Piragine Eugenia, Malanima Marco Andrea, Ceccanti Costanza, Guidi Lucia, Martelli Alma, Lucenteforte Ersilia, Calderone Vincenzo
Department of Pharmacy, University of Pisa, Pisa, Italy.
Interdepartmental Research Center "Nutraceuticals and Food for Health (NUTRAFOOD)", University of Pisa, Pisa, Italy.
Phytother Res. 2024 Dec;38(12):5765-5781. doi: 10.1002/ptr.8350. Epub 2024 Sep 29.
Dyslipidemia is a risk factor for cardiovascular diseases. Preclinical studies have shown that organosulfur compounds from the Alliaceae and Brassicaceae plants, such as garlic (Allium sativum L.) and broccoli (Brassica oleracea L.), have potential lipid-lowering effects. However, their clinical efficacy is controversial, especially in "drug-free" patients. The aim of this work was to summarize evidence on the lipid-lowering properties of extracts containing organosulfur compounds in patients with dyslipidemia. Studies were searched in four databases (Medline, Scopus, Embase, and CENTRAL), from inception to October 11, 2023.Controlled clinical studies on patients with dyslipidemia receiving Alliaceae or Brassicaceae were included. The outcome was the change in lipid parameters from baseline. Random-effect meta-analysis of the extracted data was performed using R software. The effect size was expressed as mean difference (MD) and 95% confidence interval (CI). The certainty of evidence was assessed with the GRADE approach. Out of 28 studies that were reviewed, 22 were included in the meta-analysis (publication period: 1981-2022). Results showed that Alliaceae extracts significantly reduce total cholesterol [MD: -15.2 mg/dL; 95% CI: -21.3; -9.1] and low-density lipoprotein cholesterol levels [MD: -12.0 mg/dL; 95% CI: -18.1; -5.7], although with low certainty of evidence. Conversely, the lipid-lowering properties of Brassicaceae extracts are still unexplored. Our results support the use of Alliaceae extracts in patients with hypercholesterolemia, but future high-quality studies are needed. Our work suggests further exploration of the efficacy of Brassicaceae extracts, which may have high nutraceutical/phytotherapeutic potential, opening new perspectives in the management of dyslipidemia.
血脂异常是心血管疾病的一个危险因素。临床前研究表明，来自葱属和十字花科植物的有机硫化合物，如大蒜（Allium sativum L.）和西兰花（Brassica oleracea L.），具有潜在的降脂作用。然而，它们的临床疗效存在争议，尤其是在“无药物治疗”的患者中。这项工作的目的是总结血脂异常患者中含有机硫化合物提取物降脂特性的证据。从数据库创建到2023年10月11日，在四个数据库（Medline、Scopus、Embase和CENTRAL）中进行了检索。纳入了对接受葱属或十字花科植物治疗的血脂异常患者的对照临床研究。结局指标是血脂参数相对于基线的变化。使用R软件对提取的数据进行随机效应荟萃分析。效应大小以平均差（MD）和95%置信区间（CI）表示。采用GRADE方法评估证据的确定性。在审查的28项研究中，22项纳入了荟萃分析（发表时间：1981 - 2022年）。结果表明，葱属植物提取物显著降低总胆固醇[MD：-15.2mg/dL；95%CI：-21.3；-9.1]和低密度脂蛋白胆固醇水平[MD：-12.0mg/dL；95%CI：-18.1；-5.7]，尽管证据确定性较低。相反，十字花科植物提取物的降脂特性仍未得到充分研究。我们的结果支持在高胆固醇血症患者中使用葱属植物提取物，但未来需要高质量的研究。我们的工作表明需要进一步探索十字花科植物提取物的疗效，其可能具有很高的营养保健/植物治疗潜力，为血脂异常的管理开辟新的前景。
