Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine, University of Perugia, Perugia, Italy.
Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine, University of Perugia, Perugia, Italy.
Pharmacol Res. 2016 Aug;110:76-88. doi: 10.1016/j.phrs.2016.04.021. Epub 2016 May 6.
Dyslipidemia and hyperglycemia are associated with an increased risk of ischemic cardiovascular disease. Positive effects of a nutraceutical combination comprising red yeast rice, berberine, policosanol, astaxanthin, coenzyme Q10 and folic acid (NComb) on plasma lipid and glucose levels have been reported in some but not all clinical trials. To address this inconsistency, we tried to estimate the size of lipid- and glucose-lowering effects of NComb through a systematic review and meta-analysis of randomized controlled trials. A systematic literature search in PubMed-Medline, SCOPUS and Google Scholar databases was conducted to identify randomized controlled trials investigating the effects of NComb on plasma lipids and glucose levels. Inverse variance-weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated for net changes in lipid and glucose levels using a random-effects model. Random-effects meta-regression was performed to assess the effect of putative confounders on plasma lipid and glucose levels. Fourteen trials (1670 subjects in the NComb arm and 1489 subjects in the control arm) met the eligibility criteria for lipid analysis and 10 trials (1014 subjects in the NComb arm and 962 subjects in the control arm) for glucose analysis. Overall, WMDs were significant for the impact of NComb supplementation on plasma levels of total cholesterol (-26.15mg/dL, p<0.001), LDL-cholesterol (-23.85mg/dL, p<0.001), HDL-cholesterol (2.53mg/dL, p<0.001), triglycerides (-13.83mg/dL, p<0.001) and glucose (-2.59mg/dL, p=0.010). NComb-induced amelioration of lipid profile was not affected by duration of supplementation nor by baseline lipid levels; conversely, a greater glucose-lowering effect of NComb was found with higher baseline glucose levels and longer durations of supplementation. In conclusion, the present results suggest that NComb supplementation is associated with improvement of lipid and glucose profile. Short-term beneficial effects of NComb supplementation appear to be maintained in the long term.
血脂异常和高血糖与缺血性心血管疾病风险增加有关。一些临床试验报告了一种包含红曲米、黄连素、多廿烷醇、虾青素、辅酶 Q10 和叶酸的营养组合（NComb）对血浆脂质和葡萄糖水平的积极影响，但并非所有临床试验都有此结果。为了解决这一不一致性，我们试图通过系统评价和荟萃分析来估计 NComb 对血脂和血糖降低效果的大小。在 PubMed-Medline、SCOPUS 和 Google Scholar 数据库中进行了系统文献检索，以确定研究 NComb 对血浆脂质和葡萄糖水平影响的随机对照试验。使用随机效应模型计算脂质和葡萄糖水平净变化的逆方差加权均数差（WMD）和 95%置信区间（CI）。进行随机效应荟萃回归以评估潜在混杂因素对血浆脂质和葡萄糖水平的影响。有 14 项试验（NComb 组 1670 例，对照组 1489 例）符合脂质分析的入选标准，10 项试验（NComb 组 1014 例，对照组 962 例）符合血糖分析的入选标准。总体而言，NComb 补充剂对血浆总胆固醇（-26.15mg/dL，p<0.001）、LDL-胆固醇（-23.85mg/dL，p<0.001）、HDL-胆固醇（2.53mg/dL，p<0.001）、甘油三酯（-13.83mg/dL，p<0.001）和血糖（-2.59mg/dL，p=0.010）水平的影响具有显著的 WMD。NComb 改善血脂谱的效果不受补充持续时间或基线血脂水平的影响；相反，NComb 的降血糖作用在基线血糖水平较高和补充持续时间较长时更为明显。总之，本研究结果表明，NComb 补充剂与改善血脂和血糖谱有关。NComb 补充剂的短期有益作用似乎可以长期维持。
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