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Służały P, Paśko P, Galanty A. Natural Products as Hepatoprotective Agents-A Comprehensive Review of Clinical Trials. PLANTS (BASEL, SWITZERLAND) 2024; 13:1985. [PMID: 39065511 PMCID: PMC11280762 DOI: 10.3390/plants13141985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/18/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024]
Abstract
The hepatoprotective effects of natural products have been a significant focus in recent decades due to the growing demand for the help in the treatment of hepatic impairments. This review specifically delves into the findings of clinical trials involving 13 selected natural products, namely plants and their derived compounds (e.g., artichoke, berberine, and turmeric), algae (e.g., spirulina), probiotics, and other products like phospholipids and vitamin D. A literature search was performed in the Scopus database, PubMed, and Google Scholar, covering all articles found up to June 2024. Artichoke, berberine, chlorella, chicory, green tea, probiotics, phospholipids, schisandra, silymarin, spirulina, and vitamin D caused a decrease in liver enzymes, while for cinnamon and turmeric such an effect was either not observed or not convincing. The presented results indicate that some natural products might satisfactorily improve hepatic outcomes in NAFLD, NASH, and other liver disorders; however, further studies and metanalyses are needed to clearly demonstrate their effectiveness.
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Affiliation(s)
- Piotr Służały
- Department of Pharmacognosy, Jagiellonian University Medical College, Medyczna 9, 30-688 Cracow, Poland;
| | - Paweł Paśko
- Department of Food Chemistry and Nutrition, Jagiellonian University Medical College, Medyczna 9, 30-688 Cracow, Poland;
| | - Agnieszka Galanty
- Department of Pharmacognosy, Jagiellonian University Medical College, Medyczna 9, 30-688 Cracow, Poland;
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Trogkanis E, Karalexi MA, Sergentanis TN, Kornarou E, Vassilakou T. Safety and Efficacy of the Consumption of the Nutraceutical "Red Yeast Rice Extract" for the Reduction of Hypercholesterolemia in Humans: A Systematic Review and Meta-Analysis. Nutrients 2024; 16:1453. [PMID: 38794691 PMCID: PMC11124448 DOI: 10.3390/nu16101453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
Previous studies have shown encouraging results regarding the efficacy and safety of nutraceuticals, such as "red yeast rice (RYR) extract", on reducing hypercholesterolemia in humans. A systematic review and meta-analysis was conducted from January 2012 to May 2022. The search was strictly focused on clinical trials that examined the association between RYR extract consumption and parameters of the lipid profile in humans. Fourteen double-blinded clinical trials were identified. The interventions lasted 4-24 weeks. In most studies, there was one intervention group and one control group. RYR extract consumption statistically significantly reduced total cholesterol (mean absolute reduction: 37.43 mg/dL; 95% confidence interval [CI]: -47.08, -27.79) and low-density lipoprotein cholesterol (LDL-C; mean absolute reduction: 35.82 mg/dL; 95% CI: -43.36, -28.29), but not high-density lipoprotein cholesterol, triglycerides and apolipoproteins A-I and B. As regards the safety, RYR extract was considered a safe choice with neither threatening nor frequent side effects. The consumption of RYR extract by people with hypercholesterolemia was associated with statistically significant reduction in total cholesterol and LDL-C, whereas it was not associated with an increase in life-threatening side effects. Further research on specific subpopulations and outcomes could establish a consensus on determining the clinical benefits and potential risks, if any, of this nutraceutical.
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Affiliation(s)
- Efstratios Trogkanis
- Department of Public Health Policy, University of West Attica, 11521 Athens, Greece; (E.T.); (T.N.S.); (E.K.)
| | - Maria A. Karalexi
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, 45110 Ioannina, Greece;
| | - Theodoros N. Sergentanis
- Department of Public Health Policy, University of West Attica, 11521 Athens, Greece; (E.T.); (T.N.S.); (E.K.)
| | - Eleni Kornarou
- Department of Public Health Policy, University of West Attica, 11521 Athens, Greece; (E.T.); (T.N.S.); (E.K.)
| | - Tonia Vassilakou
- Department of Public Health Policy, University of West Attica, 11521 Athens, Greece; (E.T.); (T.N.S.); (E.K.)
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3
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Tavan A, Noroozi S, Zamiri B, Gholchin Vafa R, Rahmani M, Mehdizadeh Parizi M, Ahmadi A, Heydarzade R, Montaseri M, Hosseini SA, Kojuri J. Evaluation the effects of red yeast rice in combination with statin on lipid profile and inflammatory indices; a randomized clinical trial. BMC Nutr 2022; 8:138. [PMID: 36434733 PMCID: PMC9700919 DOI: 10.1186/s40795-022-00639-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/15/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Dyslipidemia is a prominent cause of cardiovascular disease as it leads to inflammation and plaque deposition within arteries. Treatment includes lifestyle modifications and lipid-lowering medications. We aimed to assess the therapeutic effects of red yeast rice (RYR) alongside statin therapy. METHODS This triple-blind randomized clinical trial involved 92 dyslipidemia patients and was performed in 2019. Standard laboratory tests were used to assess the serum LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), total cholesterol, triglyceride (TG), and high sensitivity C-reactive protein (hs-CRP) levels. Subsequently, patients randomly received one daily RYR or placebo tablet for 1 month beside routine single statin therapy. Subsequently, blood tests were repeated and compared against the baseline. Liver function tests were also requested. RESULTS Total cholesterol significantly (P = 0.019) decreased in the treatment group (- 10.2 mg/dL) compared with the placebo group (- 1.3 mg/dL). HDL cholesterol decreased by 2.19 mg/dL in the treatment group but increased by 0.53 mg/dL in the treatment group (P = 0.083). LDL cholesterol declined in both placebo (- 5.09) and treatment (- 0.73) groups (P = 0.187). TG increased by about 7 mg/dL in the treatment group but fell by roughly 1 mg/dL in the placebo group (P = 0.386). Hs-CRP increased by 0.28 mg/dL in the treatment group but decreased by 0.09 mg/dL in the placebo group (P = 0.336). CONCLUSIONS We found that adding RYR (Lesstat®) to statin medications significantly decreases total cholesterol. However, no significant effect was seen on other lipid profile components or Hs-CRP. Finally, we showed that RYR is safe to add to statins considering liver function (clinicaltrials.gov: NCT05095480).
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Affiliation(s)
- Ali Tavan
- grid.412571.40000 0000 8819 4698Professor Kojuri Cardiology Clinic, Shiraz University of Medical Sciences, Niayesh Medical Complex, Niayesh St, Shiraz, Iran
| | - Saam Noroozi
- grid.411135.30000 0004 0415 3047Fasa University of Medical Sciences, Fasa, Iran
| | - Bardia Zamiri
- grid.412571.40000 0000 8819 4698Professor Kojuri Cardiology Clinic, Shiraz University of Medical Sciences, Niayesh Medical Complex, Niayesh St, Shiraz, Iran
| | - Reza Gholchin Vafa
- grid.412571.40000 0000 8819 4698Professor Kojuri Cardiology Clinic, Shiraz University of Medical Sciences, Niayesh Medical Complex, Niayesh St, Shiraz, Iran
| | - Mohammadhossein Rahmani
- grid.412571.40000 0000 8819 4698Professor Kojuri Cardiology Clinic, Shiraz University of Medical Sciences, Niayesh Medical Complex, Niayesh St, Shiraz, Iran
| | - Mohammadjavad Mehdizadeh Parizi
- grid.412571.40000 0000 8819 4698Professor Kojuri Cardiology Clinic, Shiraz University of Medical Sciences, Niayesh Medical Complex, Niayesh St, Shiraz, Iran
| | - Amin Ahmadi
- grid.412571.40000 0000 8819 4698Professor Kojuri Cardiology Clinic, Shiraz University of Medical Sciences, Niayesh Medical Complex, Niayesh St, Shiraz, Iran
| | - Reza Heydarzade
- grid.412571.40000 0000 8819 4698Professor Kojuri Cardiology Clinic, Shiraz University of Medical Sciences, Niayesh Medical Complex, Niayesh St, Shiraz, Iran
| | - Mohammad Montaseri
- grid.412571.40000 0000 8819 4698Professor Kojuri Cardiology Clinic, Shiraz University of Medical Sciences, Niayesh Medical Complex, Niayesh St, Shiraz, Iran ,grid.412571.40000 0000 8819 4698Cardiology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Ali Hosseini
- grid.412571.40000 0000 8819 4698Professor Kojuri Cardiology Clinic, Shiraz University of Medical Sciences, Niayesh Medical Complex, Niayesh St, Shiraz, Iran
| | - Javad Kojuri
- grid.412571.40000 0000 8819 4698Professor Kojuri Cardiology Clinic, Shiraz University of Medical Sciences, Niayesh Medical Complex, Niayesh St, Shiraz, Iran ,grid.412571.40000 0000 8819 4698Cardiology Department, Shiraz University of Medical Sciences, Shiraz, Iran ,grid.412571.40000 0000 8819 4698Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Arnaboldi L, Corsini A, Bellosta S. Artichoke and bergamot extracts: a new opportunity for the management of dyslipidemia and related risk factors. Minerva Med 2022; 113:141-157. [PMID: 35313442 DOI: 10.23736/s0026-4806.21.07950-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The relationship between low LDL-C (cholesterol associated with low-density lipoprotein) and a lower relative risk of developing cardiovascular disease (CVD) has been widely demonstrated. Although from a pharmacological point of view, statins, ezetimibe and PCSK inhibitors, alone or in combination are the front and center of the therapeutic approaches for reducing LDL-C and its CV consequences, in recent years nutraceuticals and functional foods have increasingly been considered as a valid support in the reduction of LDL-C, especially in patients with mild/moderate hyperlipidemia - therefore not requiring pharmacological treatment - or in patients intolerant to statins or other drugs. An approach also shared by the European Atherosclerosis Society (EAS). Of the various active ingredients with hypolipidemic properties, we include the artichoke (Cynara cardunculus, Cynara scolymus) and the bergamot (Citrus bergamia) which, thanks essentially to the significant presence of polyphenols in their extracts, can exert this action associated with a number of other complementary inflammation and oxidation benefits. In light of these evidence, this review aimed to describe the effects of artichoke and bergamot in modifying the lipid and inflammatory parameters described in in vitro, in vivo and clinical studies. The available data support the use of standardized compositions of artichoke and bergamot extracts, alone or in combination, in the treatment of mild to moderate dyslipidemia, in patients suffering from metabolic syndrome, hepatic steatosis, or intolerant to common hypolipidemic treatments.
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Bioactive Compounds from Cardoon as Health Promoters in Metabolic Disorders. Foods 2022; 11:foods11030336. [PMID: 35159487 PMCID: PMC8915173 DOI: 10.3390/foods11030336] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 01/16/2022] [Accepted: 01/18/2022] [Indexed: 12/14/2022] Open
Abstract
Cardoon (Cynara cardunculus L.) is a Mediterranean plant and member of the Asteraceae family that includes three botanical taxa, the wild perennial cardoon (C. cardunculus L. var. sylvestris (Lamk) Fiori), globe artichoke (C. cardunculus L. var. scolymus L. Fiori), and domesticated cardoon (C. cardunculus L. var. altilis DC.). Cardoon has been widely used in the Mediterranean diet and folk medicine since ancient times. Today, cardoon is recognized as a plant with great industrial potential and is considered as a functional food, with important nutritional value, being an interesting source of bioactive compounds, such as phenolics, minerals, inulin, fiber, and sesquiterpene lactones. These bioactive compounds have been vastly described in the literature, exhibiting a wide range of beneficial effects, such as antimicrobial, anti-inflammatory, anticancer, antioxidant, lipid-lowering, cytotoxic, antidiabetic, antihemorrhoidal, cardiotonic, and choleretic activity. In this review, an overview of the cardoon nutritional and phytochemical composition, as well as its biological potential, is provided, highlighting the main therapeutic effects of the different parts of the cardoon plant on metabolic disorders, specifically associated with hepatoprotective, hypolipidemic, and antidiabetic activity.
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Moradi S, Shokri-Mashhadi N, Saraf-Bank S, Mohammadi H, Zobeiri M, Clark CCT, Rouhani MH. The effects of Cynara scolymus L. supplementation on liver enzymes: A systematic review and meta-analysis. Int J Clin Pract 2021; 75:e14726. [PMID: 34383355 DOI: 10.1111/ijcp.14726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/09/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE A systematic review and meta-analysis was conducted to summarise studies conducted on the effects of artichoke supplementation on liver enzymes. METHODS Suitable studies were detected by searching online databases, including Medline, Embase, Cochrane Library, and Scopus databases, until 05 June 2021. As liver enzymes were reported in different units, standardised mean differences (SMD) were used and data were pooled using a random-effects model. Heterogeneity, publication bias, and sensitivity analysis were also assessed. RESULTS Pooled analysis, of eight clinical trials, revealed that artichoke supplementation significantly reduced the concentration of aspartate aminotransferase (AST) (P = .001) and alanine transaminase (ALT) (P = .016), in comparison with placebo. Subgroup analysis suggested that artichoke administration significantly reduces AST and ALT in patients with non-alcoholic fatty liver disease (P = .003 for AST and P < .001 for ALT), and ALT among overweight/obese subjects (P = .025). CONCLUSIONS Artichoke supplementation elicited significant reductions in liver enzymes, especially among patients with non-alcoholic fatty liver disease.
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Affiliation(s)
- Sajjad Moradi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nafiseh Shokri-Mashhadi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sahar Saraf-Bank
- Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Zobeiri
- Department of Internal Medicine, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - Mohammad Hossein Rouhani
- Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Cicero AFG, Fogacci F, Stoian AP, Vrablik M, Al Rasadi K, Banach M, Toth PP, Rizzo M. Nutraceuticals in the Management of Dyslipidemia: Which, When, and for Whom? Could Nutraceuticals Help Low-Risk Individuals with Non-optimal Lipid Levels? Curr Atheroscler Rep 2021; 23:57. [PMID: 34345932 PMCID: PMC8332568 DOI: 10.1007/s11883-021-00955-y] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2021] [Indexed: 12/20/2022]
Abstract
Purpose of Review The aim of this review is to summarize the available clinical efficacy and safety data related to the most studied and used lipid-lowering nutraceuticals. Recent Findings A growing number of meta-analyses of randomized clinical trials supports the effectiveness and tolerability of some lipid-lowering nutraceuticals such as red yeast rice, plant sterols and stanols, soluble fibers, berberine, artichoke extracts, bergamot polyphenol fraction, garlic, green tea, and spiruline. No significant safety concern has been raised for the use of such products. Association of more lipid-lowering nutraceuticals and of some nutraceuticals with lipid-lowering drugs has been tested as well. Summary Current evidence suggests that some clinically tested lipid-lowering nutraceuticals could be safely used to improve plasma lipid levels in subjects affected by mild-to-moderate dyslipidaemia with low cardiovascular risk.
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Affiliation(s)
- Arrigo F G Cicero
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy. .,Italian Society of Nutraceuticals (SINut), Bologna, Italy. .,IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy. .,Atherosclerosis Research Center, University of Bologna, Via Albertoni, 15, 40138, Bologna, Italy.
| | - Federica Fogacci
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy.,Italian Society of Nutraceuticals (SINut), Bologna, Italy.,IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Anca Pantea Stoian
- Faculty of Medicine, Department of Diabetes, Nutrition and Metabolic Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Michal Vrablik
- Third Department of Internal Medicine, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Łódź, Poland
| | - Peter P Toth
- CGH Medical Center, Sterling, IL, USA.,Cicarrone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Manfredi Rizzo
- Italian Society of Nutraceuticals (SINut), Bologna, Italy.,Faculty of Medicine, Department of Diabetes, Nutrition and Metabolic Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (Promise), University of Palermo, Palermo, Italy
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Cicero AFG, Fogacci F, Zambon A. Red Yeast Rice for Hypercholesterolemia: JACC Focus Seminar. J Am Coll Cardiol 2021; 77:620-628. [PMID: 33538260 DOI: 10.1016/j.jacc.2020.11.056] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 01/04/2023]
Abstract
The extracts of red yeast rice (RYR) are currently the most effective cholesterol-lowering nutraceuticals. This activity is mainly due to monacolin K, a weak reversible inhibitor of 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase, whose daily consumption causes a reduction in low-density lipoprotein (LDL)-cholesterol plasma levels up to 15% to 25% within 6 to 8 weeks. The decrease in LDL-cholesterol is accompanied by a proportional decrease in total and non-high-density lipoprotein cholesterol, plasma apolipoprotein B, and high-sensitivity C-reactive protein. Some trials suggest that RYR use is associated with improvement in endothelial function and arterial stiffness, whereas a long-term study supports its role in the prevention of cardiovascular events. Despite the statin-like mechanism of action, the risk related to 3 to 10 mg monacolin K taken per day is minimal (mild myalgia in previously severely statin-intolerant subjects). RYR could represent a therapeutic tool to support lifestyle improvement in managing mild to moderate hypercholesterolemia in low-risk patients, including those who cannot be treated with statins or other LDL-cholesterol-lowering therapies.
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Affiliation(s)
- Arrigo F G Cicero
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy.
| | - Federica Fogacci
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy
| | - Alberto Zambon
- Department of Medicine-DIMED, University of Padua, Padua, Italy
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9
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Matacchione G, Gurău F, Baldoni S, Prattichizzo F, Silvestrini A, Giuliani A, Pugnaloni A, Espinosa E, Amenta F, Bonafè M, Procopio AD, Rippo MR, Olivieri F, Sabbatinelli J. Pleiotropic effects of polyphenols on glucose and lipid metabolism: Focus on clinical trials. Ageing Res Rev 2020; 61:101074. [PMID: 32335301 DOI: 10.1016/j.arr.2020.101074] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 03/03/2020] [Accepted: 04/13/2020] [Indexed: 12/18/2022]
Abstract
Epidemiological evidence from observational studies suggests that dietary polyphenols (PPs) - phytochemicals found in a variety of plant-based foods - can reduce the risk of developing type 2 diabetes mellitus (T2DM). Clinical trials have also indicated that PPs may help manage the two key features of T2DM, hyperglycemia and dyslipidemia. Since the incidence of T2DM is dramatically increasing worldwide, identifying food-based approaches that can reduce the risk of developing it and help manage its main risk factors in early-stage disease has clinical and socioeconomic relevance. After a brief overview of current epidemiological data on the incidence of T2DM in individuals consuming PP-rich diets, we review the evidence from clinical trials investigating PP-enriched foods and/or PP-based nutraceutical compounds, report their main results, and highlight the knowledge gaps that should be bridged to enhance our understanding of the role of PPs in T2DM development and management.
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10
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Pasta A, Formisano E, Cremonini AL, Maganza E, Parodi E, Piras S, Pisciotta L. Diet and Nutraceutical Supplementation in Dyslipidemic Patients: First Results of an Italian Single Center Real-World Retrospective Analysis. Nutrients 2020; 12:E2056. [PMID: 32664400 PMCID: PMC7400882 DOI: 10.3390/nu12072056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Dyslipidemias are a heterogeneous group of metabolic disorders mainly characterized by an increased risk of atherosclerotic cardiovascular disease (ASCVD) or other conditions, such as acute pancreatitis in hypertriglyceridemia. The aim of this study was to evaluate the effect of diet treatment and nutraceutical (NUTs) supplementation on the plasma lipid profile in outpatient dyslipidemic subjects, considering the influence of several factors (i.e., gender, age, body mass index, alcohol consumption, and smoking habits). METHODS 487 dyslipidemic patients spanning from 2015 to 2019 were treated with a Mediterranean diet or NUTs in a real-word setting and were retrospectively analyzed. General characteristics and lipid profile at baseline and after the follow-up period were evaluated. RESULTS Diet alone reduced total cholesterol (-19 mg/dL, -7.7%), LDL cholesterol (-18 mg/dL, -10.1%), and triglycerides (-20 mg/dL, -16.7%). Triglycerides (TG) decreased more in men, while women were associated with higher reduction of LDL cholesterol (LDL-C). Different types of NUTs further ameliorate lipid profiles when associated with diet. Nevertheless, most patients at low ASCVD risk (222 out of 262, 81.6%) did not achieve the 2019 ESC/EAS guidelines recommended LDL-C goals (i.e., LDL-C < 116 mg/dL). CONCLUSION Lipid-lowering diet improves lipid profile, and NUTs can boost its efficacy, but taken together they are mainly unsatisfactory with respect to the targets imposed by 2019 EAS/ESC guidelines.
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Affiliation(s)
- Andrea Pasta
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy; (A.P.); (A.L.C.); (E.M.); (E.P.); (S.P.)
| | - Elena Formisano
- Nutritional Unit ASL-1 Imperiese, Giovanni Borea Civil Hospital, 18038 Sanremo, Italy;
| | - Anna Laura Cremonini
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy; (A.P.); (A.L.C.); (E.M.); (E.P.); (S.P.)
| | - Elio Maganza
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy; (A.P.); (A.L.C.); (E.M.); (E.P.); (S.P.)
| | - Erika Parodi
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy; (A.P.); (A.L.C.); (E.M.); (E.P.); (S.P.)
| | - Sabrina Piras
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy; (A.P.); (A.L.C.); (E.M.); (E.P.); (S.P.)
| | - Livia Pisciotta
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy; (A.P.); (A.L.C.); (E.M.); (E.P.); (S.P.)
- Dietetics and Clinical Nutrition Unit, IRCCS Policlinic Hospital San Martino, 16132 Genoa, Italy
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11
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Jalili C, Moradi S, Babaei A, Boozari B, Asbaghi O, Lazaridi AV, Hojjati Kermani MA, Miraghajani M. Effects of Cynara scolymus L. on glycemic indices:A systematic review and meta-analysis of randomized clinical trials. Complement Ther Med 2020; 52:102496. [PMID: 32951745 DOI: 10.1016/j.ctim.2020.102496] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/29/2020] [Accepted: 06/26/2020] [Indexed: 02/09/2023] Open
Abstract
OBJECTIVES Cynara scolymus L. (common artichoke) and its products have been considered as potential phytotherapeutic agents for various conditions, such as cardiovascular, hepatic and gastric diseases, among others. Until now, the effects of artichoke and artichoke products administration on glycemic indices have not been sufficiently appraised. The present study evaluated the effects of artichoke and artichoke products administration on the glycemic indices. METHODS Clinical trials were identified in the Cochrane Library, PubMed, Embase and Scopus databases; to infinity until 15 March 2020. Weighted mean differences (WMD) were pooled using a random-effects model. Heterogeneity, sensitivity analysis and publication bias were reported using standard methods. RESULTS Pooled analysis of nine Randomized controlled trials (RCTs), demonstrated that the administration of artichoke and artichoke products led to a significant reduced fasting blood sugar (FBS) (WMD: -5.28 mg/dl, 95 % CI: -8.95, -1.61; p = 0.005). However, other glycemic indeces including fasting insulin (WMD: -0.45 μIU/dL, 95 % CI: -1.14, 0.25; p = 0.20), HOMA-IR (MD: -0.25, 95 % CI: -0.57, 0.07; p = 0.12) or Hemoglobin A1c (HbA1c) (WMD: -0.09, 95 % CI: -0.20, 0.02; p = 0.09) did not alter after the administration of artichoke and artichoke products. A subgroup analysis comparing the kind of intervention, revealed that just the supplementation of artichoke and artichoke products, in a noco-supplementation form, was efficacy for the reduction of Homeostatic model assessment of insulin resistance (HOMA-IR) (WMD: -0.52, 95 % CI: -0.85, -0.19; p = 0.002). CONCLUSIONS The supplementation of artichoke and artichoke products can significantly reduce the FBS concentrations in humans. Moreover, these outcomes suggested that just the supplementation of artichoke and artichoke products is more effective in the reduction of HOMA-IR levels than the co-supplementation form. However, additional clinical trials with longer study periods are necessitated to obtain a robust conclusion for producing new guidelines as part of a healthy diet.
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Affiliation(s)
- Cyrus Jalili
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sajjad Moradi
- Halal Research Center of IRI, FDA, Tehran, Iran; Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Atefeh Babaei
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran; Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
| | - Behnoosh Boozari
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Omid Asbaghi
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Anastasia-Viktoria Lazaridi
- The Early Life Research Unit, Academic Division of Child Health, Obstetrics and Gynaecology, Medical School, University of Nottingham, Nottingham, NG7 2UH, United Kingdom
| | - Mohammad Ali Hojjati Kermani
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Miraghajani
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; The Early Life Research Unit, Academic Division of Child Health, Obstetrics and Gynaecology, Medical School, University of Nottingham, Nottingham, NG7 2UH, United Kingdom.
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12
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Abstract
The extract of red yeast rice (RYR) is the most effective cholesterol-lowering nutraceutical on the market. In particular, its effectiveness is directly related to the amount of monacolin K within the extract (up to 10 mg/day). Consuming monacolin K on a daily basis reduces low-density lipoprotein (LDL) cholesterol plasma levels between 15% and 25% within 6 to 8 weeks. Certainly, the decrease in LDL-cholesterol is accompanied by a similar reduction in total cholesterol, non-high-density lipoprotein cholesterol, plasma apolipoprotein B, matrix metalloproteinases 2 and 9, and high-sensitivity C-reactive protein. Furthermore, the RYR lipid-lowering effect is associated with significant improvements in pulse wave velocity and endothelial function, which are validated and reliable biomarker tools able to detect vascular aging. Although it has a mechanism of action similar to statins, a daily consumption of between 3 and 10 mg monacolin K has only minimal associated risks, and mild myalgias are seen only in the frailest patients (those who also cannot tolerate minimal dosages of statin). The monacolin K found in RYR is a safe and effective supplement for managing mild to moderate hypercholesterolemia in people with no additional cardiovascular risk factors.
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Affiliation(s)
- Arrigo F G Cicero
- UNIVERSITY OF BOLOGNA, BOLOGNA, ITALY
- ITALIAN SOCIETY OF NUTRACEUTICALS (SINUT), BOLOGNA, ITALY
| | | | - Maciej Banach
- MEDICAL UNIVERSITY OF LODZ, POLAND
- POLISH MOTHER'S MEMORIAL HOSPITAL RESEARCH INSTITUTE, LODZ, POLAND
- UNIVERSITY OF ZIELONA GORA, ZIELONA GORA, POLAND
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13
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Venturelli A, Brighenti V, Mascolo D, Pellati F. A new strategy based on microwave-assisted technology for the extraction and purification of beeswax policosanols for pharmaceutical purposes and beyond. J Pharm Biomed Anal 2019; 172:200-205. [PMID: 31060032 DOI: 10.1016/j.jpba.2019.04.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 10/27/2022]
Abstract
Policosanols (PCs) are a mixture of long chain primary aliphatic alcohols mainly known for their ability to reduce cholesterol level. Due to this property, there is an increasing interest in the extraction process of these compounds. In this context, beeswax, a natural product produced by honey bees of the genus Apis, is a promising source for their extraction and purification. The present research work was aimed at the development of a new procedure for the extraction and purification of PCs from yellow beeswax by using microwave-assisted technology, which hitherto has never been applied to this mixture. The developed process comprises three main steps: 1) microwave-assisted trans-esterification; 2) microwave-assisted hydrolysis; 3) final purification by means of preparative liquid chromatography. The final step is responsible for the increased purity of PCs, thanks to the removal of undesired compounds, such as natural paraffins. The predominant alcohols investigated in this work are tetracosanol (C24OH), hexacosanol (C26OH), octacosanol (C28OH), triacontanol (C30OH) and dotriacontanol (C32OH). Compound identification was performed using GC-EI-MS, while GC-FID analysis was chosen for the quantification of the main fatty alcohols present in the product. This new method represents a useful tool for the production of PCs from beeswax to be used in pharmaceuticals and nutraceuticals for human use, feed and veterinary supplements.
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Affiliation(s)
| | - Virginia Brighenti
- Tydock Pharma s.r.l., Strada Gherbella, 294, 41126, Modena, Italy; Department of Life Sciences, University of Modena and Reggio Emilia, Via G. Campi 103, 41125, Modena, Italy
| | - Danilo Mascolo
- Confindustria Emilia-Romagna, Via Barberia 13, 40123, Bologna, Italy
| | - Federica Pellati
- Department of Life Sciences, University of Modena and Reggio Emilia, Via G. Campi 103, 41125, Modena, Italy.
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14
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Fogacci F, Banach M, Mikhailidis DP, Bruckert E, Toth PP, Watts GF, Reiner Ž, Mancini J, Rizzo M, Mitchenko O, Pella D, Fras Z, Sahebkar A, Vrablik M, Cicero AFG. Safety of red yeast rice supplementation: A systematic review and meta-analysis of randomized controlled trials. Pharmacol Res 2019; 143:1-16. [PMID: 30844537 DOI: 10.1016/j.phrs.2019.02.028] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 02/28/2019] [Accepted: 02/28/2019] [Indexed: 01/15/2023]
Abstract
Recently, concerns regarding the safety of red yeast rice (RYR) have been raised after the publication of some case reports claiming toxicity. Since the previous meta-analyses on the effects of RYR were mainly focused on its efficacy to improve lipid profile and other cardiovascular parameters, we carried out a meta-analysis on safety data derived from the available randomized controlled clinical trials (RCTs). Primary outcomes were musculoskeletal disorders (MuD). Secondary outcomes were non-musculoskeletal adverse events (Non-MuD) and serious adverse events (SAE). Subgroups analyses were carried out considering the intervention (RYR alone or in association with other nutraceutical compounds), monacolin K administered daily dose (≤3, 3.1-5 or >5 mg/day), follow-up (>12 or ≤12 weeks), with statin therapy or statin-intolerance and type of control treatment (placebo or statin treatment). Data were pooled from 53 RCTs comprising 112 treatment arms, which included 8535 subjects, with 4437 in the RYR arm and 4303 in the control one. Monacolin K administration was not associated with increased risk of MuD (odds ratio (OR) = 0.94, 95% confidence interval (CI) 0.53,1.65). Moreover, we showed reduced risk of Non-MuD (OR = 0.59, 95%CI 0.50, 0.69) and SAE (OR = 0.54, 95%CI 0.46, 0.64) vs. control. Subgroups analyses confirmed the high tolerability profile of RYR. Furthermore, increasing daily doses of monacolin K were negatively associated with increasing risk of Non-MuD (slope: -0.10; 95%CI: -0.17, -0.03; two-tailed p < 0.01). Based on our data, RYR use as lipid-lowering dietary supplement seems to be overall tolerable and safe in a large kind of moderately hypercolesterolaemic subjects.
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Affiliation(s)
- Federica Fogacci
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland; Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland.
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, UK
| | - Eric Bruckert
- Institute of Cardiometabolism and Nutrition (ICAN), Endocrinology Department, Hopital Pitié Salpetrière, Paris, France
| | - Peter P Toth
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA; Preventive Cardiology, CGH Medical Center, Sterling, IL, USA
| | - Gerald F Watts
- Cardiometabolic Service, Department of Cardiology, Royal Perth Hospital, School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Željko Reiner
- University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Department of Internal Medicine, Zagreb, Croatia
| | - John Mancini
- Department of Medicine, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Manfredi Rizzo
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Olena Mitchenko
- Dyslipidaemia Department, Institute of Cardiology AMS of Ukraine, Ukraine
| | - Daniel Pella
- 1st Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Košice, Slovakia
| | - Zlatko Fras
- Preventive Cardiology Unit, Department of Vascular Medicine, Division of Internal Medicine, University Medical Centre Ljubljana, Slovenia
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Michal Vrablik
- Third Department of Internal Medicine, First Medical Faculty, Charles University, Prague, Czech Republic
| | - Arrigo F G Cicero
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy.
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15
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Houston M. Dyslipidemia. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00027-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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16
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Cicero AFG, Colletti A, Bajraktari G, Descamps O, Djuric DM, Ezhov M, Fras Z, Katsiki N, Langlois M, Latkovskis G, Panagiotakos DB, Paragh G, Mikhailidis DP, Mitchenko O, Paulweber B, Pella D, Pitsavos C, Reiner Ž, Ray KK, Rizzo M, Sahebkar A, Serban MC, Sperling LS, Toth PP, Vinereanu D, Vrablík M, Wong ND, Banach M. Lipid-lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel. Nutr Rev 2017; 75:731-767. [PMID: 28938795 DOI: 10.1093/nutrit/nux047] [Citation(s) in RCA: 213] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
In recent years, there has been growing interest in the possible use of nutraceuticals to improve and optimize dyslipidemia control and therapy. Based on the data from available studies, nutraceuticals might help patients obtain theraputic lipid goals and reduce cardiovascular residual risk. Some nutraceuticals have essential lipid-lowering properties confirmed in studies; some might also have possible positive effects on nonlipid cardiovascular risk factors and have been shown to improve early markers of vascular health such as endothelial function and pulse wave velocity. However, the clinical evidence supporting the use of a single lipid-lowering nutraceutical or a combination of them is largely variable and, for many of the nutraceuticals, the evidence is very limited and, therefore, often debatable. The purpose of this position paper is to provide consensus-based recommendations for the optimal use of lipid-lowering nutraceuticals to manage dyslipidemia in patients who are still not on statin therapy, patients who are on statin or combination therapy but have not achieved lipid goals, and patients with statin intolerance. This statement is intended for physicians and other healthcare professionals engaged in the diagnosis and management of patients with lipid disorders, especially in the primary care setting.
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Affiliation(s)
- Arrigo F G Cicero
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy; and Italian Society of Nutraceuticals
| | - Alessandro Colletti
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy; and Italian Society of Nutraceuticals
| | - Gani Bajraktari
- Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo; Medical Faculty, University of Prishtina, Prishtina, Kosovo; and Kosovo Society of Cardiology
| | - Olivier Descamps
- Department of Internal Medicine, Centres Hospitaliers Jolimont, Haine Saint-Paul, Belgium; and Belgian Atherosclerosis Society
| | - Dragan M Djuric
- Institute of Medical Physiology "Richard Burian," Faculty of Medicine, University of Belgrade, Belgrade, Serbia; and Serbian Association for Arteriosclerosis, Thrombosis and Vascular Biology Research
| | - Marat Ezhov
- Russian Cardiology Research and Production Centre, Moscow, Russia; and Russian National Atherosclerosis Society
| | - Zlatko Fras
- Preventive Cardiology Unit, Department of Vascular Medicine, Division of Internal Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia; Chair for Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; and Slovenian Society of Cardiology
| | - Niki Katsiki
- Second Department of Propaedeutic Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Michel Langlois
- Department of Laboratory Medicine, AZ Sint-Jan Hospital, Bruges, Belgium; and Belgian Atherosclerosis Society
| | - Gustavs Latkovskis
- Faculty of Medicine and Institute of Cardiology and Regenerative Medicine, University of Latvia, Riga, Latvia; and Baltic Atherosclerosis Society
| | - Demosthenes B Panagiotakos
- School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Gyorgy Paragh
- Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; and Hungarian Atherosclerosis Society
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London, London, UK
| | - Olena Mitchenko
- Dyslipidaemia Department, Institute of Cardiology AMS of Ukraine, Kiev, Ukraine; and Ukrainian Atherosclerosis Society
| | - Bernhard Paulweber
- 1st Department of Internal Medicine, Paracelsus Private Medical University, Salzburg, Austria; and Austrian Atherosclerosis Society
| | - Daniel Pella
- 1st Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Košice, Slovakia; and Slovak Association of Atherosclerosis
| | - Christos Pitsavos
- Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece; and Hellenic Atherosclerosis Society
| | - Željko Reiner
- University Hospital Centre Zagreb, School of Medicine University of Zagreb, Department of Internal Medicine, Zagreb, Croatia; and Croatian Atherosclerosis Society
| | - Kausik K Ray
- Department of Primary Care and Public Health, Imperial College, London, UK
| | - Manfredi Rizzo
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy; and Euro-Mediterranean Institute of Science and Technology, Palermo, Italy
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maria-Corina Serban
- Center for Interdisciplinary Research, and Department of Functional Sciences, University of Medicine and Pharmacy "Victor Babes," Timisoara, Romania
| | - Laurence S Sperling
- Division of Cardiology, Emory University, Emory Clinical Cardiovascular Research Institute, Atlanta, Georgia, USA
| | - Peter P Toth
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland, USA; and Preventive Cardiology, CGH Medical Center, Sterling, Illinois, USA
| | - Dragos Vinereanu
- University of Medicine and Pharmacy "Carol Davila," Bucharest, Romania; Department of Cardiology, University and Emergency Hospital, Bucharest, Romania; and Romanian Society of Cardiology
| | - Michal Vrablík
- Third Department of Internal Medicine, First Medical Faculty, Charles University, Prague, Czech Republic; and Czech Atherosclerosis Society
| | - Nathan D Wong
- Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, California, USA
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland; Polish Mother's Memorial Hospital Research Institute, Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland; Lipid and Blood Pressure Meta-Analysis Collaboration Group; and Polish Lipid Association
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17
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18
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Cicero AF, Colletti A, Bajraktari G, Descamps O, Djuric DM, Ezhov M, Fras Z, Katsiki N, Langlois M, Latkovskis G, Panagiotakos DB, Paragh G, Mikhailidis DP, Mitchenko O, Paulweber B, Pella D, Pitsavos C, Reiner Ž, Ray KK, Rizzo M, Sahebkar A, Serban MC, Sperling LS, Toth PP, Vinereanu D, Vrablík M, Wong ND, Banach M. Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel. Arch Med Sci 2017; 13:965-1005. [PMID: 28883839 PMCID: PMC5575230 DOI: 10.5114/aoms.2017.69326] [Citation(s) in RCA: 191] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 07/28/2017] [Indexed: 02/05/2023] Open
Affiliation(s)
- Arrigo F.G. Cicero
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy; Italian Society of Nutraceuticals (SINut)
| | - Alessandro Colletti
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy; Italian Society of Nutraceuticals (SINut)
| | - Gani Bajraktari
- Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo; Medical Faculty, University of Prishtina, Prishtina, Kosovo; Kosovo Society of Caridology
| | - Olivier Descamps
- Institute of Medical Physiology “Richard Burian“, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Serbian Association for Arteriosclerosis, Thrombosis and Vascular Biology Research
| | - Dragan M. Djuric
- Institute of Medical Physiology “Richard Burian“, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Serbian Association for Arteriosclerosis, Thrombosis and Vascular Biology Research
| | - Marat Ezhov
- Russian Cardiology Research and Production Centre, Moscow, Russia; Russian National Atherosclerosis Society
| | - Zlatko Fras
- Preventive Cardiology Unit, Department of Vascular Medicine, Division of Internal Medicine, University Medical Centre Ljubljana, Slovenia; Chair for Internal Medicine, Faculty of Medicine, University of Ljubljana, Slovenia; Slovenian Society of Cardiology
| | - Niki Katsiki
- Second Department of Propaedeutic Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Michel Langlois
- Department of Laboratory Medicine, AZ Sint-Jan Hospital, Bruges, Belgium; Belgian Atheroclerosis Society
| | - Gustavs Latkovskis
- Faculty of Medicine and Institute of Cardiology and Regenerative Medicine, University of Latvia, Riga, Latvia; Baltic Atherosclerosis Society
| | - Demosthenes B. Panagiotakos
- School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Gyorgy Paragh
- Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Hungarian Atherosclerosis Society
| | - Dimitri P. Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, Medical School, University College London (UCL), London, UK
| | - Olena Mitchenko
- 13Dyslipidaemia Department, Institute of Cardiology AMS of Ukraine, Ukraine; Ukrainian Atherosclerosis Society
| | - Bernhard Paulweber
- First Department of Internal Medicine, Paracelsus Private Medical University, Salzburg, Austria; Austrian Atheroclerosis Society (AAS)
| | - Daniel Pella
- 1 Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Košice, Slovakia; Slovak Association of Atherosclerosis
| | - Christos Pitsavos
- Cardiology Clinic, School of Medicine, University of Athens, Greece; Hellenic Atherosclerosis Society
| | - Željko Reiner
- University Hospital Centre Zagreb, School of Medicine University of Zagreb, Department of Internal Medicine, Zagreb, Croatia; Croatian Atherosclerosis Society
| | - Kausik K. Ray
- Department of Primary Care and Public Health, Imperial College, London, UK
| | - Manfredi Rizzo
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy; Euro-Mediterranean Institute of Science and Technology, Palermo, Italy
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maria-Corina Serban
- Center for Interdisciplinary Research, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania; Department of Functional Sciences, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
| | - Laurence S. Sperling
- Division of Cardiology, Emory University, Emory Clinical Cardiovascular Research Institute, Atlanta, Georgia, USA
| | - Peter P. Toth
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA; Preventive Cardiology, CGH Medical Center, Sterling, Illinois, USA
| | - Dragos Vinereanu
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania; Department of Cardiology, University and Emergency Hospital, Bucharest, Romania; Romanian Society of Cardiology
| | - Michal Vrablík
- Third Department of Internal Medicine, First Medical Faculty, Charles University, Prague, Czech Republic; Czech Atherosclerosis Society
| | - Nathan D. Wong
- Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, USA
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland; Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland; Lipid and Blood Pressure Meta-Analysis Collaboration (LBPMC) Group; Polish Lipid Association (PoLA)
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19
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Cicero AFG, Colletti A, Fogacci F, Bove M, Rosticci M, Borghi C. Effects of a Combined Nutraceutical on Lipid Pattern, Glucose Metabolism and Inflammatory Parameters in Moderately Hypercholesterolemic Subjects: A Double-blind, Cross-over, Randomized Clinical Trial. High Blood Press Cardiovasc Prev 2017; 24:13-18. [PMID: 27339779 PMCID: PMC5315731 DOI: 10.1007/s40292-016-0163-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Accepted: 06/07/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND There is an increasing interest for combined nutraceuticals that can act on several points of lipid and glucose metabolism with preventive purposes. However, the simple assemblage of nutraceuticals with potentially additive mechanism of action need to be clinically tested. METHODS To assess the effects of a combination of nutraceuticals based on artichoke, red yeast rice, banaba, and coenzyme Q10, we performed a double bind, cross-over designed trial versus placebo in 30 adults with LDL cholesterol suboptimal in primary prevention of cardiovascular disease. After a period of 3 weeks of dietary habits correction, patients began a period of 6 weeks of treatment with nutraceutical or placebo, followed by 2 weeks of washout and finally 6 weeks in cross-over. Data related to lipid pattern, insulin resistance, renal function, liver and CPK have been obtained at each visit. RESULTS In particular, the after the nutraceutical treatment the enrolled patients experienced a significant improvement in total cholesterol (-13.6 %), LDL-C (-18.2 %), non-HDL-C (-15 %), glutamic oxaloacetic transaminase (-10 %), glutamate-pyruvate transaminase (-30.9 %), and hs-CRP (-18.2 %) versus placebo. No changes have been observed in the other investigated parameters in both groups. CONCLUSIONS The tested combination of nutraceuticals has shown clinical efficacy in the reduction of total cholesterol, non-HDL, LDL and triglycerides, while improving the level of liver transaminases and high sensitivity C-reactive protein. Further confirmation are needed to verify these observations on the middle and long term with a larger number of subjects.
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Affiliation(s)
- Arrigo Francesco Giuseppe Cicero
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy.
- Hypertension Research Center, Poliambulatorio Pad. 2, Via Albertoni, 15, 40138, Bologna, Italy.
| | - Alessandro Colletti
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy
| | - Federica Fogacci
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy
| | - Marilisa Bove
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy
| | - Martina Rosticci
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy
| | - Claudio Borghi
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy
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20
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Effects of long-term supplementation of policosanol on blood cholesterol/glucose levels and 3-hydroxy-3-methylglutaryl coenzyme a reductase activity in a rat model fed high cholesterol diets. Food Sci Biotechnol 2016; 25:899-904. [PMID: 30263351 DOI: 10.1007/s10068-016-0147-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 03/03/2016] [Accepted: 03/14/2016] [Indexed: 02/08/2023] Open
Abstract
Policosanol is a well-defined nutraceutical for the management of blood cholesterol levels. The present study examined (i) the effect of policosanol supplementation on blood cholesterol and glucose levels and (ii) changes in hepatic cholesterol biosynthesis using 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMG-CoA reductase) activity in Wistar rats fed high cholesterol diets. The Wistar rats were assigned randomly to high-cholesterol diets (1.25% cholesterol) with or without policosanol (8.0 mg/kg body weight) for 6 weeks. Compared with the control group, dietary treatment with policosanol resulted in a significant decrease of blood cholesterol (p<0.01), blood glucose (p<0.01), triglyceride (p<0.001), and low density lipoprotein-cholesterol levels (p<0.01) and HMG-CoA reductase activity (p<0.001) in the liver. These results indicate that policosanol decreases blood cholesterol levels by suppressing cholesterol biosynthesis via decrease of HMG-CoA activity. Policosanol has the potential to be developed into an effective dietary strategy for both postprandial hyperglycemia and hypercholesterolemia.
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21
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The Effects of Red Yeast Rice Dietary Supplement on Blood Pressure, Lipid Profile and C-reactive Protein in Hypertension: A Systematic Review. Crit Rev Food Sci Nutr 2015; 57:1831-1851. [DOI: 10.1080/10408398.2015.1018987] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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22
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Byun AR, Chun H, Lee J, Lee SW, Lee HS, Shim KW. Effects of a Dietary Supplement with Barley Sprout Extract on Blood Cholesterol Metabolism. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2015; 2015:473056. [PMID: 26101533 PMCID: PMC4458530 DOI: 10.1155/2015/473056] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 05/06/2015] [Indexed: 11/17/2022]
Abstract
Objective. Barley sprout (Hordeum vulgare L.) contains 4.97% fat, 52.6% polysaccharide, and 34.1% protein along with a variety of vitamins, minerals, and polyphenolic compounds. Hexacosanol is one such compound from the barley leaf that might improve cholesterol metabolism by decreasing cholesterol synthesis. Method. Therefore, this study was conducted to investigate the effects of barley sprout extract on serum lipid metabolism in healthy volunteers (n = 51). Subjects were randomly divided into two groups: one group consumed a single capsule of barley leaf extract daily (n = 25, 42.48 ± 13.58 years) and the other consumed placebo capsules (n = 26, 40.54 ± 11.1 years) for 12 weeks. Results. After 12 weeks, total cholesterol and low-density lipoprotein- (LDL-) cholesterol were not lower in the barley sprout extract group compared to the placebo group (p = 0.415 and p = 0.351, resp.) and no differences in clinical or laboratory findings were observed between both groups. Conclusion. Our study failed to show significant lipid-lowering effects of barley sprout extract, possibly due to dosage, duration of therapy, and small sample size. Despite our nonsignificant findings, barley sprout has a possibility as a functional health food; therefore future research is needed.
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Affiliation(s)
- A Ri Byun
- Department of Family Medicine, Ewha Woman's University Mokdong Hospital, Ewha Woman's University School of Medicine, Seoul, Republic of Korea
| | - Hyejin Chun
- Health Promotion Center, Ewha Woman's University Mokdong Hospital, Seoul 158-710, Republic of Korea
| | - Jin Lee
- Department of Family Medicine, Ewha Woman's University Mokdong Hospital, Ewha Woman's University School of Medicine, Seoul, Republic of Korea
| | - Sang Wha Lee
- Department of Family Medicine, Ewha Woman's University Mokdong Hospital, Ewha Woman's University School of Medicine, Seoul, Republic of Korea
| | - Hong Soo Lee
- Department of Family Medicine, Ewha Woman's University Mokdong Hospital, Ewha Woman's University School of Medicine, Seoul, Republic of Korea
| | - Kyung Won Shim
- Department of Family Medicine, Ewha Woman's University Mokdong Hospital, Ewha Woman's University School of Medicine, Seoul, Republic of Korea
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Li Y, Jiang L, Jia Z, Xin W, Yang S, Yang Q, Wang L. A meta-analysis of red yeast rice: an effective and relatively safe alternative approach for dyslipidemia. PLoS One 2014; 9:e98611. [PMID: 24897342 PMCID: PMC4045580 DOI: 10.1371/journal.pone.0098611] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 05/05/2014] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE To explore whether red yeast rice is a safe and effective alternative approach for dyslipidemia. METHODS Pubmed, the Cochrane Library, EBSCO host, Chinese VIP Information (VIP), China National Knowledge Infrastructure (CNKI), Wanfang Databases were searched for appropriate articles. Randomized trials of RYR (not including Xuezhikang and Zhibituo) and placebo as control in patients with dyslipidemia were considered. Two authors read all papers and independently extracted all relevant information. The primary outcomes were serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C). The secondary outcomes were increased levels of alanine transaminase, aspartate aminotransferase, creatine kinase, creatinine and fasting blood glucose. RESULTS A total of 13 randomized, placebo-controlled trials containing 804 participants were analyzed. Red yeast rice exhibited significant lowering effects on serum TC [WMD = -0.97 (95% CI: -1.13, -0.80) mmol/L, P<0.001], TG [WMD = -0.23 (95% CI: -0.31, -0.14) mmol/L, P<0.001], and LDL-C [WMD = -0.87 (95% CI: -1.03, -0.71) mmol/L, P<0.001] but no significant increasing effect on HDL-C [WMD = 0.08 (95% CI: -0.02, 0.19) mmol/L, P = 0.11] compared with placebo. No serious side effects were reported in all trials. CONCLUSIONS The meta-analysis suggests that red yeast rice is an effective and relatively safe approach for dyslipidemia. However, further long-term, rigorously designed randomized controlled trials are still warranted before red yeast rice could be recommended to patients with dyslipidemia, especially as an alternative to statins.
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Affiliation(s)
- Yinhua Li
- Department of Arteriosclerosis, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Long Jiang
- Department of Arteriosclerosis, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhangrong Jia
- Department of Arteriosclerosis, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Wei Xin
- Department of Arteriosclerosis, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Shiwei Yang
- Department of Arteriosclerosis, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Qiu Yang
- Department of Arteriosclerosis, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- * E-mail: (QY); (LW)
| | - Luya Wang
- Department of Arteriosclerosis, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- * E-mail: (QY); (LW)
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Scientific Opinion on the substantiation of a health claim related to the combination of artichoke leaf dry extract standardised in caffeoylquinic acids, monacolin K in red yeast rice, sugar‐cane derived policosanols, OPC from French maritime pine bark, garlic dry extract standardised in allicin, d‐α‐tocopheryl hydrogen succinate, riboflavin and inositol hexanicotinate in Limicol® and reduction of blood LDL‐cholesterol concentrations pursuant to Article 14 of Regulation (EC) No 1924/2006. EFSA J 2013. [DOI: 10.2903/j.efsa.2013.3327] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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