Nutraceutical Combinations in Hypercholesterolemia: Evidence from Randomized, Placebo-Controlled Clinical Trials
Abstract
:1. Introduction
2. Methodology
3. Lipid-Lowering Molecular Mechanism of Action and Efficacy of Single Compound Present in the NC
4. Study Design in the Selected Clinical Trials
5. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
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Refs | Natural Active Components | Type of RCT | Study Intervention Period (Weeks) | Total Subjects (n) | Male (n) | Female (n) | Age Range (Years) | LDL-Cholesterol (LDL-C) | Total Cholesterol (TC) | Adverse Effects | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Intervention Group | Placebo Group | Difference of Changes between Arms | Intervention Group | Placebo Group | Difference of Changes between Arms | |||||||||||||
Baseline vs. Final Mean LDL-C ± SD, (mg/dL) | LDL-C Reduction | Baseline vs.Final Mean LDL-C ± SD (mg/dL) | LDL-C Reduction | p Value | Baseline vs. Final Mean TC ± SD (mg/dL) | TC Reduction | Baseline vs. Final Mean TC ± SD (mg/dL) | TC Reduction | p Value | |||||||||
[10] | Bifidobacterium longum BB536 (1 bn UFC) Coenzyme Q10 (20 mg) Niacin (16 mg) RYR extract (10 mg monacolin K) | parallel | 12 | 33 | 16 | 17 | 18–70 | 177 (167, 193) 1 vs. 136.5 (118,151.5) 1 | −25.7% | 189 (174, 198) 1 vs. 183 (171, 202) 1 | NA | <0.0001 | 271 (239, 285) 1 vs. 208 (201, 263) 1 | −16.7% | 271 (256, 289) 1 vs. 267 (259, 293) | NA | <0.0001 | No |
[11] | Phytosterols 1.5 g Vitamin E (12 mg) RYR extract (10 mg monacolin K) Olive leaf extract (5 mg hydroxytyrosol) | parallel | 12 | 40 | 13 | 27 | 35–75 | 150.1 (142, 159.8) 1 vs. 120 (112.7, 129.3) 1 | −19.7% | 143.2 (133.9, 152.1) 1 vs. 138.6 (130.5, 145.9) 1 | −6.7% | <0.001 | 234.3 (225.1, 244.0) 1 vs. 201.5 (215.4, 234.7) 1 | −13.9% | 225.1 (215.4, 234.7) 1 vs. 218.5 (207.7, 229.3) 1 | −3.0% | <0.001 | No |
[12] | Artichoke extract (500 mg) Banaba extract (75 mg) Coenzyme Q10 (50 mg) RYR 200 (10 mg monacolin K) Vitamin B3 (9 mg) Vitamin B6 (1.4 mg) Vitamin B12 (0.83 mcg) Folic acid (110 mcg) | crossover | 6-2-6 | 30 | NA | NA | 25–75 | NA | −30.3 mg/dL | NA | −8.4 mg/dL | <0.05 | NA | −34.1 mg/dL | NA | −10.1 mg/dL | <0.05 | No |
[13] | Phytosterols (400 mg) RYR extract (5 mg monacolin K) L-tyrosol (2.5 mg) | parallel | 8 | 50 | 30 | 20 | 35–69 | 162.3 ± 21.9 vs. NA | −38.0 mg/dL | 151.7 ± 24.3 vs. NA | −20 mg/dL | <0.05 | 234.5 ± 24.7 vs. NA | −38.2 mg/dL | 225.1 ± 25.3 vs. NA | −22.2 mg/dL | <0.05 | No |
[14] | Coenzyme Q10 (30 mg) RYR extract (10 mg monacolin K) | parallel | 24 | 40 | 18 | 22 | 18–70 | 158.5 ± 15.4 vs. 116.8 ± 9.9 | −26.3% | 161.6 ± 13.8 vs. 167.1 ± 14.2 | +3.4% | <0.05 | 229.1 ± 14.1 vs. 180.7 ± 15.3 | −21.1% | 233.4 ± 12.8 vs. 238.4 ± 14.6 | +2.1% | <0.05 | No |
[15] | Berberine (500 mg) RYR extract (10 mg monacolin K) Policosanols (10 mg) | parallel | 6 | 50 | 26 | 24 | 18–70 | 175.6 ± 25.1 vs. NA | −40.9 mg/dL | 170.6 ± 22.0 vs. NA | −1.5 mg/dL | <0.001 | 254.8 ± 28.9 vs. NA | −44.0 mg/dL | 250.9 ± 30.8 vs. NA | −1.16 mg/dL | <0.001 | No |
[16] | Phytosterols (2 g) Curcumin (200 mg) | 2 × 2 fractional | 4 | 37 2 | NA | NA | 18–70 | 166.8 ± 5.8 3 vs. 142.4 ± 6.2 3 | −14.42% | 175.6 ± 6.9 3 vs. 172.9 ± 7.3 3 | −0.89% | 0.006 | 251.3 ± 7.3 3 vs. 222.3 ± 6.2 3 | −11.01% | 255.9 ± 6.9 3 vs. 252.9 ± 8.1 3 | −1.23% | 0.005 | No |
[17] | Berberine (500 mg) RYR 200 mg (10 mg monacolin K) Policosanol (10 mg) Coenzyme Q10 (2 mg) Astaxanthin (0.5 mg) Folic acid (0.2 mg) | parallel | 12 | 104 | 32 | 72 | ˃18 | 155.7 ± 14.6 vs. 135.3 ± 28.7 | −14.93% | 159.3 ± 15.6 vs. 147.5 ± 26.0 | −8.02% | 0.029 | 243.6 ± 24.3 vs. 221.8 ± 34.4 | −10.46% | 243.4 ± 19.5 vs. 232.8 ± 28.8 | −5.5% | 0.01 | No |
[18] | Artichoke leaf dry extract (200 mg) RYR 166.67 mg (0.4% monacolin K) Dicalcium phosphate (199 mg) Microcrystalline cellulose (87.36 mg) Calcium citrate (63.22 mg) Tricalcium phosphate (34 mg) Magnesium stearate (22 mg) Vitamin E (12.86 mg) Garlic dry extract (10 mg) Pine bark extract (6.67 mg) Sugar cane extract (3.70 mg) Vitamin B2 (1.60 mg) Vitamin B3 (2.92 mg) | parallel | 16 | 39 | 11 | 28 | 21–55 | 170.0 ± 20.0 vs. NA | −19.1% p < 0.001 vs. baseline | 170.0 ± 30.0 vs. NA | +2.8% p = 0.37 vs. baseline | NA | 250.0 ± 30.0 vs. NA | −14.1% p < 0.001 vs. baseline | 250.0 ± 30.0 vs. NA | +1.3 p = 0.53 vs. baseline | NA | No |
[19] | Catechins (149.4 mg) Purified black tea theaflavins (75 mg) | parallel | 11 | 66 2 | 44 | 22 | 18–65 | 150.5 ± 25.8 vs. 151.3 ± 27.4 | NA | 154.0 ± 18.9 vs. 151.3 ± 17.8 | NA | 0.106 | 223.1 ± 32.0 vs. 221.6 ± 32.8 | NA | 217.3 ± 21.6 vs. 215.8 ± 21.62 | NA | 0.118 | Yes |
[20] | Berberine (500 mg) RYR (10 mg monacolin K) Hydroxytyrosol (5 mg) Coenzyme Q10 (2 mg) | parallel | 4 | 106 2 | NA | NA | 18–75 | 147.5 ± 16.3 vs. 120.4 ± 18.8 | −39.1 mg/dL | 143.6 ± 15.0 vs. 149.3 ± 19.5 | +5.7 mg/dL | <0.001 | 234.6 ± 18.0 vs. 204.9 ± 22.2 | −45.9 mg/dL | 235.6 ± 17.9 vs. 238.0 ± 21.5 | +2.4 mg/dL | <0.001 | Yes |
[21] | Phytosterols (800 mg) Niacin (27 mg) Policosanols (10 mg) RYR extract (5 mg monacolin K) | parallel | 8 | 88 | 38 | 47 | 30–75 | 155.1 ± 19.9 vs. 122.6 ± 24.7 | −32.5 mg/dL | 161.5 ± 21.3 vs. 164.0 ± 20.4 | +2.5 mg/dL | <0.01 | 229.1 ± 27.9 vs. 197.1 ± 28.3 | −33.0 mg/dL | 232.6 ± 21.6 vs. 239.8 ± 23.6 | +8.2 mg/dL | <0.01 | No |
[22] | RYR extract 375 mg (3.75 mg monacolin K) Guggul extract (110 mg) Chromium picolinate (50 μg) | parallel | 8 | 80 | 38 | 42 | 18–65 | 137.6 ± 20.2 vs. 115.5 ± 22.2 | −16.1% | 134.4 ± 20.5 vs. 145.1 ± 23.7 | +8.0% | <0.05 | 205.0 ± 17.6 vs. 173.5 ± 21.7 | −15.4% | 200.8 ± 22.9 vs. 204.5 ± 22.8 | +1.8% | <0.05 | Yes |
[23] | Artichoke leaf extract 4 Berberine 4 | parallel | 8 | 40 | NA | NA | ˃18 | 156.7 ± 10.9 vs. 131.9 ± 9.1 | −16% | 157.4 ± 9.8 vs. 136.7 ± 10.8 | NA | <0.01 | 247.1 ± 11.7 vs. 199.9 ± 10.2 | −19.0% | 245.8 ± 13.6 vs. 223.6 ± 11.9 | NA | <0.01 | No |
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Protic, O.; Bonfigli, A.R.; Antonicelli, R. Nutraceutical Combinations in Hypercholesterolemia: Evidence from Randomized, Placebo-Controlled Clinical Trials. Nutrients 2021, 13, 3128. https://doi.org/10.3390/nu13093128
Protic O, Bonfigli AR, Antonicelli R. Nutraceutical Combinations in Hypercholesterolemia: Evidence from Randomized, Placebo-Controlled Clinical Trials. Nutrients. 2021; 13(9):3128. https://doi.org/10.3390/nu13093128
Chicago/Turabian StyleProtic, Olga, Anna Rita Bonfigli, and Roberto Antonicelli. 2021. "Nutraceutical Combinations in Hypercholesterolemia: Evidence from Randomized, Placebo-Controlled Clinical Trials" Nutrients 13, no. 9: 3128. https://doi.org/10.3390/nu13093128