口服镁补充剂对血管和内皮功能的影响：一项更新的随机对照试验系统评价与荟萃分析。
完整摘要 · 中文译文
背景：镁被认为通过其对内皮功能、血管僵硬度和血压的影响，在心血管健康中发挥作用。本系统综述和荟萃分析旨在更新并评估镁补充剂对成人血管功能和心脏代谢结局的影响。 方法：基于PRISMA 2020指南，对PubMed、Web of Science、Scopus、CENTRAL和ClinicalTrials.gov进行了系统检索，检索时间截至2026年4月23日，以纳入评估镁补充剂对血流介导的扩张（FMD）、脉搏波速度（PWV）和颈动脉内膜-中层厚度（CIMT）影响的随机安慰剂对照试验，并将血清镁水平及收缩压和舒张压作为次要结局。同时进行了随机效应模型、亚组分析（剂量、持续时间、剂型）、荟萃回归、敏感性分析和发表偏倚评估。 结果：本研究共纳入十二项随机对照试验，其中镁组389例患者，安慰剂组276例患者。镁补充剂对FMD总体无显著影响（均差 = 2.86；95% 置信区间：-1.31至7.03；p = 0.18）。然而，剂量 > 400 mg/天显著改善FMD（均差 = 8.32；95% 置信区间：3.45至13.19；p < 0.01），但仅包含2项研究。CIMT显著降低（均差 = -0.08；95% 置信区间：-0.15至-0.01；p = 0.03），而PWV无显著变化（均差 = -0.17；95% 置信区间：-0.60至0.25；p = 0.43）。血清镁水平显著升高（均差 = 0.05；9 5% CI：0.02 至 0.07；p < 0.01）在总体及亚组中均如此，而血压降低未达到统计学显著性（p > 0.3）。Meta回归显示，较高镁剂量和较高基线收缩压对FMD有显著修饰作用，基线体重指数（BMI）、基线PWV和基线CIMT与FMD呈显著负相关。 结论：补充镁可能改善内皮功能并降低CIMT，尤其在较高剂量时，但由于研究数量有限且对动脉僵硬度及血压的影响不一致，应谨慎解读该结果。需要进一步开展大规模试验以确认最佳给药策略及临床获益。
完整摘要 · 英文原文
BACKGROUND: Magnesium has been suggested to play a role in cardiovascular health through its effects on endothelial function, vascular stiffness, and blood pressure. This systematic review and meta-analysis aimed to update and evaluate the effect of magnesium supplementation on vascular function and cardiometabolic outcomes in adults. METHODS: A systematic search based on PRISMA 2020 guidelines was conducted on PubMed, Web of Science, Scopus, CENTRAL, and ClinicalTrials.gov up to 23 April 2026 to include randomized placebo-controlled trials assessing the effects of magnesium supplementation on flow-mediated dilation (FMD), pulse wave velocity (PWV), and carotid intima-media thickness (CIMT), and as secondary outcomes for serum magnesium levels and systolic and diastolic blood pressure. Random-effect model, subgroup analyses (dose, duration, formulation), meta-regression, sensitivity analyses, and publication bias assessment were performed as well. RESULTS: A total of twelve randomized controlled trials comprising 389 patients in the magnesium group and 276 patients in the placebo group were included in this study. Magnesium supplementation showed no significant overall effect on FMD (MD = 2.86; 95% CI: - 1.31 to 7.03; p = 0.18). However, doses > 400 mg/day significantly improved FMD (MD = 8.32; 95% CI: 3.45 to 13.19; p < 0.01), but it included 2 studies. CIMT was significantly reduced (MD = - 0.08; 95% CI: - 0.15 to - 0.01; p = 0.03), while PWV showed no significant change (MD = - 0.17; 95% CI: - 0.60 to 0.25; p = 0.43). Serum magnesium increased significantly (MD = 0.05; 95% CI: 0.02 to 0.07; p < 0.01) in overall and in subgroups, whereas blood pressure reductions were not statistically significant (p > 0.3). Meta-regression showed significant modifying effects of higher magnesium doses and higher baseline SBP on FMD, and a significant inverse correlation of baseline body mass index (BMI), baseline PWV, and baseline CIMT on FMD. CONCLUSION: Magnesium supplementation may improve endothelial function and reduce CIMT, particularly at higher doses, although it should be interpreted cautiously because of limited studies and inconsistent effects on arterial stiffness and blood pressure. Further large-scale trials are required to confirm optimal dosing strategies and clinical benefits.