Effects of phytosterol supplementation on lipid profiles in patients with hypercholesterolemia: a systematic review and meta-analysis of randomized controlled trials

Gao, Yusi; Xun, Ruilong; Xia, Jiayue; Xia, Hui; Sun, Guiju

doi:10.1039/d2fo03663k

Cited by 9 publications

(3 citation statements)

References 126 publications

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“…After screening the titles and abstracts of the 412 remaining papers, 380 publications did not fulfill inclusion criteria and were excluded. Ultimately, 17 meta‐analyses with 23 study arms with a total of 52,958 participants were included in this umbrella meta‐analysis (Abumweis et al, 2008; Amir Shaghaghi et al, 2013; Baker et al, 2009; Demonty et al, 2009; Ferguson et al, 2016; Fontané et al, 2023; Gao et al, 2023; Han et al, 2016; Moruisi et al, 2006; Musa‐Veloso et al, 2011; Ras et al, 2013; Ras et al, 2014; Scholle et al, 2009; Seppo et al, 2007; Wu et al, 2009; Xia et al, 2022; Ying et al, 2019). Included meta‐analyses were published between 2006 and 2023, with a number of included primary studies in each meta‐analysis ranging from 4 to 141.…”

Section: Resultsmentioning

confidence: 99%

The effect of phytosterol supplementation on lipid profile: A critical umbrella review of interventional meta‐analyses

Wang,

Feng,

Prabahar

et al. 2023

Phytotherapy Research

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Despite multiple investigations assessing the impact of phytosterol supplementation on serum lipid levels, there is still a great deal of debate regarding the benefits of this intervention in the management of dyslipidemia. Therefore, we aimed at clarifying this dilemma by conducting the present umbrella review of interventional meta‐analyses. Scopus, PubMed, Web of Science, and EMBASE were used to search for pertinent publications on the effect of phytosterol supplementation on the lipid profile in humans up to June 2023. To compute the overall effect size (ES) and confidence intervals (CI), the random‐effects model was used. The I2 statistic and Cochrane's Q‐test were applied to estimate the heterogeneity among the studies. Seventeen meta‐analyses with 23 study arms were included in the umbrella meta‐analysis. Data pooled from the 23 eligible arms revealed that phytosterol supplementation reduces low‐density lipoprotein cholesterol (LDL‐C) (ES = −11.47 mg/dL; 95% CI: −12.76, −10.17, p < 0.001), total cholesterol (TC) (ES = −13.02 mg/dL; 95% CI: −15.68, −10.37, p < 0.001), and triglyceride (TG) (ES = −3.77 mg/dL; 95% CI: −6.04, −1.51, p = 0.001). Subgroup analyses showed that phytosterol administration with dosage ≥2 g/day and duration over 8 weeks and in hypercholesterolemic subjects was more likely to decrease LDL‐C, TC, and TG. Phytosterol administration did not significantly modify HDL‐C (ES = 0.18 mg/dL; 95% CI: −0.13, −0.51, p = 258) levels when compared to controls. The present umbrella meta‐analysis confirms that phytosterol administration significantly reduces LDL‐C, TC, and TG, with a greater effect with doses of ≥2 g/day and treatment duration >8 weeks, suggesting its possible application as a complementary therapy for cardiovascular risk reduction. Further studies are needed to determine the efficacy of phytosterols in patients with specific health conditions, as well as to ascertain the adverse effects, the maximum tolerable dose, and the maximum recommended duration of phytosterol administration.

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Section: Resultsmentioning

confidence: 99%

The effect of phytosterol supplementation on lipid profile: A critical umbrella review of interventional meta‐analyses

Wang,

Feng,

Prabahar

et al. 2023

Phytotherapy Research

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“…44 A recent meta-analysis of randomized controlled trials provided additional support for the cholesterol-lowering effects of plant sterols, demonstrating significant reductions in TC and LDL-C levels. 45 The analysis also highlighted the importance of factors such as dose, esterification, intervention cycle, and region in influencing the efficacy of dietary phytosterols. The findings indicate that phytosterols may effectively lower TC and LDL-C levels in individuals with hypercholesterolemia while having no impact on HDL-C and TG levels.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of randomized controlled trials on the health effects of chocolate enriched/fortified/supplemented with functional components

Frumuzachi,

Babotă,

Tanase

et al. 2024

Food Funct.

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“…Furthermore, plant steroids facilitate lipid metabolism, lowering cholesterol concentration and lowering the risk of cardiovascular complications. Understanding these mechanisms can guide the development of new treatments for DM [ 23 ]. However, only a single biomedical study explored its potential in managing DM.…”

Section: Literature Search Strategymentioning

confidence: 99%

Review on the Anti-Hyperglycemic Potential of Psidium guajava and Seriphium plumosum L.

Thembane,

Hlatshwayo,

Ngcobo

et al. 2024

Plants

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The treatment and management of diabetes mellitus (DM) with conventional therapies, such as insulin injections and oral hypoglycemic agents, present significant challenges due to their side effects and burdensome administration. Therapies often manage symptoms rather than addressing insulin regulation, akin to medications like thiazolidinediones and glinides, which resemble many medicinal plants. Medicinal plants offer potential alternative treatments due to bioactive compounds targeting diabetes causes. We aimed to explore the antidiabetic potential of two medicinal plants, Psidium guajava and Seriphium plumosum L., by investigating their phytochemical constituents, medicinal uses, pharmacological actions, and mechanisms. This review followed specific guidelines and searched databases including PubMed, Scopus, ScienceDirect, and Web of Science for studies on medicinal plants and DM. Eligible studies underwent quality assessment and were categorized based on their design and interventions for data synthesis. This review identified the phytochemical constituents in Psidium guajava and Seriphium plumosum L., including tannins, flavonoids, phenols, and steroids, exerting antidiabetic effects through various mechanisms like antioxidant activity, anti-inflammatory effects, stimulation of insulin secretion, glucose regulation, and inhibition of carbohydrate-digesting enzymes. Psidium guajava and Seriphium plumosum L. exhibit promising antidiabetic potential, offering alternative approaches to diabetes management. Polyherbalism, combining multiple plant extracts, may enhance therapeutic efficacy in diabetes treatment. Comprehensive research is needed to explore the combined therapeutic effects of these plants and develop more effective antidiabetic treatments. This review highlights the importance of harnessing natural resources to combat the global burden of DM. Further research is warranted to fully explore the combined therapeutic effects of these plants and develop novel treatments.

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Effects of phytosterol supplementation on lipid profiles in patients with hypercholesterolemia: a systematic review and meta-analysis of randomized controlled trials

Abstract: Abstract： Phytosterols (PSs) have been reported to improve blood lipids in patients with hypercholesterolemia for many years. However, meta-analyses of the effects of phytosterols on lipid profiles are limited and...

Cited by 9 publications

References 126 publications

The effect of phytosterol supplementation on lipid profile: A critical umbrella review of interventional meta‐analyses

The effect of phytosterol supplementation on lipid profile: A critical umbrella review of interventional meta‐analyses

A systematic review of randomized controlled trials on the health effects of chocolate enriched/fortified/supplemented with functional components

Review on the Anti-Hyperglycemic Potential of Psidium guajava and Seriphium plumosum L.

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