Wei Chuyang, Cai Ruitao, Song Yingte, Liu Xiaoyong, Xu Hui-Lian
School of Biological Science and Technology, University of Jinan, Jinan 250024, China.
Nutrients. 2025 May 24;17(11):1784. doi: 10.3390/nu17111784.
The purpose of this paper is to comprehensively review the research progress of nattokinase in lowering blood lipid, including its source, structure and physicochemical properties, mechanisms of functions, clinical research status, and safety considerations, so as to provide reference for further research on the application of nattokinase in the treatment of dyslipidemia. Natto is a traditional Japanese fermented food, which is made from soybeans fermented by Bacillus natto. During the fermentation process, natto will produce a variety of biologically active substances, including nattokinase. Nattokinase (NK) is a serine protease with stable enzyme activity and good freeze-thaw tolerance, which exerts lipid-lowering and anti-atherosclerotic effects by activating hormone-sensitive lipase (HSL), inhibiting hydroxymethylglutaryl monoacyl coenzyme A reductase (HMG-CoA reductase), and enhancing lipoprotein lipase (LPL) activity. Large-scale clinical trials have confirmed that nattokinase significantly improves the lipid profile and reduces the atherosclerotic plaque area and intima-media thickness with a favorable safety profile. Compared with traditional lipid-lowering drugs (e.g., statins and fibrates), nattokinase has a multifaceted lipid-lowering mechanism and lower risk of side effects, which makes it suitable for patients intolerant of traditional drugs; when combined with natural products such as statins, fibrates, red yeast, and lifestyle interventions, it can play a synergistic role and further reduce the risk of cardiovascular disease. There are various types of nattokinase preparations on the market, and consumers should choose regular products with high activity and purity, and pay attention to their safety and applicable population.
本文旨在全面综述纳豆激酶在降血脂方面的研究进展，包括其来源、结构与理化性质、作用机制、临床研究现状以及安全性考量，为进一步研究纳豆激酶在治疗血脂异常中的应用提供参考。纳豆是一种传统的日本发酵食品，由纳豆杆菌发酵大豆制成。在发酵过程中，纳豆会产生多种生物活性物质，包括纳豆激酶。纳豆激酶（NK）是一种丝氨酸蛋白酶，酶活性稳定，冻融耐受性良好，通过激活激素敏感性脂肪酶（HSL）、抑制羟甲基戊二酰单酰辅酶A还原酶（HMG-CoA还原酶）以及增强脂蛋白脂肪酶（LPL）活性发挥降血脂和抗动脉粥样硬化作用。大规模临床试验证实，纳豆激酶能显著改善血脂谱，减小动脉粥样硬化斑块面积和内膜中层厚度，且安全性良好。与传统降血脂药物（如他汀类和贝特类）相比，纳豆激酶具有多方面的降血脂机制且副作用风险较低，这使其适用于不耐受传统药物的患者；与他汀类、贝特类、红曲等天然产物以及生活方式干预措施联合使用时，可发挥协同作用，进一步降低心血管疾病风险。市场上有多种纳豆激酶制剂，消费者应选择活性高、纯度高的正规产品，并注意其安全性和适用人群。
