槲皮素可以调节GLUT4基因的表达,并在分子水平上具有抗氧化作用。
    BACKGROUND: Metformin is an insulin sensitizer that is widely used for the treatment of insulin resistance in polycystic ovary syndrome patients. However, metformin can cause gastrointestinal side effects.
    OBJECTIVE: This study showed that the effects of quercetin are comparable to those of metformin. Therefore, this study aimed to systematically evaluate the efficacy of quercetin in treating PCOS.
    METHODS: The present systematic search of the Chinese National Knowledge Infrastructure (CNKI), Wanfang Data Information Site, Chinese Scientific Journals Database (VIP), SinoMed, Web of Science, and PubMed databases was performed from inception until February 2024. The methodological quality was then assessed by SYRCLE\'s risk of bias tool, and the data were analyzed by RevMan 5.3 software.
    RESULTS: Ten studies were included in the meta-analysis. Compared with those in the model group, quercetin in the PCOS group had significant effects on reducing fasting insulin serum (FIS) levels (P = 0.0004), fasting blood glucose (FBG) levels (P = 0.01), HOMA-IR levels (P < 0.00001), cholesterol levels (P < 0.0001), triglyceride levels (P = 0.001), testosterone (T) levels (P < 0.00001), luteinizing hormone (LH) levels (P = 0.0003), the luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio (P = 0.01), vascular endothelial growth factor (VEGF) levels (P < 0.00001), malondialdehyde (MDA) levels (P = 0.03), superoxide dismutase (SOD) levels (P = 0.01) and GLUT4 mRNA expression (P < 0.00001).
    CONCLUSIONS: This meta-analysis suggested that quercetin has positive effects on PCOS treatment. Quercetin can systematically reduce insulin, blood glucose, cholesterol, and triglyceride levels in metabolic pathways. In the endocrine pathway, quercetin can regulate the function of the pituitary-ovarian axis, reduce testosterone and luteinizing hormone (LH) levels, and lower the ratio of LH to follicle-stimulating hormone (FSH). Quercetin can regulate the expression of the GLUT4 gene and has antioxidative effects at the molecular level.
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  • 文章类型: Meta-Analysis
    目的:系统评价抗氧化治疗儿童和青少年注意缺陷多动障碍(ADHD)的安全性和有效性。
    方法:在PubMed,Embase,和Cochrane图书馆从数据库开始到2022年11月12日。两名研究者独立筛选了文献,提取的数据,并对纳入研究的质量进行评价。使用RStudio4.2.1进行网络荟萃分析(PROSPERO注册号CRD42023382824)。
    结果:48项研究涉及12种抗氧化药物(白藜芦醇,碧萝醇,omega-3,omega-6,槲皮素,磷脂酰丝氨酸,杏仁,维生素D,锌,叶酸,银杏叶,乙酰-L-肉碱)最终包括在内,3,650名患者。网络荟萃分析显示,ω-6(0.18),维生素D(0.19),根据SUCRA,槲皮素(0.24)是前三名最安全的药物。omega-3(SUCRA0.35),碧萝诺(SUCRA0.36),维生素D(SUCRA0.27)在改善注意力方面最有效,多动症,和康纳斯家长评定量表(CPRS)的总分,分别。在提高注意力方面,多动症,和康纳斯教师评定量表(CTRS)总分,碧萝醇(SUCRA0.32),磷脂酰丝氨酸+omega-3(SUCRA0.26),锌(SUCRA0.34)是最有效的,分别。在提高注意力方面,多动症评分量表-家长,最佳药物是磷脂酰丝氨酸(SUCRA0.39),白藜芦醇+MPH(SUCRA0.24),和磷脂酰丝氨酸(SUCRA0.34),分别。在提高注意力方面,多动症评分量表的多动症和总分-教师,碧萝醇(SUCRA0.32),维生素D(SUCRA0.31)和维生素D(SUCRA0.18)是最佳药物,分别。在CGI(SUCRA0.95)和CPT(SUCRA0.42)中,omega-36的响应率最高。
    结论:12种抗氧化剂的安全性和有效性排名各不相同。由于纳入研究的方法学质量较低,概率排序不能完全解释临床疗效,结果需要谨慎解释。仍需要更多高质量的研究来验证我们的发现。
    OBJECTIVE: To systematically evaluate the safety and efficacy of antioxidant therapy in children and adolescents with attention deficit hyperactivity disorder (ADHD).
    METHODS: Randomized controlled trials and prospective studies on antioxidant therapy in children and adolescents with ADHD were searched in PubMed, Embase, and Cochrane Library from the inception of databases to November 12, 2022. Two investigators independently screened the literature, extracted data, and evaluated the quality of the included studies. Network meta-analysis (PROSPERO registration number CRD 42023382824) was carried out by using R Studio 4.2.1.
    RESULTS: 48 studies involving 12 antioxidant drugs (resveratrol, pycnogenol, omega-3, omega-6, quercetin, phosphatidylserine, almond, vitamin D, zinc, folic acid, ginkgo biloba, Acetyl-L-carnitine) were finally included, with 3,650 patients. Network meta-analysis showed that omega-6 (0.18), vitamin D (0.19), and quercetin (0.24) were the top three safest drugs according to SUCRA. The omega-3 (SUCRA 0.35), pycnogenol (SUCRA 0.36), and vitamin D (SUCRA 0.27) were the most effective in improving attention, hyperactivity, and total score of Conners\' parent rating scale (CPRS), respectively. In terms of improving attention, hyperactivity, and total score of Conners\' teacher rating scale (CTRS), pycnogenol (SUCRA 0.32), phosphatidylserine+omega-3 (SUCRA 0.26), and zinc (SUCRA 0.34) were the most effective, respectively. In terms of improving attention, hyperactivity and total score of ADHD Rating Scale-Parent, the optimal agents were phosphatidylserine (SUCRA 0.39), resveratrol+MPH (SUCRA 0.24), and phosphatidylserine (SUCRA 0.34), respectively. In terms of improving attention, hyperactivity and total score of ADHD Rating Scale-Teacher, pycnogenol (SUCRA 0.32), vitamin D (SUCRA 0.31) and vitamin D (SUCRA 0.18) were the optimal agents, respectively. The response rate of omega-3+6 was the highest in CGI (SUCRA 0.95) and CPT (SUCRA 0.42).
    CONCLUSIONS: The rankings of safety and efficacy of the 12 antioxidants vary. Due to the low methodological quality of the included studies, the probability ranking cannot fully explain the clinical efficacy, and the results need to be interpreted with caution. More high-quality studies are still needed to verify our findings.
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