重症患者におけるクルクミン補給：ランダム化比較試験のGRADE評価システマティックレビューおよびメタアナリシス

Curcuminoids are dietary polyphenols that can improve health indices through various mechanisms, such as anti-inflammatory, antioxidant, and other clinical properties. Due to the lack of evidence on the efficacy of curcuminoids in critically ill patients, this meta-analysis was conducted. The aim of this study was to assess and quantify the influence of curcumin supplementation on markers of inflammation, liver function, and clinical outcomes in critically ill patients. In this study, relevant randomized clinical trials were identified via electronic database searches, including MEDLINE, Scopus, and Web of Science, up until January 2025. The Cochrane risk-of-bias tool was utilized to assess the quality of the studies. Standardized mean differences (SMDs) and risk ratio (RR) in changes between intervention and placebo groups were calculated. Both random-effects and fixed-effects models were applied, and pre-specified stratified analyses were performed to explore potential sources of heterogeneity. Out of a total of 691 studies screened, seven trials met the inclusion criteria, encompassing data from 571 participants. The pooled analysis demonstrated that curcumin supplementation significantly lowered alanine transaminase (ALT) levels (SMD: -0.4, 95% CI: -0.8 to -0.001, p = 0.03), total bilirubin levels (SMD: -0.4, 95% CI: -0.9 to -0.07, p = 0.01), Sequential Organ Failure Assessment (SOFA) scores (SMD: -0.8, 95% CI: -1.2 to -0.4, p < 0.001), the duration of intensive care unit (ICU) stays (SMD: -0.3 days, 95% CI: -0.6 to -0.1, p = 0.01), compared to placebo. Furthermore, curcumin supplementation was associated with significant increases in albumin (SMD: 0.3, 95% CI: 0.001 to 0.6, p = 0.004) and alkaline phosphatase levels (SMD: 0.4, 95% CI: 0.02 to 0.8, p = 0.01). This meta-analysis demonstrates that curcumin supplementation improves liver function, albumin levels, SOFA scores, and ICU stay duration in critically ill patients, suggesting its potential role in mitigating organ dysfunction in this population.