Role of Nutraceuticals in Hypolipidemic Therapy.
Role of Nutraceuticals in Hypolipidemic Therapy.
复制标题
DOI：
10.3389/fcvm.2015.00022
复制
发表时间：
2015-01-01
影响因子：
3.6
通讯作者：
Averna, Maurizio R
中科院分区：
文献类型：
--
作者：
Barbagallo, Carlo M;Cefalo, Angelo Baldassare;Averna, Maurizio R
营养食品是存在于食物中并用于治疗的食物成分或活性成分。本文分析了具有降脂作用的分子的特性。不同的营养食品可能有不同的作用机制：主要通过作用于HMG-CoA还原酶(多酚、大蒜，尤其是红曲米)抑制胆固醇的合成，增加低密度脂蛋白受体的活性(黄连素)，减少肠道胆固醇的吸收(大蒜、植物类固醇、益生菌)，以及干扰胆汁代谢的能力(益生菌、古古尔)。基于不同的作用机制，一些营养品能够增强他汀类药物的作用。营养食品经常在没有相关证据的情况下使用：作用机制没有得到明确证实；大多数临床数据来自小型、非对照研究，最后，除了发酵红米，没有临床试验可以证明这些干预措施和减少临床事件之间的关系。因此，在所有的营养食品中，有必要推断出那些真正有文献记载的疗效。然而，这些类型的治疗通常患者耐受性良好。总体而言，心血管风险中等或低的受试者是营养食品的最佳适应症，但它们也可能对在经典疗法中出现副作用的患者有用。最后，考虑到一些营养食品的相加作用，与经典药物联合治疗可能会提高临床目标的实现。因此，营养食品可能是降血脂治疗的一种有用的替代方案，如果使用得当，可能是一种有效的心血管预防策略。
Nutraceuticals are food components or active ingredients present in foods and used in therapy. This article analyzes the characteristics of the molecules with a lipid-lowering effect. The different nutraceuticals may have different mechanisms of action: inhibition of cholesterol synthesis primarily through action on the enzyme HMG-CoA reductase (policosanol, polyphenols, garlic and, above all, red yeast rice), increase in LDL receptor activity (berberine), reduction of intestinal cholesterol absorption (garlic, plant sterols, probiotics), and also the ability to interfere with bile metabolism (probiotics, guggul). Based on the different mechanisms of action, some nutraceuticals are then able to enhance the action of statins. Nutraceuticals are often used without relevant evidence: mechanisms of action are not clearly confirmed; most of clinical data are derived from small, uncontrolled studies, and finally, except for fermented red rice, there are no clinical trials which may document the relationship between these interventions and the reduction of clinical events. Therefore, among all nutraceuticals, it is necessary to extrapolate those having a really documentable efficacy. However, these kinds of treatments are usually well-tolerated by patients. Overall, subjects with a middle or low cardiovascular risk are the best indication of nutraceuticals, but they may also be useful for patients experiencing side effects during classical therapies. Finally, in consideration of the additive effect of some nutraceuticals, a combination therapy with classical drugs may improve the achievement of clinical targets. Thus, nutraceuticals may be a helpful alternative in hypolipidemic treatment and, if properly used, might represent a valid strategy of cardiovascular prevention.