植物甾醇/甾酯对血脂、血胆固醇作用的系统评价研究

A systematic review of the effects of phytosterols/stanols on blood lipid and blood cholesterol profiles

目的系统评价植物甾醇/甾酯的降血脂、血胆固醇作用。方法运用系统评价的方法,全面检索电子数据库:MedLine(1980-2007),EMbase(1980-2007),Co-chrane图书馆临床对照试验资料库(2007年第2期)、中国生物医学文献数据库(1980-2007)、中文科技期刊全文数据库(1980-2007)、国际药学文摘数据库(1980-2007),以及手工检索相关领域其他参考文献。应用Jadad评分法评价纳入研究的方法学质量,提取有效数据,用RevMan4.2软件进行meta分析。结果共纳入20个随机对照试验1273例。meta分析结果显示,植物甾醇/甾酯组与对照组相比可以明显降低TC、LDL-C、TG水平,其值分别为[WMD-0.36,95%CI(-0.46,-0.26),P<0.00001]、[WMD-0.35mmol/l,95%CI(-0.47,-0.22),P<0.00001]、[WMD-0.00mmol/l,95%CI(-0.05,0.05),P=0.97]、[WMD-0.09,95%CI(-0.15,-0.03),P=0.004];植物甾醇/甾酯组对ApoB、TC/HDL、LDL/HDL也有显著作用;但对HDL-C、ApoA1无影响。结论本研究显示,饮料、人造奶油等食品中添加植物甾醇/甾酯(1.5-3.0g/d),能显著降低血胆固醇、血脂。

Objective To assess the effects of phytosterols/stanols in lowering total cholesterol and blood profiles in humans.Methods We searched MEDLINE(1980 to 2007),EMBASE(1980 to 2007),The Cochrane Library(Issue 2,2007),IPA(980 to 2007),CMBdisc,CNKI.We also handsearched some related journals.The quality of included trails was evaluated by Jadad scale and meta-analysis was conducted by RevMan 4.2.Results We identified 20 studies including 1273 cases.The meta-analysis results indicated that the treat group could significantly decrease TC、LDL-C、TG compared with the control group,and the values were \[WMD -0.36,95%CI(-0.46,-0.26),P<0.00001\]、\[WMD -0.35mmol/l,95%CI(-0.47,-0.22),P<0.00001\]、\[WMD -0.00mmol/l,95%CI(-0.05,0.05),P<0.00001\]、\[WMD -0.09,95%CI(-0.15,-0.03),P=0.004\] respectively.ApoB、TC/HDL、LDL/HDL were also significantly influenced by phytosterols/stanols,however HDL-C and ApoA1 were not significantly influenced.Conclusion The review indicated that foods such as drink,margarine enriched with 1.5-3.0g/d phytosterols/stanols a significant cholesterol lowering effect.