Preuss H G, Wallerstedt D, Talpur N, Tutuncuoglu S O, Echard B, Myers A, Bui M, Bagchi D
Department of Physiology, Georgetown University Medical Center, Washington, DC 20007, USA.
J Med. 2000;31(5-6):227-46.
Hypercholesterolemia, a significant cardiovascular risk factor, is prevalent in the American population. Many drugs lower circulating cholesterol levels, but they are not infrequently associated with severe side effects. Accordingly, natural means to lower cholesterol levels safely would be welcomed. We examined 40 hypercholesterolemic subjects (total cholesterol 210-300 mg/dL) in a randomized, double-blind, placebo-controlled study. The four groups of ten subjects received either placebo bid, chromium polynicotinate (Cr) 200 microg bid, grape seed extract (GSE) 100 mg bid, or a combination of Cr and GSE at the same dosage bid. Over two months, the average percent change +/- SEM in the total cholesterol from baseline among groups was: placebo -3.5% +/- 4, GSE -2.5% +/- 2, Cr -10% +/- 5, and combination -16.5% +/- 3. The decrease in the last group was significantly different from placebo (p < 0.01). The major decrease in cholesterol concentration was in the LDL levels: placebo -3.0% +/- 4, GSE -1.0% +/- 2.0, Cr -14% +/- 4.0, and the combination -20% +/- 6.0. Again, the combination of Cr and GSE significantly decreased LDL when compared to placebo (p<0.01). HDL levels essentially did not change among the groups. Also, there was no significant difference in the triglyceride concentrations among the groups; and no statistically significant differences were seen in the levels of autoantibodies to oxidized LDL (Ox-LDL). However, the trend was for the two groups receiving GSE to have greater decreases in the latter parameter, i.e., -30.7% and -44.0% in the GSE and combined groups in contrast to -17.3% and -10.4% in the placebo and chromium groups. We determined the number of subjects in each group who decreased autoantibodies to oxidized LDL greater than 50% over eight weeks and found these ratios among groups: placebo = 2/9, Cr = 1/10, GSE = 6/10, and combined = 3/8. Thus, 50% of subjects (9/18) receiving GSE had a greater than 50% decrease in autoantibodies compared to 16% (3/19) in the two groups not receiving GSE. No significant changes occurred in the levels of circulating homocysteine and blood pressure among the four groups. We conclude that a combination of Cr and GSE can decrease total cholesterol and LDL levels significantly. Furthermore, there was a trend to decrease the circulating autoantibodies to oxidized LDL in the two groups receiving GSE.
高胆固醇血症是一个重要的心血管危险因素，在美国人群中普遍存在。许多药物可降低循环胆固醇水平，但它们常常伴有严重的副作用。因此，安全降低胆固醇水平的天然方法将受到欢迎。我们在一项随机、双盲、安慰剂对照研究中检查了40名高胆固醇血症患者（总胆固醇210 - 300mg/dL）。四组各10名受试者分别接受每日两次安慰剂、200微克每日两次聚烟酸铬（Cr）、100毫克每日两次葡萄籽提取物（GSE），或相同剂量的Cr与GSE组合。在两个月的时间里，各组总胆固醇相对于基线的平均变化百分比±标准误为：安慰剂组-3.5%±4，GSE组-2.5%±2，Cr组-10%±5，组合组-16.5%±3。最后一组的下降与安慰剂组有显著差异（p<0.01）。胆固醇浓度的主要下降发生在低密度脂蛋白水平：安慰剂组-3.0%±4，GSE组-1.0%±2.0，Cr组-14%±4.0，组合组-20%±6.0。同样，与安慰剂组相比，Cr与GSE的组合显著降低了低密度脂蛋白（p<0.01）。各组高密度脂蛋白水平基本没有变化。此外，各组甘油三酯浓度没有显著差异；氧化低密度脂蛋白（Ox-LDL）自身抗体水平也没有统计学上的显著差异。然而，趋势是接受GSE的两组在后一参数上有更大程度的下降，即GSE组和组合组分别下降-30.7%和-44.0%，而安慰剂组和铬组分别下降-17.3%和-10.4%。我们确定了每组中在八周内氧化低密度脂蛋白自身抗体下降超过50%的受试者数量，并发现各组的这些比例为：安慰剂组 = 2/9，Cr组 = 1/10，GSE组 = 6/10，组合组 = 3/8。因此，接受GSE的受试者中有50%（9/18）的氧化低密度脂蛋白自身抗体下降超过50%，而未接受GSE的两组中这一比例为16%（3/19）。四组中循环同型半胱氨酸水平和血压没有显著变化。我们得出结论，Cr与GSE的组合可显著降低总胆固醇和低密度脂蛋白水平。此外，接受GSE的两组有降低循环中氧化低密度脂蛋白自身抗体的趋势。
