Efficacy of Nutraceutical Combination of Monacolin K, Berberine, and Silymarin on Lipid Profile and PCSK9 Plasma Level in a Cohort of Hypercholesterolemic Patients
Efficacy of Nutraceutical Combination of Monacolin K, Berberine, and Silymarin on Lipid Profile and PCSK9 Plasma Level in a Cohort of Hypercholesterolemic Patients
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DOI：
10.1089/jmf.2019.0168
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发表时间：
2019-10-30
影响因子：
2.4
通讯作者：
Pisciotta, Livia
中科院分区：
文献类型：
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作者：
Formisano, Elena;Pasta, Andrea;Pisciotta, Livia
治疗血脂异常的指南包括使用营养品（NUT）与生活方式的改变，以实现治疗目标。在NUT丸中，可能存在不同的物质;在这项研究中，我们研究了含有莫纳可林K（MonK）+KA（1：1），小檗碱（BBR）和水飞蓟素的组合NUT。该研究的目的是评价53例患有多基因高胆固醇血症的患者的低密度脂蛋白胆固醇（LDL-C）降低，其特征是采用SCORE算法计算的低/中等心血管风险。将含MonK+KA（1：1）、BBR和sylimarin的NUT治疗2个月对血脂的影响与匹配对照组中给予阿托伐他汀（ATO）10 mg进行比较。在基线和研究结束时测定NUT治疗组的血清前蛋白转化酶枯草杆菌蛋白酶/kexin 9型（PCSK 9）水平和胆固醇负荷能力（CLC）;评估变化。NUT作为降脂药有效，具有广泛的个体间反应变异性（平均LDL-C从170.8 +/- 19.9至123.8 +/- 20.0，变化为-47.0 +/- 21.5 mg/dL; P <0.001），其作用与ATO诱导的作用相似。NUT的使用显著改变了PCSK 9水平（P < .01）和CLC（P < .001），最终抑制了直接在人巨噬细胞上测量的血清介导的泡沫细胞生成。NUT降低LDL-C水平的效果与10 mg ATO诱导的效果相似，并且离体改善脂蛋白的功能特征，具有抗动脉粥样硬化作用。
The guidelines for the treatment of dyslipidemias include the use of nutraceuticals (NUTs) in association with lifestyle modifications to achieve therapeutic goals. In NUT pill, different substances may be associated; in this study we investigated a combined NUT containing monacolin K (MonK)+KA (1:1), berberine (BBR), and silymarin. The aim of the study was to evaluate low-density lipoprotein cholesterol (LDL-C) reduction in 53 patients suffering from polygenic hypercholesterolemia, characterized by a low/intermediate cardiovascular risk calculated with SCORE algorithm. The effects on lipid profile of 2-month treatment with NUT containing MonK+KA (1:1), BBR, and sylimarin, were compared with Atorvastatin (ATO) 10 mg administrated in a matched control group. Serum proprotein convertase subtilisin/kexin type 9 (PCSK9) levels and the cholesterol loading capacity (CLC) were determined at baseline and at the end of the study in NUT-treated group; variations were assessed. NUT was effective as lipid-lowering agent with a wide interindividual response variability (mean LDL-C from 170.8 +/- 19.9 to 123.8 +/- 20.0 with a change of -47.0 +/- 21.5 mg/dL; P < .001) and the effect was similar to that induced by ATO. The use of NUT significantly modified PCSK9 levels (P < .01) and CLC (P < .001), ultimately suppressing the serum-mediated foam cell generation directly measured on human macrophages. NUT reduces LDL-C levels with an effect similar to what is induced by 10 mg of ATO and ex vivo improves the functional profile of lipoproteins with antiatherogenic action.