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Scientific Reports Aug 2016Efficacy and safety data from trials with suitable endpoints have shown that non-statin medication in combination with a statin is a potential strategy to further reduce... (Comparative Study)
Comparative Study Meta-Analysis Review
Efficacy and safety data from trials with suitable endpoints have shown that non-statin medication in combination with a statin is a potential strategy to further reduce cardiovascular events. We aimed to evaluate the overall effect of stanol- or sterol-enriched diets on serum lipid profiles in patients treated with statins by conducting a meta-analysis of randomized controlled trials (RCTs). We used the PubMed, Cochrane library and ClinicalTrials.gov databases to search for literature published up to December 2015. Trials were included in the analysis if they were RCTs evaluating the effect of plant stanols or sterols in patients under statin therapy that reported corresponding data on serum lipid profiles. We included 15 RCTs involving a total of 500 participants. Stanol- or sterol-enriched diets in combination with statins, compared with statins alone, produced significant reductions in total cholesterol of 0.30 mmol/L (95% CI -0.36 to -0.25) and low-density lipoprotein (LDL) cholesterol of 0.30 mmol/L (95% CI -0.35 to -0.25), but not in high-density lipoprotein cholesterol or triglycerides. These results persisted in the subgroup analysis. Our meta-analysis provides further evidence that stanol- or sterol-enriched diets additionally lower total cholesterol and LDL-cholesterol levels in patients treated with statins beyond that achieved by statins alone.
Topics: Cholesterol; Cholesterol, HDL; Cholesterol, LDL; Drug Therapy, Combination; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Lipid Metabolism; Lipids; Phytosterols; Randomized Controlled Trials as Topic; Triglycerides
PubMed: 27539156
DOI: 10.1038/srep31337 -
Annals of Nutrition & Metabolism 2015The prevalence of cardiovascular diseases (CVD) is rising and it is the prime cause of death in all developed countries. Bioactive compounds (BACs) can play a role in... (Review)
Review
BACKGROUND/AIMS
The prevalence of cardiovascular diseases (CVD) is rising and it is the prime cause of death in all developed countries. Bioactive compounds (BACs) can play a role in CVD prevention and treatment. To examine the scientific evidence supporting BACs groups' efficacy in CVD prevention and treatment, we conducted a systematized review.
METHODS
All available information on Medline, LILACS and EMBASE; all randomized controlled trials (RCTs) with prospective, parallel or crossover designs in humans in which the BACs effect was compared with that of placebo/control. Vascular homeostasis, blood pressure, endothelial function, oxidative stress and inflammatory biomarkers were considered primary outcomes.
RESULTS
We selected 26 articles, verifying their quality based on the Scottish Intercollegiate Guidelines Network, establishing diverse quality levels of scientific evidence according to the design and bias risk of a study. Grades of recommendation were included, depending on the evidence strength of antecedents.
CONCLUSIONS
Evidence shows that certain BACs' derivative from active lipids and nitrogen compounds, mainly from horse chestnut seed extract, sterol plants, allium derivatives, and certain doses of beta-glucans, can be helpful in decreasing the prevalence of CVD risk factors. However, further rigorous evidence is necessary to support and prove BACs' effect on CVD prevention and treatment.
Topics: Cardiovascular Diseases; Diet; Dietary Carbohydrates; Dietary Fiber; Flavonoids; Humans; MEDLINE; Nitrogen Compounds; Phytochemicals; Phytosterols; Polysaccharides; Randomized Controlled Trials as Topic; Sulfur Compounds; beta-Glucans
PubMed: 26045206
DOI: 10.1159/000430960 -
The Cochrane Database of Systematic... Jan 2010A cholesterol-lowering diet and several other dietary interventions have been suggested as a management approach either independently or as an adjuvant to drug therapy... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
A cholesterol-lowering diet and several other dietary interventions have been suggested as a management approach either independently or as an adjuvant to drug therapy in children and adults with familial hypercholesterolemia. However, a consensus has yet to be reached on the most appropriate dietary treatment.
OBJECTIVES
To examine whether a cholesterol-lowering diet is more effective in reducing ischaemic heart disease and lowering cholesterol than no dietary intervention in children and adults with familial hypercholesterolaemia. Further, to compare the efficacy of supplementing a cholesterol-lowering diet with either omega-3 fatty acids, soya proteins, plant sterols or plant stanols.
SEARCH STRATEGY
We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Inborn Errors of Metabolism Trials Register.Most recent search of the Group's Inborn Errors of Metabolism Trials Register: 09 October 2009.We also searched PubMed till 01 June 2008.
SELECTION CRITERIA
Randomised controlled trials, both published and unpublished, where a cholesterol-lowering diet in children and adults with familial hypercholesterolaemia has been compared to other forms of dietary treatment or to no dietary intervention were included.
DATA COLLECTION AND ANALYSIS
Two authors independently assessed the trial eligibility and methodological quality and one extracted the data, with independent verification of data extraction by a colleague.
MAIN RESULTS
In the present update, four new trials have been added making eleven trials with a total of 331 participants eligible for inclusion. Only short-term outcomes could be assessed due to the short duration of follow up in the included studies. None of the primary outcomes, (incidence of ischaemic heart disease, number of deaths and age at death) were evaluated in any of the included studies. No significant difference was noted for the majority of secondary outcomes for any of the planned comparisons. However, a significant difference was found only for the following comparison and outcome: total cholesterol levels for the comparison between plant sterols and cholesterol-lowering diet, mean difference 0.70 (95% confidence interval 0.19 to 1.21).
AUTHORS' CONCLUSIONS
No conclusions can be made about the effectiveness of a cholesterol-lowering diet, or any of the other dietary interventions suggested for familial hypercholesterolaemia, due to the lack of adequate data. Large, parallel, randomised controlled trials are needed to investigate the effectiveness of a cholesterol-lowering diet and the addition of omega-3 fatty acids, plant sterols or stanols, soya protein to a cholesterol-lowering diet.
Topics: Adult; Child; Cross-Over Studies; Diet, Fat-Restricted; Fatty Acids, Omega-3; Humans; Hyperlipoproteinemia Type II; Phytosterols; Randomized Controlled Trials as Topic; Soybean Proteins
PubMed: 20091526
DOI: 10.1002/14651858.CD001918.pub2 -
Journal of the American Dietetic... Feb 2008During the past few decades numerous studies have reported the atherogenic potential of saturated fatty acids, trans-fatty acids, and cholesterol, and beneficial effects... (Review)
Review
During the past few decades numerous studies have reported the atherogenic potential of saturated fatty acids, trans-fatty acids, and cholesterol, and beneficial effects of fiber, phytostanols/phytosterols, n-3 fatty acids, a Mediterranean diet, and other plant-based approaches. The purpose of this article is to provide a comprehensive and systematic review of the evidence associated with key dietary factors and risk of cardiovascular disease-an umbrella term encompassing diseases that affect the heart and blood vessels, including coronary heart disease, coronary artery disease, dyslipidemia, and hypertension-in conjunction with the work of the American Dietetic Association Evidence Analysis Library review on diet and lipids, updated with new evidence from the past 2 years. The criteria used and results cited provide scientific rationale for food and nutrition professionals and other health professionals for counseling patients. Details of these searches are available within the American Dietetic Association Evidence Analysis Library online (http://adaevidencelibrary.com). Potential mechanisms and needs for future research are summarized for each relevant nutrient, food, or food component.
Topics: Cardiovascular Diseases; Diet; Dietary Fats; Evidence-Based Medicine; Humans; Lipid Metabolism; Nutrition Policy; Nutritional Physiological Phenomena; Randomized Controlled Trials as Topic; Risk Factors
PubMed: 18237578
DOI: 10.1016/j.jada.2007.10.050 -
The Cochrane Database of Systematic... 2000This systematic review aimed to assess the effects of beta-sitosterols (B-sitosterol) on urinary symptoms and flow measures in men with of benign prostatic hyperplasia... (Review)
Review
OBJECTIVES
This systematic review aimed to assess the effects of beta-sitosterols (B-sitosterol) on urinary symptoms and flow measures in men with of benign prostatic hyperplasia (BPH).
SEARCH STRATEGY
Trials were searched in computerized general and specialized databases (MEDLINE, EMBASE, Cochrane Library, Phytodok), by checking bibliographies, and by contacting manufacturers and researchers.
SELECTION CRITERIA
Trials were eligible for inclusion provided they (1) randomized men with BPH to receive B-sitosterol preparations in comparison to placebo or other BPH medications, and (2) included clinical outcomes such as urologic symptom scales, symptoms, or urodynamic measurements.
DATA COLLECTION AND ANALYSIS
Information on patients, interventions, and outcomes was extracted by at least two independent reviewers using a standard form. Main outcome measure for comparing the effectiveness of B-sitosterols with placebo and standard BPH medications was the change in urologic symptom scale scores. Secondary outcomes included changes in nocturia as well as urodynamic measures (peak and mean urine flow, residual volume, prostate size). Main outcome measure for side effects was the number of men reporting side effects.
MAIN RESULTS
519 men from 4 randomized, placebo-controlled, double-blind trials, (lasting 4 to 26 weeks) were assessed. 3 trials used non-glucosidic B-sitosterols and one utilized a preparation that contained 100% B-sitosteryl-B-D-glucoside. B-Sitosterols improved urinary symptom scores and flow measures. The weighted mean difference (WMD) for the IPSS was -4.9 IPSS points (95%CI = -6.3 to -3.5, n = 2 studies). The WMD for peak urine flow was 3.91 ml/sec (95%CI = 0.91 to 6.90, n = 4 studies) and the WMD for residual volume was -28.62 ml (95%CI = -41. 42 to -15.83, n = 4 studies). The trial using 100% B-sitosteryl-B-D-glucoside (WA184) show improvement in urinary flow measures. B-sitosterols did not reduce prostate size. Withdrawal rates for men assigned to B-sitosterol and placebo were 7.8% and 8. 0%, respectively.
REVIEWER'S CONCLUSIONS
The evidence suggests non-glucosidic B-sitosterols improve urinary symptoms and flow measures. Their long term effectiveness, safety and ability to prevent BPH complications are not known.
Topics: Humans; Male; Phytotherapy; Prostatic Hyperplasia; Sitosterols; Urodynamics
PubMed: 10796740
DOI: 10.1002/14651858.CD001043 -
Journal of the American College of... Oct 2009To characterize the effect of plant sterols/stanols on serum lipids in hypercholesterolemic patients on concurrent statin therapy, we conducted a meta-analysis of... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To characterize the effect of plant sterols/stanols on serum lipids in hypercholesterolemic patients on concurrent statin therapy, we conducted a meta-analysis of randomized controlled trials.
METHODS
A systematic literature search of MEDLINE, EMBASE, Cochrane CENTRAL, and the Natural Medicines Comprehensive Database was conducted from the earliest possible date through May 2008. Trials were included in the analysis if they were randomized controlled trials evaluating the use of plant sterols/stanols in combination with statins in hypercholesterolemic patients that reported efficacy data on total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, or triglycerides. The weighted mean difference (WMD) of the change from baseline (in mg/dL) with 95% confidence interval (CI) was calculated as the difference between the mean in the plant sterol/stanol groups and the control groups, using a random-effects model.
RESULTS
Eight studies (n = 306 patients) met the inclusion criteria. Upon meta-analysis, the use of plant sterols/stanols in combination with statin therapy significantly lowered total cholesterol (WMD, -14.01 mg/dL [95% CI, -18.66 to -9.37], p < 0.0001) and LDL cholesterol (WMD, -13.26 mg/dL [95% CI, -17.34 to -9.18], p < 0.0001) but not HDL cholesterol or triglycerides.
CONCLUSIONS
Based upon the current literature, we can only say that plant sterols/stanols, when administered in addition to statins, favorably affect total and LDL cholesterol with 95% confidence. Randomized trials examining the impact of plant sterols/stanols in combinatation with statins on patient morbidity and mortality are needed.
Topics: Anticholesteremic Agents; Drug Therapy, Combination; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypercholesterolemia; Phytosterols; Phytotherapy; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 20439548
DOI: 10.1080/07315724.2009.10719784 -
Phytotherapy Research : PTR May 2019Present meta-analysis investigates the effects of phytosterols and phytostanol (PS) supplementation on anthropometric indices, using data from randomized controlled... (Meta-Analysis)
Meta-Analysis
Possible anti-obesity effects of phytosterols and phytostanols supplementation in humans: A systematic review and dose-response meta-analysis of randomized controlled trials.
Present meta-analysis investigates the effects of phytosterols and phytostanol (PS) supplementation on anthropometric indices, using data from randomized controlled trials. We performed a systematic search in the databases: PubMed, Scopus, Cochran, and Web of Science. Weighted mean difference (WMD) with 95% confidence intervals (CIs) were presented. Overall, 79 randomized controlled trials investigated the effects of PS on anthropometric indices. Meta-analysis results did not reveal any significant effect of PS supplementation on weight (66 trials-WMD: -0.083 kg; CI [-0.233, 0.066]; I = 42.5%), percentage fat mass (6 trials-WMD: -0.090%; CI [-0.789, 0.610]; I = 0.0%), and waist circumference (WC; 5 trials-WMD: -0.039 cm; CI [-0.452, 0.374]; I = 0.0%). However, body mass index (BMI) significantly decreased after PS supplementation (39 trials-WMD: -0.063 kg/m2, p = 0.024, I = 25.1%). Subgroup analyses showed that PS supplementation in subjects with baseline BMI ≥25 and hyperlipidemic significantly decreased body weight and BMI. The overall results showed that although PS supplementation did not affect anthropometric indices (except BMI), baseline status regarding BMI and hyperlipidemia and also dose and duration could be contributing factors for favorable effects.
Topics: Dietary Supplements; Humans; Obesity; Phytosterols; Randomized Controlled Trials as Topic
PubMed: 30838686
DOI: 10.1002/ptr.6319 -
Nutrients Jun 2019Human studies have shown diurnal rhythms of cholesterol and bile acid synthesis, but a better understanding of the role of the circadian system in cholesterol...
Diurnal Variation of Markers for Cholesterol Synthesis, Cholesterol Absorption, and Bile Acid Synthesis: A Systematic Review and the Bispebjerg Study of Diurnal Variations.
Human studies have shown diurnal rhythms of cholesterol and bile acid synthesis, but a better understanding of the role of the circadian system in cholesterol homeostasis is needed for the development of targeted interventions to improve metabolic health. Therefore, we performed a systematic literature search on the diurnal rhythms of cholesterol synthesis and absorption markers and of bile acid synthesis markers. We also examined the diurnal rhythms of the cholesterol synthesis markers lathosterol and desmosterol, and of the cholesterol absorption markers cholestanol, campesterol, and sitosterol in serum samples from the Bispebjerg study. These samples were collected every three hours over a 24-hour period in healthy males ( 24) who consumed low-fat meals. The systematic search identified sixteen papers that had examined the diurnal rhythms of the cholesterol synthesis markers lathosterol ( 3), mevalonate ( 9), squalene ( 2), or the bile acid synthesis marker 7α-hydroxy-4-cholesten-3-one (C4) ( 4). Results showed that lathosterol, mevalonate, and squalene had a diurnal rhythm with nocturnal peaks, while C4 had a diurnal rhythm with daytime peaks. Furthermore, cosinor analyses of the serum samples showed a significant diurnal rhythm for lathosterol ( < 0.001), but not for desmosterol, campesterol, sitosterol, and cholestanol ( > 0.05). In conclusion, cholesterol synthesis and bile acid synthesis have a diurnal rhythm, though no evidence for a diurnal rhythm of cholesterol absorption was found under highly standardised conditions. More work is needed to further explore the influence of external factors on the diurnal rhythms regulating cholesterol homeostasis.
Topics: Adolescent; Adult; Bile Acids and Salts; Biomarkers; Cholestanol; Cholesterol; Circadian Rhythm; Desmosterol; Female; Humans; Intestinal Absorption; Male; Middle Aged; Phytosterols; Sitosterols; Time Factors; Young Adult
PubMed: 31247945
DOI: 10.3390/nu11071439 -
Complementary Therapies in Medicine Mar 2020Carotenoids (including zeaxanthin and lycopene) and phytosterols reportedly confer beneficial effects on metabolic profile and function, which is of clinical importance.... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Carotenoids (including zeaxanthin and lycopene) and phytosterols reportedly confer beneficial effects on metabolic profile and function, which is of clinical importance. Thus, we sought to review the saffron effects on waist circumstance (WC), fasting plasma glucose (FPG), and HA1C concentrations reported in Randomized Control Trials (RCTs).
METHOD
A comprehensive systematic electronic search was performed in PubMed/MEDLINE, Embase, Google Scholar, Cochrane, Web of sciences, and SCOPUS to identify RCTs up to February 2019 without any language restrictions. The pooled weighted mean difference (WMD) calculated with DerSimonian-Laird random. PRISMA guidelines adhered to for this meta-analysis.
RESULT
Nine articles with 12 arms containing 595 participants were included in this study. Our study found WC was significantly reduced (WMD: -2.18 cm, 95 % CI: -4.05, -0.32) and FPG (WMD: -6.54 mg/dl, 95 % CI: -10.22, -2.85) following saffron intervention. Subgroup analysis highlighted that FPG levels (WMD: -10.24 mg/dl, 95 % CI: -15.76, -4.72) reduced significantly when intervention duration was longer than twelve weeks. There was no significant effect on HA1C levels (WMD: -0.13 mg/dl, 95 % CI: -0.31, 0.04) following saffron intervention.
CONCLUSION
In conclusion, the present study indicates beneficial effects on WC and FPG, following saffron supplementation.
Topics: Blood Glucose; Crocus; Dietary Supplements; Glycated Hemoglobin; Humans; Randomized Controlled Trials as Topic; Waist Circumference
PubMed: 32147057
DOI: 10.1016/j.ctim.2020.102298 -
Journal of Ethnopharmacology Nov 2021The worldwide increasing prevalence of dyslipidemia has become a global health concern. Various herbal remedies have been claimed to be effective for the treatment of...
ETHNOPHARMACOLOGICAL RELEVANCE
The worldwide increasing prevalence of dyslipidemia has become a global health concern. Various herbal remedies have been claimed to be effective for the treatment of dyslipidemia in traditional and folkloric medicine of different regions clinical trials have been conducted to investigate their efficacy. The aim of the current systematic review is to critically assess the meta-analyses of controlled trials (CT) evaluated herb medicines for dyslipidemia.
MATERIALS AND METHODS
Relevant studies from Web of Science, PubMed, Scopus, and Cochrane Library databases based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist until January 2021 have been searched. All meta-analyses which pooled studies on the effect of herbal medicines on lipid profile including total cholesterol (TC), triglyceride (TG), and low- or high-density lipoprotein cholesterol (LDL-C, HDL-C) were also included. Meta-analyses of in vitro, animal or observational studies were excluded.
RESULTS
The overall of 141 meta-analyses were revealed. Vegetable oils, phytosterols, tea, soy protein, nuts, and curcumin have been studied frequently among the herbal medicines. Among 13 meta-analyses on vegetable oils, the greater reduce of TC (18.95 mg/dl), LDL-C (16.24 mg/dl) and TG (13.69 mg/dl) were exhibited from sunflower oil. Furthermore, rice bran oil (6.65 mg/dl) increased HDL-C significantly. Phytosterols in 12 meta-analyses demonstrated significant improvements in reducing TC, LDL-C and TG as 16.4, 23.7, and 8.85 mg/dl, respectively, and rise in HDL-C as 10.6 mg/dl. The highest reduction in serum level of TC, LDL-C and TG was reported while intake Green tea; 27.57, 24.75, and 31.87 mg/dl, accordingly within 9 meta-analyses. Average improvement of lipid profiles by 6 meta-analyses on plant proteins were 23.2, 21.7, 15.06, and 1.55 mg/dl for TC, LDL-C, TG, and HDL-C, respectively. Among 11 meta-analyses on nuts, almond showed better and significant alleviations in TC (10.69 mg/dl), walnut in LDL-C (9.23 mg/dl), pistachio in TG (22.14 mg/dl), and peanut in HDL-C (2.72 mg/dl). Overall, Curcumin, Curcuminoid, and Turmeric have resulted in the reduction of TC (25.13 mg/dl), LDL-C (39.83 mg/dl), TG (33.65 mg/dl), and an increase in the HDL-C (4.31 mg/dl).
CONCLUSION
The current systematic review shed light on the use of herbal medicines for the management of dyslipidemia. However, more well-conducted CTs are required to determine effective doses of herbal medicines.
Topics: Dyslipidemias; Humans; Hypolipidemic Agents; Meta-Analysis as Topic; Phytotherapy; Plant Preparations; Plants, Medicinal
PubMed: 34252530
DOI: 10.1016/j.jep.2021.114407