槲皮素对实验性非酒精性脂肪肝的疗效的Meta分析

Meta-Analysis of the Effect of Quercetin on Experimental Non-Alcoholic Fatty Liver Disease

摘要: 本研究的目的是系统地评估槲皮素治疗实验性非酒精性脂肪肝(NAFLD)的疗效。方法：检索Pubmed、Embase、Web of Science、Cochrane图书馆、国家生物医学数据库(CBM)、中国知网(CNKI)、维普数据库(VIP)和万方数据库，寻找数据库成立至2022年5月期间所有关于槲皮素治疗实验性NAFLD的中英文随机试验。干预措施包括槲皮素、槲皮素提取物等。观察的理化指标包括肝功能、血糖、血脂和炎症因子等。有两位研究人员都进行了文献回顾和数据提取，然后用Revman 5.4软件进行数据分析。结果：共筛选了11项随机对照动物试验，样本为205只动物。荟萃分析的结果显示1) NAFLD干预组相较模型组在降低ALT (MD−1.62，95%CI为−2.22~−1.03；P = 0. 71；I² = 0%)、AST (MD−2.22，95%Cl为−2.89~−1.55；P = 0.52； I²= 0%)、ALP (MD−3.69，95%Cl为−4.66~−2.71；P = 0.29；I² = 19%)方面的效果更加优越；2) 干预组的血脂改善效果优于模型组，TC (MD−2.22，95%Cl为−2.86~−1.55；P = 0.35；I2 = 9%)、TG (MD−1.33，95%Cl为−1.75~−0.91；P = 0.16；I² = 37%)；3) 血糖(MD−3.30，95%Cl为−4.93~−1.68；P < 0.00001；I² = 86%)以及HOMA-IR (MD−1.71，95%Cl为−2.75~−0.68；P = 0.07；I² = 61%)得到改善；4) 减轻体重(MD−2.79，95%Cl为−3.64~−1.94；P = 0.30；I² = 17%)；5) 降低肝指数(MD−6.19，95%Cl为−8.00~−4.38；P = 0.65；I² = 0%)；6)调节相关炎症因子(TNF-α、IL-6、IL-1β)的表达，表明其起到抗实验性NAFLD作用。结论：槲皮素对NAFLD有明显的疗效，为未来NAFLD的临床治疗提供了指导，但缺点是仍需要足够大的样本和多中心的随机对照试验来证实这点。

Abstract: Objective: To systematically evaluate the efficacy of quercetin in experimental non-alcoholic fatty liver disease (NAFLD), and provide evidence for clinical treatment. Methods: Internet search in Chinese and English databases such as Pubmed, Embase, Web of Science, Cohrane Library, CBM, CNKI, VIP and Wanfang. From the date of the establishment of databases to May 2022, the literature of Chinese and English randomized controlled trials on quercetin treatment of experimental NAFLD was collected. The intervention group consisted of quercetin, quercetin extracts etc. The outcome measures were liver function, blood glucose, blood lipids, inflammatory factor and related physicochemical parameters. After the two researchers reviewed the literature together and extracted the data, they analysed the data using Review Manager 5.4 software. Results: A total of 11 RCT tests and 205 animal cases were included. The results of this Meta analysis showed that 1) ALT (MD−1.62, 95%CI: −2.22~−1.03; P = 0.71; I2 = 0%), AST (MD−2.22, 95%Cl: −2.89~−1.55; P = 0.52; I2 = 0%), ALP (MD−3.69, 95%Cl: −4.66~−2.71; P = 0.29; I2 = 19%) were much lower in the intervention group than in the model one, liver function was improved; 2) TC (MD−2.22, 95%Cl: −2.86~−1.55; P = 0.35; I2 = 9%), TG (MD−1.33, 95%Cl: −1.75~−0.91; P = 0.16; I2 = 37%) were more improved than model group; 3) Blood glucose (MD−3.30, 95%Cl: −4.93~−1.68; P < 0.00001; I2 = 86%) and HOMA-IR (MD−1.71, 95%Cl: −2.75~−0.68; P = 0.07; I2 = 61%) were more improved than model group; 4) Body weight (MD−2.79, 95%Cl: −3.64~−1.94; P = 0.30; I2 = 17%) was more reduced than model group; 5) Liver index (MD−6.19, 95%Cl: −8.00~−4.38; P = 0.65; I2 = 0%) was more reduced than model group; 6) Expression of related inflammatory factors (TNF-α, IL-6, IL-1β) was regulated, which played a role in improving experimental NAFLD. Conclusion: Quercetin has efficacy on experimental NAFLD, as well as the certain guiding significance for NAFLD clinical diagnosis and treatment in the future, but it still needs to be validated by sufficient large sample and multi-center RCT study.