Effect of Fructose on Established Lipid Targets: A Systematic Review and Meta-Analysis of Controlled Feeding Trials
Effect of Fructose on Established Lipid Targets: A Systematic Review and Meta-Analysis of Controlled Feeding Trials
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DOI：
10.1161/jaha.114.001700
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发表时间：
2015-09-01
影响因子：
5.4
通讯作者：
Sievenpiper, John L.
中科院分区：
文献类型：
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作者：
Chiavaroli, Laura;de Souza, Russell J.;Sievenpiper, John L.
背景-关于果糖在介导心血管风险中的作用的争论仍然活跃。更新果糖对心血管疾病既定治疗脂质靶点影响的证据（低密度脂蛋白胆固醇[LDL]-C、载脂蛋白B、非高密度脂蛋白胆固醇[HDL-C]）和代谢综合征（甘油三酯和HDL-C），我们进行了系统的审查和荟萃分析控制喂养试验。和科克伦图书馆检索了截至2015年7月7日的随访>= 7天的对照喂养试验，这些试验研究了口服果糖与对照碳水化合物相比对所有健康背景的参与者的脂质（LDL-C、载脂蛋白B、非HDL-C、甘油三酯和HDL-C）的影响。两名独立审查员提取了相关数据。使用随机效应模型合并数据，并表示为平均差异和95% CI。研究间异质性进行了评估（Cochran Q统计）和量化（I-2统计）。符合资格标准的51等热量试验（n=943），其中果糖提供等热量交换其他碳水化合物，和8高热量试验（n=125），其中果糖补充控制饮食与多余的热量相比，控制饮食没有多余的热量。在等热量试验中，果糖对LDL-C、非HDL-C、载脂蛋白B、甘油三酯或HDL-C没有影响。然而，在高热量试验中，果糖增加了载脂蛋白B（n=2项试验;平均差异= 0.18 mmol/L; 95% CI：0.05，0.30; P=0.005）和甘油三酯（n=8项试验;平均差异= 0.26 mmol/L; 95% CI：0.11，0.41; P = 0.005）。
Background-Debate over the role of fructose in mediating cardiovascular risk remains active. To update the evidence on the effect of fructose on established therapeutic lipid targets for cardiovascular disease (low-density lipoprotein cholesterol [LDL]-C, apolipoprotein B, non-high-density lipoprotein cholesterol [HDL-C]), and metabolic syndrome (triglycerides and HDL-C), we conducted a systematic review and meta-analysis of controlled feeding trials.Methods and Results-MEDLINE, EMBASE, CINHAL, and the Cochrane Library were searched through July 7, 2015 for controlled feeding trials with follow-up >= 7 days, which investigated the effect of oral fructose compared to a control carbohydrate on lipids (LDL-C, apolipoprotein B, non-HDL-C, triglycerides, and HDL-C) in participants of all health backgrounds. Two independent reviewers extracted relevant data. Data were pooled using random effects models and expressed as mean difference with 95% CI. Interstudy heterogeneity was assessed (Cochran Q statistic) and quantified (I-2 statistic). Eligibility criteria were met by 51 isocaloric trials (n=943), in which fructose was provided in isocaloric exchange for other carbohydrates, and 8 hypercaloric trials (n=125), in which fructose supplemented control diets with excess calories compared to the control diets alone without the excess calories. Fructose had no effect on LDL-C, non-HDL-C, apolipoprotein B, triglycerides, or HDL-C in isocaloric trials. However, in hypercaloric trials, fructose increased apolipoprotein B (n=2 trials; mean difference = 0.18 mmol/L; 95% CI: 0.05, 0.30; P=0.005) and triglycerides (n=8 trials; mean difference = 0.26 mmol/L; 95% CI: 0.11, 0.41; P