Xia Wei, Xiang Song, Gaman Mihnea-Alexandru, Jamilian Parmida, Prabahar Kousalya, Du Guanggang, Gao Dan
Department of Endocrinology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China.
Phytother Res. 2022 Dec;36(12):4398-4408. doi: 10.1002/ptr.7646. Epub 2022 Sep 30.
Various studies have proven that phytosterols and phytostanols (PS) are lipid-lowering agents. These compounds play a role in regulating high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglyceride (TG) metabolism. Although various drugs are available and are currently used to treat dyslipidemia, the management of lipid abnormalities during the postmenopausal period remains a challenge. Thus, scientists are trying to develop new strategies to reduce serum lipids concentrations using natural products. However, the impact of PS administration on serum lipids in postmenopausal women remains unclear. Hence, the purpose of this study was to assess the effect of PS supplementation on the lipid profile in postmenopausal women based on a systematic review of the literature and a meta-analysis of randomized controlled trials. PubMed/Medline, Scopus, Embase, and Web of Science were searched to identify suitable papers published until January 18, 2022. We combined the effect sizes with the DerSimonian and Laird method using a random effects model. PS supplementation resulted in a significant decrease in TC (weighted mean difference [WMD]: -16.73 mg/dl) and LDL-C (WMD: -10.06 mg/dl) levels. No effect of PS supplementation on TG (WMD: -1.14 mg/dl) or HDL-C (WMD: -0.29 mg/dl) concentrations was detected. In the stratified analysis, there was a notable reduction in TC and LDL-C levels when the PS dose was ≥2 g/day (TC: -22.22 mg/dl and LDL-C: -10.14 mg/dl) and when PS were administered to participants with a body mass index ≥25 kg/m (TC: -20.22 mg/dl and LDL-C: -14.85 mg/dl). PS administration can decrease TC and LDL-C, particularly if the dose of administration is ≥2 g/day and if the participants are overweight or obese. Further high-quality studies are needed to firmly establish the clinical efficacy of PS usage in postmenopausal females.
多项研究已证明，植物甾醇和植物甾烷醇（PS）是降脂剂。这些化合物在调节高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）和甘油三酯（TG）代谢中发挥作用。尽管有多种药物可用于治疗血脂异常，但绝经后脂质异常的管理仍然是一项挑战。因此，科学家们正试图开发利用天然产物降低血脂浓度的新策略。然而，PS给药对绝经后女性血脂的影响仍不明确。因此，本研究的目的是基于对文献的系统评价和随机对照试验的荟萃分析，评估补充PS对绝经后女性血脂谱的影响。检索了PubMed/Medline、Scopus、Embase和Web of Science，以确定截至2022年1月18日发表的合适论文。我们使用随机效应模型，采用DerSimonian和Laird方法合并效应量。补充PS导致TC（加权平均差[WMD]：-16.73mg/dl）和LDL-C（WMD：-10.06mg/dl）水平显著降低。未检测到补充PS对TG（WMD：-1.14mg/dl）或HDL-C（WMD：-0.29mg/dl）浓度有影响。在分层分析中，当PS剂量≥2g/天时（TC：-22.22mg/dl，LDL-C：-10.14mg/dl）以及当PS给予体重指数≥25kg/m的参与者时（TC：-20.22mg/dl，LDL-C：-14.85mg/dl），TC和LDL-C水平有显著降低。PS给药可降低TC和LDL-C，特别是当给药剂量≥2g/天且参与者超重或肥胖时。需要进一步的高质量研究来确定PS在绝经后女性中的临床疗效。
