Effects of ginseng on C-reactive protein level: A systematic review and meta-analysis of clinical trials.

The aim of this meta-analysis was to assess effects of ginseng supplementation on CRP/hs-CRP levels in clinical trial studies. A systematic literature search was carried out for clinical trials published in ISI web of Science, Scopus, PubMed and Cochrane Library databases from the beginning to 16th February 2018. Of 83 articles found in the first step of the systematic search, seven studies with nine arms included in this meta-analysis. Results of pooled random-effect size analysis of nine trials showed non-significant decreasing effects of ginseng supplementation on CRP level (WMD: -0.1 mg/l, 95% CI, -0.26, 0.1; P = 0.27) with significant heterogeneity shown within the studies. The subgroup analysis showed that ginseng supplementation could significantly reduce CRP level by 0.51 (95% CI: -0.68, -0.34; P < 0001, test for heterogeneity: P = 0.44, I2 = 0.0%) in patients with a baseline serum CRP level of greater than 3 mg/dl. Trial duration and dose of ginseng supplementation included no significant effects on CRP level in this meta-analysis. Results of the current meta-analysis study have shown that ginseng supplementation can decrease significantly serum CRP/hsCRP levels in patients with elevated serum level of this inflammatory marker.

Saboori S ，Falahi E ，Yousefi Rad E ，Asbaghi O ，Khosroshahi MZ ... -  《-》

Effects of alpha-lipoic acid supplementation on C-reactive protein level: A systematic review and meta-analysis of randomized controlled clinical trials.

The aim of this meta-analysis was to assess effects of alpha-lipoic acid supplementation on C-reactive protein (CRP) levels in clinical trial studies. A systematic search was carried out on clinical trial studies published in PubMed, ISI Web of Science, Cochrane Library and Scopus databases completed by manual search on reference list of eligible studies accomplished by November 4, 2017. Of a total number of 508 studies found in the first step of literature search, only 11 were included with 264 participants in supplementation groups and 287 in control groups. Estimated pooled random effects size analysis showed a significant reducing effect of alpha-lipoic acid supplementation on CRP level (-0.72 mg/l, 95% CI; -1.4, -0.04; P = 0.03) with a significant heterogeneity between the selected studies. Sub-group analysis showed that alpha-lipoic acid supplementation could significantly reduce serum CRP level when the baseline CRP level was greater than 3 mg/l (-1.02 mg/l, 95% CI: -1.3, -0.73) and when trial duration was >8 weeks (-0.99 mg/l, 95% CI: -1.29, -0.70). Results of subgroup analysis also showed that alpha lipoic acid supplementation could decrease CRP level only in non-diabetic patients (-1.02 mg/l, 95% CI: -1.31, -0.74). Results of the current meta-analysis study showed that alpha-lipoic acid supplementation could significantly decrease CRP level in patients with elevated levels of this inflammatory marker.

Saboori S ，Falahi E ，Eslampour E ，Zeinali Khosroshahi M ，Yousefi Rad E ... -  《-》

Effects of ginseng supplementation on selected markers of inflammation: A systematic review and meta-analysis.

The present meta-analysis was performed to evaluate the efficacy of ginseng administration on serum level of inflammatory biomarkers. We performed a systematic search of all available randomized controlled trials (RCTs) conducted up to June 2018 in the following electronic databases: PubMed, Scopus, Cochrane, and Google Scholar. RCTs that investigated the effect ginseng supplementation on high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were included for final analysis. A total of seven RCTs were included in the meta-analysis. Results indicated significant reduction in IL-6 (mean difference [MD]: -0.265 pg/ml, 95% CI [-0.396, -0.135], p < .001) and TNF-α (MD: -2.471 pg/ml, 95% CI [-2.904, -2.039], p < .001) and no significant change in hs-CRP (MD: -0.125 mg/L, 95% CI [-0.597, 0.347], p = .604). Although there was publication bias across studies, trim and fill analysis showed that results from unpublished studies could not change the results for CRP. However, removing one study in sensitivity analysis did reveal a significant reduction in CRP. We conclude that ginseng supplementation significantly lowered IL-6 and TNF-α but did not significantly lower CRP. However, these findings were not robust, because they showed sensitivity for CRP and IL-6, and future long-term well-designed dose-escalating trials are required.

Mohammadi H ，Hadi A ，Kord-Varkaneh H ，Arab A ，Afshari M ，Ferguson AJR ，Ghaedi E ... -  《-》

Effect of cinnamon (Cinnamomum Zeylanicum) supplementation on serum C-reactive protein concentrations: A meta-analysis and systematic review.

The effect of cinnamon (Cinnamomum Zeylanicum) on serum C-reactive protein (CRP), an acute phase protein commonly used as a marker of inflammation, is uncertain. Therefore, the objective of the present study was to conduct a systematic review and meta-analysis of published randomised controlled trials (RCTs) of cinnamon to determine the effect on levels of serum CRP, relative to controls. Studies were identified by a search of electronic databases including PubMed, Cochrane Library, Google Scholar and Scopus before August 2018. Combined and stratified analyses were used. Weighted mean differences (WMD) and its 95% confidence interval were estimated for net change in serum CRP by using random-effects model. The heterogeneity of meta-analysis was assessed by χ2 and I2 test. Six studies were identified, and data from 285 participants were included. Pooled analysis showed significant reductions in serum CRP (WMD: -0.81 mg/L, 95% CI: -1.36 to -0.26, p = 0.004), with significant heterogeneity between selected studies. Improvements in sub-group analysis were observed when baseline CRP levels were greater than 3 mg/dL, and in trials of >12 weeks duration. Doses <1500 mg/day and ≥1500 mg/day were effective in lowering serum CRP (WMD: -0.56 mg/dL, 95% CI: -1.01 to -0.10, p = 0.02 and WMD: -2.13 mg/dL, 95% CI: -4.08 to -0.19, p = 0.03), respectively, with significantly reduced heterogeneity in trials with lower doses of cinnamon <1500 mg/day (test for heterogeneity: P = 0.22 and I2 = 33%). No changes were found in controls. Cinnamon supplementation improves levels of serum CRP, particularly in chronic conditions, where basal CRP levels are raised. Further well-designed studies are warranted to confirm or not the above-mentioned findings.

Vallianou N ，Tsang C ，Taghizadeh M ，Davoodvandi A ，Jafarnejad S ... -  《-》

A Meta-analysis of Randomized Control Trials: The Impact of Vitamin C Supplementation on Serum CRP and Serum hs-CRP Concentrations.

The present meta-analysis was designed to assess the effects of vitamin C supplementation on serum C-reactive Protein (CRP) levels. We conducted a comprehensive systematic search of the literature in Scopus, PubMed and Google Scholar until May 2018. The pooled Weighted Mean Difference (WMD) and its 95% Confidence Interval (CI) in baseline and at the end of the trial were calculated to assess the net change in serum CRP by using random-effects model. The heterogeneity was assessed by I2 test. Combined and stratified analyses were used in the metaanalysis. From 306 articles found and screened in our initial search, 12 studies were included with 446 participants in supplementation groups and 447 in control groups. The pooled effect size analysis showed a significant reducing effect of vitamin C supplementation on circulating CRP level (-0.23 mg/L, 95% CI, -0.44, -0.03, p=0.02), with a significant heterogeneity effect across the studies involved. Subgroup analyses showed that vitamin C supplementation significantly lowered CRP among trials. The most significant effect was found 1) on hs- CRP as the representative inflammatory marker (-0.43 mg/L, 95% CI -0.76, -0.1) 2) in subjects with a baseline CRP≥3 (-1.48 mg/L, 95% CI -2.84, -0.11) 3) in subjects under <60 years old of age (-0.23 mg/L, 95% CI -0.44,- 0.01) 4) or using intravenous administration of vitamin C (-0.89 mg/L, 95% CI -1.49,-0.3). The present meta-analysis shows that vitamin C supplementation reduces serum CRP level, particularly in younger subjects, with higher CRP baseline level, at a lower dosage and intravenous administration.

Jafarnejad S ，Boccardi V ，Hosseini B ，Taghizadeh M ，Hamedifard Z ... -  《-》