A meta‐analysis of prospective cohort studies of flavonoid subclasses and stroke risk

Abstract

Epidemiological studies indicate that higher intakes of flavonoids are associated with reduced stroke risk, however, which subtypes play significant roles to protect against stroke remain unclear. A systematic literature search in PubMed and Web of Science databases was performed up to Oct. 2021. Flavonoids or their subtypes (flavanol, flavanone, flavone, flavan-3-ol, isoflavone, or anthocyanin) were paired with stoke as the search term. Multivariate-adjusted relative risks (RRs) with 95% confidence intervals (CIs) for the highest versus the lowest category were pooled by using a randomeffects model. Dose-response analysis was implemented by using a restricted cubic spline regression model. Ten independent prospective cohort studies with 387,076 participants and 9,564 events were included. Higher intakes of flavanones were inversely associated with stroke risk (RR = 0.85; 95%CI: 0.78, 0.93). Dose-response analysis showed that 50 mg/day increment of flavanones was associated with 11% reduction in stroke risk (RR = 0.89; 95%CI: 0.84, 0.94). Flavan-3-ols was marginally inversely associated with stroke risk (RR = 0.92; 95%CI: 0.82, 1.02). Dose-response analysis showed that 200 mg/day increment of flavan-3-ols was associated with 14% reduction in stroke risk (RR = 0.86; 95%CI: 0.75, 0.98). The non-significant association was observed with respect to other flavonoid subclasses. This study demonstrated higher intakes of flavanones and flavan-3-ols were associated with a lower risk of stroke. Dietary intakes of lemon and citrus rich in flavanones and flavan-3-ols might have beneficial functions for the protection against stroke. The findings of these associations of the present study need to be confirmed in other regions and ethnic origins.dose-response analysis, flavonoid subclass, meta-analysis, stroke risk | INTRODUCTIONFlavonoids are widely found in fruits, vegetables and other plants. The main food sources of flavonoids include tea, citrus, berries, apples and wine (Kim, Vance, & Chun, 2016). Over the past few decades, plenty of people have recognized the importance of fruits and vegetables for health and are dedicated to knowing which compounds have a significant impact on the prevention of non-communicable diseases (Perez-Vizcaino & Fraga, 2018). Epidemiological studies have shown inverse associations between total flavonoids intake and chronic metabolic diseases, including coronary heart disease (CHD), cancer and stroke

|Therapeutic and preventive effects of apigenin in cerebral ischemia: a review

“…First, all the conclusions on the therapeutic effects of APG come from animal or cellular experiments, and its therapeutic mechanism in humans is not clear. Second, although flavonoids have been found to have preventive and therapeutic effects on CI, 109 the mechanism of long-term efficacy of APG in preventing CI has also not been experimentally proven. Finally, the most critical issue is how to achieve an effective dose of APG in the treatment of patients with CI.…”