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The Effects of N-Acetylcysteine on Inflammatory Markers and Homocysteine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Publisher



Hallajzadeh J1 ; Milajerdi A2, 3 ; Reiner Z4 ; Kolahdooz F5 ; Asemi Z6
Authors
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Authors Affiliations
  1. 1. Department of Biochemistry and Nutrition, Research Center for Evidence-Based Health Management, Maragheh University of Medical Sciences, Maragheh, Iran
  2. 2. Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Community Nutrition, School of Nutritional Scienes and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Internal Medicine, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
  5. 5. Indigenous and Global Health Research, Department of Medicine, University of Alberta, Edmonton, Canada
  6. 6. Research Center for Biochemistry and Nutrition in Metabolic Diseases, institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran

Source: Pharmaceutical Sciences Published:2020


Abstract

Background: Recently a number of trials investigated the effect of N-acetylcysteine (NAC) administration on inflammatory markers and homocysteine (Hcy). However, their fi ndings are controversial. The aim of this paper is to present a meta-analysis and give a review of all randomized controlled trials (RCTs) in order to determine the effects of NAC on inflammatory markers and Hcy. Methods: An electronic search was conducted using PubMed, Scopus, Cochrane Library, Google scholar and Web of Science databases from inception until April 2019. A study quality assessment was performed using the Jadad scale and heterogeneity between studies was statistically computed using Cochrane’s Q test and I-square (I2). Data were pooled using a random-effects model and weighted mean difference (WMD) was considered as th e ov erall effect size. Results: Out of 1115 potential citations, 10 studies (reported 13 effect sizes for different parameters) met the inclusion criteria and were eligible for this meta-analysis. NAC supplementation resulted in a significant reduction in Hcy levels (WMD: -2.05; 95% CI: -3.73, -0.37). NAC administration did not affect C-reactive protein (CRP) levels (WMD: 0.06; 95% CI: -0.21, 0.34), tumor necrosis factor-α (TNF-α) levels (WMD: 0.07; 95% CI: -0.27, 0.40), and interleukin 6 (IL-6) (WMD: -0.23; 95% CI: -1.23, 0.77). Conclusion: It could be concluded that this meta-analysis of RCTs demonstrated that NAC administration to various patients significantly improved circulating Hcy, but did not affect CRP IL-6 and TNF-α levels. ©2020 The Author(s).
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