Efficacy of Nutraceutical Combination of Monacolin K, Berberine, and Silymarin on Lipid Profile and PCSK9 Plasma Level in a Cohort of Hypercholesterolemic Patients

Formisano, Elena; Pasta, Andrea; Cremonini, Anna Laura; Favari, Elda; Ronca, Annalisa; Carbone, Federico; Semino, Tommaso; Pierro, Francesco Di; Sukkar, Samir Giuseppe; Pisciotta, Livia

doi:10.1089/jmf.2019.0168

Cited by 16 publications

(11 citation statements)

References 43 publications

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“…This finding is consistent with literature [ 24 , 48 ] and could be useful in patients with low ASCVD risk, even if the guidelines for the management of dyslipidemias highlighted the lack of high-quality randomized clinical trials. Furthermore, this type of NUTs as an addition to the diet could have various beneficial effects on the risk of atherosclerosis not only related to LDL-C reduction, as previously documented in some publications by other groups and ours [ 49 , 50 ]. On the other hand, the diet supplemented with PUFA-W3 was the most effective TG lowering treatment with a median percentage reduction of −22.6% from baseline to follow-up.…”

Section: Discussionsupporting

confidence: 69%

Diet and Nutraceutical Supplementation in Dyslipidemic Patients: First Results of an Italian Single Center Real-World Retrospective Analysis

Pasta

Formisano²,

Cremonini

et al. 2020

Nutrients

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Background: Dyslipidemias are a heterogeneous group of metabolic disorders mainly characterized by an increased risk of atherosclerotic cardiovascular disease (ASCVD) or other conditions, such as acute pancreatitis in hypertriglyceridemia. The aim of this study was to evaluate the effect of diet treatment and nutraceutical (NUTs) supplementation on the plasma lipid profile in outpatient dyslipidemic subjects, considering the influence of several factors (i.e., gender, age, body mass index, alcohol consumption, and smoking habits). Methods: 487 dyslipidemic patients spanning from 2015 to 2019 were treated with a Mediterranean diet or NUTs in a real-word setting and were retrospectively analyzed. General characteristics and lipid profile at baseline and after the follow-up period were evaluated. Results: Diet alone reduced total cholesterol (−19 mg/dL, −7.7%), LDL cholesterol (−18 mg/dL, −10.1%), and triglycerides (−20 mg/dL, −16.7%). Triglycerides (TG) decreased more in men, while women were associated with higher reduction of LDL cholesterol (LDL-C). Different types of NUTs further ameliorate lipid profiles when associated with diet. Nevertheless, most patients at low ASCVD risk (222 out of 262, 81.6%) did not achieve the 2019 ESC/EAS guidelines recommended LDL-C goals (i.e., LDL-C < 116 mg/dL). Conclusion: Lipid-lowering diet improves lipid profile, and NUTs can boost its efficacy, but taken together they are mainly unsatisfactory with respect to the targets imposed by 2019 EAS/ESC guidelines.

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Section: Discussionsupporting

confidence: 69%

Diet and Nutraceutical Supplementation in Dyslipidemic Patients: First Results of an Italian Single Center Real-World Retrospective Analysis

Pasta

Formisano²,

Cremonini

et al. 2020

Nutrients

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“…Very similar results were observed in a double blind, randomized, placebo-controlled study that investigated the lipid-lowering effect of 12 weeks treatment with a nutraceutical containing chitosan, red yeast rice, and berberine, in individuals with hypercholesterolemia [35]. As expected, the treatment significantly reduced non-HDL-cholesterol and LDL-cholesterol compared to the placebo, while no changes were observed in PCSK9 plasma levels [35], further supporting the counteracting effect of berberine on monacolin K. On the contrary, the treatment of hypercholesterolemic patients with a nutraceutical combination of monacolin K, berberine, and silymarin determined a significant increase of PCSK9 plasma levels after 8 weeks [36]. This effect is likely due to the use of a different ratio of the monacolin and berberine doses, resulting in the increasing effect on PCSK9.…”

Section: Cilinical Studiessupporting

confidence: 60%

Naturally Occurring PCSK9 Inhibitors

et al. 2020

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Genetic, epidemiological and pharmacological data have led to the conclusion that antagonizing or inhibiting Proprotein convertase subtilisin/kexin type 9 (PCSK9) reduces cardiovascular events. This clinical outcome is mainly related to the pivotal role of PCSK9 in controlling low-density lipoprotein (LDL) cholesterol levels. The absence of oral and affordable anti-PCSK9 medications has limited the beneficial effects of this new therapeutic option. A possible breakthrough in this field may come from the discovery of new naturally occurring PCSK9 inhibitors as a starting point for the development of oral, small molecules, to be used in combination with statins in order to increase the percentage of patients reaching their LDL-cholesterol target levels. In the present review, we have summarized the current knowledge on natural compounds or extracts that have shown an inhibitory effect on PCSK9, either in experimental or clinical settings. When available, the pharmacodynamic and pharmacokinetic profiles of the listed compounds are described.

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“…The above findings highlight the critical role of RC alkaloids in hyperlipidemia treatment in an obesity model. In addition, the clinical application of alkaloids was found to be more suitable for the obesity stage of prediabetes [ 24 , 25 ]. Despite these advances, we know very little about the mechanism by which hyperlipidemia and hypoglycemic effects are affected by RC intervention in an obesity model.…”

Section: Introductionmentioning

confidence: 99%

Obese rats intervened with Rhizoma coptidis revealed differential gene expression and microbiota by serum metabolomics

Luo

Zhang

et al. 2021

BMC Complement Med Ther

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Background Integrating systems biology is an approach for investigating metabolic diseases in humans. However, few studies use this approach to investigate the mechanism by which Rhizoma coptidis (RC) reduces the effect of lipids and glucose on high-fat induced obesity in rats. Methods Twenty-four specific pathogen-free (SPF) male Sprague–Dawley rats (80 ± 10 g) were used in this study. Serum metabolomics were detected by ultra-high-performance liquid chromatography coupled with quadrupole-time-of-flight tandem mass spectrometry. Liver tissue and cecum feces were used for RNA-Seq technology and 16S rRNA gene sequencing, respectively. Results We identified nine potential biomarkers, which are differential metabolites in the Control, Model and RC groups, including linoleic acid, eicosapentaenoic acid, arachidonic acid, stearic acid, and L-Alloisoleucine (p < 0.01). The liver tissue gene expression profile indicated the circadian rhythm pathway was significantly affected by RC (Q ≤ 0.05). A total of 149 and 39 operational taxonomic units (OTUs), which were highly associated with biochemical indicators and potential biomarkers in the cecum samples (FDR ≤ 0.05), respectively, were identified. Conclusion This work provides information to better understand the mechanism of the effect of RC intervention on hyperlipidemia and hypoglycemic effects in obese rats. The present study demonstrates that integrating systems biology may be a powerful tool to reveal the complexity of metabolic diseases in rats intervened by traditional Chinese medicine.

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Efficacy of Nutraceutical Combination of Monacolin K, Berberine, and Silymarin on Lipid Profile and PCSK9 Plasma Level in a Cohort of Hypercholesterolemic Patients

Cited by 16 publications

References 43 publications

Diet and Nutraceutical Supplementation in Dyslipidemic Patients: First Results of an Italian Single Center Real-World Retrospective Analysis

Diet and Nutraceutical Supplementation in Dyslipidemic Patients: First Results of an Italian Single Center Real-World Retrospective Analysis

Naturally Occurring PCSK9 Inhibitors

Obese rats intervened with Rhizoma coptidis revealed differential gene expression and microbiota by serum metabolomics

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