一项关于研究姜黄素补充剂对血脂谱影响的随机对照试验的系统评价和荟萃分析的伞状评价
An Umbrella Review of Systematic Reviews and Meta-analyses of Randomized Controlled Trials Investigating the Effect of Curcumin Supplementation on Lipid Profiles.
作者信息
Unhapipatpong Chanita, Julanon Narachai, Shantavasinkul Prapimporn Chattranukulchai, Polruang Nint, Numthavaj Pawin, Thakkinstian Ammarin
机构信息
Division of Clinical Nutrition, Department of Medicine, Khon Kaen Hospital, Khon Kaen 40000, Thailand.
Division of Dermatology, Department of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen 40002, Thailand.
出版信息
Nutr Rev. 2025 Aug 1;83(8):1520-1536. doi: 10.1093/nutrit/nuaf012.
CONTEXT
Dyslipidemia is a major risk factor for atherosclerotic cardiovascular disease (ASCVD), and curcumin may help improve lipid metabolism.
OBJECTIVE
This umbrella review and updated meta-analysis assessed the effects of curcumin supplementation on lipid profiles.
DATA SOURCES
Electronic databases (Medline, Scopus, Cochrane, and Google Scholar) were searched through March 31, 2023, without language restrictions.
DATA EXTRACTION
Two independent authors selected eligible randomized controlled trials (RCTs) involving curcumin supplementation compared with placebo, measuring total cholesterol (TC), low-density-lipoprotein cholesterol (LDL-c), high-density-lipoprotein cholesterol (HDL-c), and triglyceride (TG) levels.
DATA ANALYSIS
This study identified 26 systematic reviews and meta-analyses (MAs) that met the inclusion criteria for the umbrella review. Of these, 53 RCTs, with a corrected coverage area of 9.76% indicating a moderate degree of overlap, were included for re-pooling. Additionally, this study found 19 more RCTs, bringing the total number of studies for the updated MAs to 72.
RESULTS
Curcumin significantly reduced TC, LDL-c, and TG, with mean differences (MDs) of -7.76 mg/dL (95% CI: -11.29, -4.22; I2 = 97%), -5.84 mg/dL (95% CI: -11.63, -0.05; I2 = 98%), and -13.15 mg/dL (95% CI: -17.31, -8.98; I2 = 94%), respectively, and increased HDL-c by 2.4 mg/dL (95% CI: 1.22, 3.57; I2 = 94%). The reductions in LDL-c and TG reached the minimally clinically important differences (MCIDs). However, the reduction in TC and increase in HDL-c did not meet their respective MCIDs. Subgroup analysis showed greater lipid improvements in patients with metabolic-related diseases, particularly type 2 diabetes. Enhanced bioavailability forms of curcumin, supplementation for at least 8 weeks, and exercise yielded additional benefits.
CONCLUSION
The study confirmed that curcumin has an anti-lipidemic effect on patients with noncommunicable diseases. A form of curcumin with enhanced bioavailability is preferred, and supplementation for at least 8 weeks, along with exercise, may be used as an accessible approach to reduce the risk of ASCVD.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration no. CRD42023415577.
背景
血脂异常是动脉粥样硬化性心血管疾病（ASCVD）的主要危险因素，姜黄素可能有助于改善脂质代谢。
目的
本伞状综述和更新的荟萃分析评估了补充姜黄素对血脂谱的影响。
数据来源
检索了截至2023年3月31日的电子数据库（Medline、Scopus、Cochrane和谷歌学术），无语言限制。
数据提取
两名独立作者选择了符合条件的随机对照试验（RCT），这些试验涉及补充姜黄素与安慰剂比较，测量总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-c）、高密度脂蛋白胆固醇（HDL-c）和甘油三酯（TG）水平。
数据分析
本研究确定了26项系统评价和荟萃分析（MA）符合伞状综述的纳入标准。其中，纳入了53项RCT进行重新汇总，校正覆盖面积为9.76%，表明重叠程度适中。此外，本研究又发现了19项RCT，使更新的MA的研究总数达到72项。
结果
姜黄素显著降低了TC、LDL-c和TG，平均差异（MD）分别为-7.76mg/dL（95%CI：-11.29，-4.22；I²=97%）、-5.84mg/dL（95%CI：-11.63，-0.05；I²=98%）和-13.15mg/dL（95%CI：-17.31，-8.98；I²=94%），并使HDL-c升高了2.4mg/dL（95%CI：1.22，3.57；I²=94%）。LDL-c和TG的降低达到了最小临床重要差异（MCID）。然而，TC的降低和HDL-c的升高未达到各自的MCID。亚组分析显示，代谢相关疾病患者，特别是2型糖尿病患者的脂质改善更大。姜黄素的生物利用度增强形式、至少补充8周以及运动产生了额外的益处。
结论
该研究证实姜黄素对非传染性疾病患者具有抗血脂作用。优选生物利用度增强的姜黄素形式，至少补充8周并结合运动，可作为降低ASCVD风险的一种可行方法。
系统评价注册
PROSPERO注册号CRD42023415577。
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