School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong, China.
Guangdong Provincial Key Laboratory of Diabetology, Guangzhou Key Laboratory of Mechanistic and Translational Obesity Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
Medicine (Baltimore). 2024 Oct 18;103(42):e40020. doi: 10.1097/MD.0000000000040020.
The use of phytosterols and phytostanols (PS) as food supplements to control plasma cholesterol concentrations has recently received attention as its efficacy has been endorsed by scientific authorities and leading guidelines. However, the effects of phytosterols on lipid profiles and atherosclerosis remain incomplete and controversial. This study aims to investigate the effects of PS supplementation on lipid profiles and apolipoproteins in adults based on a systematic review of the literature and a meta-analysis of randomized controlled trials (RCTs).
A comprehensive search was conducted for RCTs published in PubMed, Embase, Cochrane Library, and Web of Science as of May 2024. Random effects model was utilized to determine the mean differences and 95% confidence interval for changes in circulating lipid profiles and apolipoproteins.
Twenty-eight RCTs with a total of 1777 participants (895 cases and 882 controls) are included in the qualitative synthesis. PS supplementation significantly reduced total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), and apolipoprotein B (Apo-B) levels, as well as Apo-B/apolipoprotein A1 ratios, but increased high-density lipoprotein cholesterol levels. PS supplementation dose is associated with TC, LDL-c, and Apo-B levels in a dose-response manner.
Our findings suggest that dietary phytosterols can effectively promote the reduction of TC, LDL-c, and Apo-B, along with increased high-density lipoprotein cholesterol in adults.
植物固醇和植物甾烷醇（PS）作为食品补充剂来控制血浆胆固醇浓度，其功效已得到科学权威和主要指南的认可，最近受到了关注。然而，植物固醇对血脂谱和动脉粥样硬化的影响仍不完整且存在争议。本研究旨在通过对文献进行系统评价和对随机对照试验（RCT）进行荟萃分析，调查 PS 补充剂对成年人血脂谱和载脂蛋白的影响。
截至 2024 年 5 月，在 PubMed、Embase、Cochrane 图书馆和 Web of Science 中对已发表的 RCT 进行了全面检索。使用随机效应模型确定循环血脂谱和载脂蛋白变化的均数差和 95%置信区间。
定性综合分析共纳入 28 项 RCT，共计 1777 名参与者（895 例病例和 882 例对照）。PS 补充显著降低了总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-c）和载脂蛋白 B（Apo-B）水平，以及 Apo-B/载脂蛋白 A1 比值，但增加了高密度脂蛋白胆固醇水平。PS 补充剂量与 TC、LDL-c 和 Apo-B 水平呈剂量反应关系。
我们的研究结果表明，膳食植物固醇可有效促进成年人 TC、LDL-c 和 Apo-B 的降低，同时增加高密度脂蛋白胆固醇。
