Red Yeast Rice Preparations Reduce Mortality, Major Cardiovascular Adverse Events, and Risk Factors for Metabolic Syndrome: A Systematic Review and Meta-analysis.
Red Yeast Rice Preparations Reduce Mortality, Major Cardiovascular Adverse Events, and Risk Factors for Metabolic Syndrome: A Systematic Review and Meta-analysis.
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DOI：
10.3389/fphar.2022.744928
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发表时间：
2022
影响因子：
5.6
通讯作者：
and BPNMI Consortium
中科院分区：
文献类型：
--
作者：
Yuan R;Yuan Y;Wang L;Xin Q;Wang Y;Shi W;Miao Y;Leng SX;Chen K;Cong W;and BPNMI Consortium
背景：代谢综合征（MetS）的特征是肥胖、胰岛素抵抗、血脂异常和高血压的共同发生。红曲制剂可能对MetS的预防和治疗有益。 目的：实施系统性综述和Meta分析，以确定RYR制剂是否改善临床终点并减少MetS的风险因素。 研究方法：在PubMed、科克伦图书馆、EMBASE、Scopus、中国知网、中国维普信息和万方数据库中检索随机对照试验（截至2020年9月发表），并使用固定或随机效应模型进行Meta分析。主要结局指标为死亡率和主要不良心血管事件（MACE），次要结局指标为血糖、血脂和血压等生化参数。注册号为CRD 42020209186。 结果：共检索到921篇文献，其中30篇纳入本文。RYR制剂组与对照组相比，MetS表现出显著改善。RYR制剂降低了死亡率和MACE（RR = 0.62，95% CI [0.49，0.78]; RR = 0.54，95% CI [0.43，0.66]）。在血糖代谢方面，空腹血糖（FPG）（MD = −0.46 mmol/L，95% CI [−0.71，−0.22]），血红蛋白A1 c（HbA 1c）（MD = −0.49，95% CI [−0.71，−0.26]）和胰岛素抵抗的稳态模型评估（HOMA−IR）（MD = −0.93，95% CI [−1.64，−0.21]）降低。关于脂质代谢，总胆固醇（TC）（MD = −0.74 mmol/L，95% CI [−1.02，−0.46]），甘油三酯（TG）（MD = −0.45 mmol/L，95% CI [−0.70，−0.21]）和低密度脂蛋白胆固醇（LDL）（MD = −0.42 mmol/L，95% CI [−0.78，−0.06]）降低，而高密度脂蛋白胆固醇（HDL）（MD = 0.14 mmol/L，95% CI [0.09，0.20]）升高。关于血压，平均动脉压（MAP）（MD = −3.79 mmHg，95% CI [−5.01，−2.57]）降低。此外，RYR制剂未增加不良反应的发生率（RR = 1.00，95%CI [0.69，1.43]）。 结论：RYR制剂可降低MetS的死亡率、MACE和多种风险因素，而不会影响安全性，这支持其用于预防和治疗MetS。然而，由于本研究的异质性，需要额外的高质量研究来提供RYR对MetS影响的更多证据。 系统综述注册：www.crd.york.ac.uk/PROSPERO，标识符CRD 42020209186
Background: Metabolic syndrome (MetS) is characterized by the cooccurrence of obesity, insulin resistance, dyslipidaemia, and hypertension. Red yeast rice (RYR) preparations might be beneficial for the prevention and treatment of MetS. Objective: To implement a systematic review and meta−analysis to determine whether RYR preparations improve clinical endpoints and reduce risk factors for MetS. Methods: The PubMed, Cochrane Library, EMBASE, Scopus, China National Knowledge Infrastructure, Chinese VIP Information, and WanFang databases were searched for randomized controlled trials (published up to September 2020), and a meta−analysis was performed using fixed− or random−effects models. The primary outcome measures were mortality and major adverse cardiovascular events (MACEs), and the secondary outcome measures were biochemical parameters of blood glucose, blood lipids, and blood pressure. The registration number is CRD42020209186. Results: A total of 921 articles were identified, of which 30 articles were included in this article. RYR preparations group demonstrated significant improvements in MetS compared with control group. RYR preparations reduced the mortality and MACEs (RR = 0.62, 95% CI [0.49, 0.78]; RR = 0.54, 95% CI [0.43, 0.66]). In terms of blood glucose metabolism, fasting plasma glucose (FPG) (MD = −0.46 mmol/L, 95% CI [−0.71, −0.22]), haemoglobin A1c (HbA1c) (MD = −0.49, 95% CI [−0.71, −0.26]) and the homeostasis model assessment of insulin resistance (HOMA−IR) (MD = −0.93, 95% CI [−1.64, −0.21]) were decreased. Regarding the lipid metabolism, total cholesterol (TC) (MD = −0.74 mmol/L, 95% CI [−1.02, −0.46]), triglycerides (TG) (MD = −0.45 mmol/L, 95% CI [−0.70, −0.21]), and low−density lipoprotein cholesterol (LDL) (MD = −0.42 mmol/L, 95% CI [−0.78, −0.06]) were decreased, while high−density lipoprotein cholesterol (HDL) (MD = 0.14 mmol/L, 95% CI [0.09, 0.20]) was increased. Regarding blood pressure, the mean arterial pressure (MAP) (MD = −3.79 mmHg, 95% CI [−5.01, −2.57]) was decreased. In addition, RYR preparations did not increase the incidence of adverse reactions (RR = 1.00, 95% CI [0.69, 1.43]). Conclusion: RYR preparations reduce mortality, MACEs, and multiple risk factors for MetS without compromising safety, which supports its application for the prevention and treatment of MetS. However, additional high−quality studies are needed to provide more evidence for the effect of RYR on MetS due to the heterogeneity in this study. Systematic Review Registration: www.crd.york.ac.uk/PROSPERO, identifier CRD42020209186
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