摘要
目的系统评价辅酶Q10(coenzyme Q10,CoQ10)对非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)患者血脂和肝酶的影响。方法计算机检索PubMed、EmBase、Cochrane Library、Web of Science、Proquest、Scopus、CNKI、SinoMed、万方以及维普数据库,收集关于CoQ10对NAFLD患者血脂和肝酶影响的随机对照试验。由2名评价员根据纳入及排除标准筛选文献、提取资料并评价纳入研究的偏倚风险,采用RevMan 5.3软件进行Meta分析。结果共纳入7项随机对照试验,包含374例患者。Meta分析结果显示:与不使用CoQ10的安慰治疗组相比,接受CoQ10治疗的NAFLD患者的血脂指标TC、LDL-C、HDL-C以及肝酶指标ALT和GGT总体上无明显下降,TG和AST下降明显。进行敏感性分析,在排除部分研究后,GGT显著降低。亚组分析显示,基于CoQ10剂量的TC、TG和ALT差异显著,基于干预时间的TG和ALT也显著降低。各研究间未发现发表偏倚。结论NAFLD患者TG和AST水平显著降低,其他血脂和肝酶指标降低并不明显;但敏感性分析和亚组分析显示在某些条件下CoQ10对TC、TG、ALT有显著作用。受纳入研究的质量和数量的影响,仍需更为严谨的多中心、大样本、双盲、随机对照试验进一步验证。
Objective To systematically evaluate the effects of coenzyme Q10(CoQ10)on blood lipids profiles and liver enzymes in patients with non-alcoholic fatty liver disease(NAFLD).Methods PubMed,EmBase,Cochrane Li-brary,Web of Science,Proquest,Scopus,CNKI,SinoMed,WanFang Data and VIP were searched to collect randomized controlled trials(RCTs)assessing the impact of CoQ10 on blood lipids and liver enzymes in NAFLD patients.Two review-ers screened articles,extracted data and assessed the risk of bias of included studies according to predefined criteria.Meta-analysis was conducted by using RevMan 5.3 software.Results A total of 7 RCTs involving 374 patients were included.Meta-analysis showed that compared to placebo,CoQ10 treatment didn′t significantly reduce the blood lipid indexes of TC,LDL-C,HDL-C and liver enzyme indexes ALT and GGT levels in NAFLD patients treated with CoQ10,but TG and AST significantly decreased.Sensitivity analysis showed that GGT decreased significantly after excluding some studies.Subgroup analysis showed significant difference based on CoQ10 dose for TC,TG and ALT,and also a significant decrease in TG and ALT based on the duration of the intervention.No publication bias was observed among the studies.Conclusion The levels of TG and AST in NAFLD patients are significantly decreased,and the other blood lipid and liver enzyme indexes are not significantly decreased.However,sensitivity analysis and subgroup analysis showed that CoQ10 has a significant effect on TC,TG and ALT under certain conditions.Due to the quality and quantity of the included stud-ies,more rigorous multi-center,large sample,double-blind,RCTs are still needed for further verification.
作者
陈禹茜
周本刚
丁岩冰
陈欣然
CHEN Yuqian;ZHOU Bengang;DING Yanbing;CHEN Xinran(Yangzhou University,Yangzhou 225000;Department of Gastroenterology,the Affiliated Hospital of Yangzhou University;Dalian Medical University;Institute of Translational Medicine,Medical College,Yangzhou University,)
出处
《胃肠病学和肝病学杂志》
CAS
2024年第7期883-890,共8页
Chinese Journal of Gastroenterology and Hepatology
基金
国家自然科学基金项目(82273084)
扬州市“十三五”科教强卫专项(YXZX20184)。
