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Master Thesis

Comparaison of nutritionnal strategies targeting the nitric oxyde pathway to improve macrovascular function: a systematic review and a meta analysis

Abstract : In endothelial cells, production of Nitric Oxide (NO) by NO synthase (NOS) lead to vasodilatation. In many pathologies associated with vascular dysfunction (diabetes, cardiovascular diseases, scleroderma…) this pathway is impacted. Our main outcome was flow mediated dilatation FMD, used as a surrogate of vascular efficiency and reflecting the endothelial NO release. We studied healthy participants to avoid confounding induced by pathological states. Predefined protocol was registered on PROSPERO (CRD42018090965) and followed PRISMA statement. We searched for double-blind randomized controlled trials (RCTs) in Medline and clinicaltrial.gov up to July 4th, 2018. Evaluated strategies were NOS substrates: L-arginine and L-citrulline, folic acids, inorganic nitrates and polyphenol, supplied by dietary ingredient or nutrient supplement. The secondary outcome was nitrate mediated dilatation (NMD). We performed two separate analysis on acute and chronic supplementation using mean difference and 95% confidence interval. 55 studies were included, 24 in acute and 38 in chronic supplementation. Acute and chronic efficiency of inorganic nitrates and polyphenols were significant on FMD. Among polyphenols, cocoa displayed the larger effect size. No significant result was found for NOS substrates, folic acids, for all on NMD and on placebo effect. Significant meta regression were on funding, duration of supplementation and smoking. The results were consistent in sensitivity analysis excluding low quality studies.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02305326
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Submitted on : Friday, October 4, 2019 - 9:27:00 AM
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Myrtille Beau Guillaumot. Comparaison of nutritionnal strategies targeting the nitric oxyde pathway to improve macrovascular function: a systematic review and a meta analysis. Pharmaceutical sciences. 2019. ⟨dumas-02305326⟩

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