背景:白藜芦醇是一种非类黄酮多酚,在减少促炎因子和维持内皮功能方面显示出希望,这暗示了它在减缓动脉粥样硬化和预防急性冠状动脉事件中的潜在作用。
目的:研究白藜芦醇对冠心病患者炎症介质和内皮功能的保护作用。
方法:在数据库中进行了彻底的搜索(CochraneLibrary,ProQuest,PubMed,LILACS,ScienceDirect,Springer,泰勒和弗朗西斯,CNKI,万方,和威普),直到2023年9月24日。血管炎症介质,观察血管内皮功能和与心血管事件相关的结局.标题和摘要进行了评估,用CochraneRoB2.0评估偏倚。通过元回归探索结果的异质性,证据的确定性由等级系统评估,试验序列分析增强了确凿证据.
结果:10项随机对照试验和3项动物试验研究了白藜芦醇对炎症介质和内皮功能的影响。在初级预防研究中,荟萃分析显示,白藜芦醇对肿瘤坏死因子-α(TNF-α)的表达显着降低(95%CI:-0.73至-0.20;P=0.0005),显示剂量依赖性关系。白细胞介素-6(IL-6)表达无明显差异,一级预防P=0.58,二级预防P=0.57。CAD事件后白藜芦醇预处理后,血管内皮一氧化氮合酶(eNOS)表达显着增加。二级预防研究没有取得显著成果;然而,元回归确定了年龄之间的关联,高血压,和低剂量与TNF-α改变的程度。证据的高确定性支持TNF-α减少,而IL-6减少和eNOS升高的证据被认为是低的。
结论:白藜芦醇可降低冠心病风险个体的TNF-α,特别是每天15毫克。然而,由于年龄等因素,其在确诊CAD患者中的有效性受到限制,高血压,剂量不足。由于样本量小,IL-6的减少尚无定论。动物研究表明白藜芦醇通过增加eNOS增强内皮功能。(PROSPERO注册号CRD42023465234)。
BACKGROUND: Resveratrol is a non-flavonoid polyphenol that shows promise in reducing pro-inflammatory factors and maintaining endothelial function, which hints at its potential role in slowing atherosclerosis and preventing acute coronary events.
OBJECTIVE: To study the cardioprotective effects of resveratrol on inflammatory mediators and endothelial function in patients with coronary artery disease (CAD).
METHODS: A thorough search was conducted in databases (Cochrane Library, ProQuest, PubMed, LILACS, ScienceDirect, Springer, Taylor&Francis, CNKI, Wanfang, and Weipu) until September 24, 2023. The vasopro-inflammatory mediators, endothelial function and outcomes related to cardiovascular events were observed. Titles and abstracts were assessed, and bias was evaluated with Cochrane RoB 2.0. Heterogeneity of results was explored by meta-regression, certainty of evidence was assessed by the GRADE system, and conclusive evidence was enhanced by trial sequence analysis.
RESULTS: Ten randomized controlled trials and 3 animal studies investigated resveratrol\'s impact on inflammatory mediators and endothelial function. In primary prevention studies, meta-analysis showed a significant reduction (95% CI: -0.73 to -0.20; P=0.0005) in tumor necrosis factor-α (TNF-α) expression with resveratrol, demonstrating a dose-dependent relationship. No significant difference was observed in interleukin-6 (IL-6) expression with P=0.58 for primary prevention and P=0.57 for secondary prevention. Vascular endothelial nitric oxide synthase (eNOS) expression was significantly increased after resveratrol pre-treatment following CAD events. Secondary prevention studies yielded no significant results; however, meta-regression identified associations between age, hypertension, and lower doses with the extent of TNF-α alterations. High certainty of evidence supported TNF-α reduction, while evidence for IL-6 reduction and eNOS elevation was deemed low.
CONCLUSIONS: Resveratrol reduces TNF-α in individuals at risk for CAD, specifically 15 mg per day. However, its usefulness in patients with confirmed CAD is limited due to factors such as age, high blood pressure, and insufficient dosage. Due to the small sample size, the reduction of IL-6 is inconclusive. Animal studies suggest that resveratrol enhances endothelial function by increasing eNOS. (PROSPERO registration No. CRD42023465234).