姜黄素对2型糖尿病患者炎症及氧化应激影响的meta分析

doi:10.3969/j.issn.1004-583X.2024.11.002

摘要/Abstract

摘要：

目的评价姜黄素对2型糖尿病(T2DM)患者炎症反应及氧化应激的影响。方法通过检索Pubmed、Embase、Web of science、Cochrane等数据库,收集姜黄素辅助治疗T2DM患者的随机对照临床试验,对符合纳入标准的研究提取数据后,采用RevMan 5.3软件进行系统评价和meta分析。结果共纳入11项RCT研究,患者645例。与对照组相比, 干预组治疗后超敏C反应蛋白(hs-CRP)水平无明显差异(P=0.07)[SMD=-0.35,95%CI(-0.73,0.03),I²=73%],总抗氧化能力(TAC)水平明显增高(P<0.001)[SMD=0.47,95%CI(0.26,0.68),I²=34%],丙二醛(MDA)水平明显减低(P=0.03)[MD=-0.48,95%CI(-0.91,-0.05),I²=90%]。涉及hs-CRP和MDA的研究异质性较大,进一步根据年龄、治疗时间、姜黄素剂量进行亚组分析未发现异质性来源。结论补充姜黄素可减轻T2DM患者的氧化应激反应,提高机体抗氧化能力,但对炎症反应无明显改善。

关键词: 糖尿病, 2型, 姜黄素, 炎症, 氧化应激

Abstract:

Objective To evaluate the effect of curcumin on inflammation and oxidative stress of patients with type 2 diabetes mellitus(T2DM). Methods Randomized controlled trials (RCTs) of curcumin supplementation for T2DM were collected by searching Pubmed, Embase, Web of science, Cochrane and other databases. Meta-analysis was performed by RevMan5.3 statistical software after data extraction of eligible studies. Results A total of 11 RCTs representing 645 patients were included. The results showed that there was no significant difference in high-sensitive C-reactive protein (hs-CRP) level between the intervention group and the control group after treatment (P=0.07) (SMD=-0.35, 95%CI[-0.73, 0.03], I²=73%). But the total antioxidant capacity (TAC) increased (P<0.001)(SMD=0.47, 95%CI[0.26, 0.68], I²=34%), and the malonaldehyde (MDA) reduced (P=0.03)(MD=-0.48, 95%CI[-0.91, -0.05], I²=90%) significantly in the intervention group compared with the control group. The heterogeneity of studies involved hs-CRP and MDA was great, but subgroup analysis based on age, duration of treatment, and curcumin dose did not found the sources of heterogeneity. Conclusion The curcumin could reduce the oxidative stress and improve the antioxidant capacity of T2DM patients, but it produced no significant effect on inflammation.

Key words: diabetes mellitus, type 2, curcumin, inflammation, oxidative stress

中图分类号:

R587.1

梁祎. 姜黄素对2型糖尿病患者炎症及氧化应激影响的meta分析[J]. 临床荟萃, 2024, 39(11): 974-979.

Liang Yi. Meta-analysis of effects of curcumin on inflammation and oxidative stress of patients with type 2 diabetes mellitus[J]. Clinical Focus, 2024, 39(11): 974-979.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2024.11.002

https://huicui.hebmu.edu.cn/CN/Y2024/V39/I11/974

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参考文献 26

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纳入研究	国家	人数 (干预/对照)	性别 (女/男)	年龄 (干预/对照)	干预措施	伴随疾病	干预时间	涉及的结局指标
Panahi ^[6],2017	伊朗	50/50	49/51	43±8/41±7	姜黄素C3复合物1 000 mg/d+胡椒碱10 mg/d	-	8周	TAC,MDA
Panahi ^[7],2018	伊朗	50/50	49/51	43±8/41±7	姜黄素C3复合物1 000 mg/d+胡椒碱10 mg/d	-	12周	CRP
Shafabakhsh ^[8],2020	伊朗	25/24	-	64.9±7.8/66.5±7.7	姜黄素提取物1 000 mg/d	冠心病	12周	TAC, MDA
Shafabakhsh ^[9],2020	伊朗	26/27	21/32	58.3±9.4/56.2±9.8	纳米姜黄素80 mg/d	行血液透析的肾脏病	12周	TAC, MDA, CRP
Adibian ^[10],2019	伊朗	21/23	22/22	58/60±7	姜黄素提取物1 500 mg/d	-	10周	CRP
Hodaei ^[11],2019	伊朗	21/23	-	58±8/60±7	姜黄素提取物1 500 mg/d	-	10周	TAC, MDA
Adab ^[12],2019	伊朗	39/26	39/36	54.76±6/55.66±8.64	姜黄粉2 100 mg/d	高脂血症	8周	TAC, CRP
Mokhtari ^[13],2021	伊朗	25/25	11/39	57.4±11.7/55.8±9.4	纳米姜黄素80 mg/d	糖尿病足溃疡3期	12周	TAC, MDA, CRP
Dastani ^[14],2022	伊朗	32/32	39/25	60.00±7.22/60.53±10.55	纳米姜黄素80 mg/d	冠脉疾病	12周	CRP
Funamoto ^[15],2019	日本	15/17	10/22	70±6/69±7	姜黄素180 mg/d	包括部分糖耐量异常者	24周	CRP
Usharani ^[16],2008	印度	23/21	21/23	55.52±10.76/49.75±8.18	NCB-02 (姜黄素提取物300 mg bid)	-	8周	MDA

纳入研究	国家	人数 (干预/对照)	性别 (女/男)	年龄 (干预/对照)	干预措施	伴随疾病	干预时间	涉及的结局指标
Panahi ^[6],2017	伊朗	50/50	49/51	43±8/41±7	姜黄素C3复合物1 000 mg/d+胡椒碱10 mg/d	-	8周	TAC,MDA
Panahi ^[7],2018	伊朗	50/50	49/51	43±8/41±7	姜黄素C3复合物1 000 mg/d+胡椒碱10 mg/d	-	12周	CRP
Shafabakhsh ^[8],2020	伊朗	25/24	-	64.9±7.8/66.5±7.7	姜黄素提取物1 000 mg/d	冠心病	12周	TAC, MDA
Shafabakhsh ^[9],2020	伊朗	26/27	21/32	58.3±9.4/56.2±9.8	纳米姜黄素80 mg/d	行血液透析的肾脏病	12周	TAC, MDA, CRP
Adibian ^[10],2019	伊朗	21/23	22/22	58/60±7	姜黄素提取物1 500 mg/d	-	10周	CRP
Hodaei ^[11],2019	伊朗	21/23	-	58±8/60±7	姜黄素提取物1 500 mg/d	-	10周	TAC, MDA
Adab ^[12],2019	伊朗	39/26	39/36	54.76±6/55.66±8.64	姜黄粉2 100 mg/d	高脂血症	8周	TAC, CRP
Mokhtari ^[13],2021	伊朗	25/25	11/39	57.4±11.7/55.8±9.4	纳米姜黄素80 mg/d	糖尿病足溃疡3期	12周	TAC, MDA, CRP
Dastani ^[14],2022	伊朗	32/32	39/25	60.00±7.22/60.53±10.55	纳米姜黄素80 mg/d	冠脉疾病	12周	CRP
Funamoto ^[15],2019	日本	15/17	10/22	70±6/69±7	姜黄素180 mg/d	包括部分糖耐量异常者	24周	CRP
Usharani ^[16],2008	印度	23/21	21/23	55.52±10.76/49.75±8.18	NCB-02 (姜黄素提取物300 mg bid)	-	8周	MDA

纳入研究	选择偏倚	实施偏倚	随访偏倚	测量偏倚	报告偏倚	总体偏倚风险
Panahi ^[6],2017	低风险	低风险	低风险	高风险	不明确	高风险
Panahi ^[7],2018	不明确	低风险	低风险	低风险	低风险	不明确
Shafabakhsh ^[8],2020	低风险	低风险	低风险	低风险	高风险	高风险
Shafabakhsh ^[9],2020	低风险	低风险	低风险	低风险	低风险	低风险
Adibian ^[10],2019	低风险	低风险	低风险	低风险	低风险	低风险
Hodaei ^[11],2019	低风险	低风险	低风险	低风险	低风险	低风险
Adab ^[12],2019	低风险	低风险	低风险	低风险	低风险	低风险
Mokhtari ^[13],2021	低风险	低风险	低风险	低风险	低风险	低风险
Dastani ^[14],2022	低风险	低风险	低风险	低风险	低风险	低风险
Funamoto ^[15],2019	低风险	低风险	低风险	低风险	低风险	低风险
Usharani ^[16],2008	不明确	低风险	低风险	低风险	低风险	不明确

纳入研究	选择偏倚	实施偏倚	随访偏倚	测量偏倚	报告偏倚	总体偏倚风险
Panahi ^[6],2017	低风险	低风险	低风险	高风险	不明确	高风险
Panahi ^[7],2018	不明确	低风险	低风险	低风险	低风险	不明确
Shafabakhsh ^[8],2020	低风险	低风险	低风险	低风险	高风险	高风险
Shafabakhsh ^[9],2020	低风险	低风险	低风险	低风险	低风险	低风险
Adibian ^[10],2019	低风险	低风险	低风险	低风险	低风险	低风险
Hodaei ^[11],2019	低风险	低风险	低风险	低风险	低风险	低风险
Adab ^[12],2019	低风险	低风险	低风险	低风险	低风险	低风险
Mokhtari ^[13],2021	低风险	低风险	低风险	低风险	低风险	低风险
Dastani ^[14],2022	低风险	低风险	低风险	低风险	低风险	低风险
Funamoto ^[15],2019	低风险	低风险	低风险	低风险	低风险	低风险
Usharani ^[16],2008	不明确	低风险	低风险	低风险	低风险	不明确

亚组	研究数	干预组数量	对照组数量	P	效应量(95%CI)	I²
年龄(岁)
>60	3	68	73	0.09	-0.70(-1.52, 0.12)	81%
<60	4	140	138	0.49	-0.13(-0.49, 0.23)	56%
干预时间(w)
≥12	5	148	152	0.07	-0.50(-1.04, 0.04)	80%
<12	2	60	59	0.86	-0.03(-0.39, 0.33)	0%
干预剂量(mg/d)
≥500	3	110	109	0.50	0.09(-0.17, 0.36)	0%
<500	4	98	102	0.007	-0.69(-1.20, -0.19)	66%