Abstract
Background and Aims A relevant role is emerging for functional foods in cardiovascular prevention. The aim of this study was to assess the effect of a nutraceutical multitargeted approach on lipid profile and inflammatory markers along with vascular remodelling in a cohort of dyslipidemic subjects without history of cardiovascular (CV) disease. Methods and Results We enrolled 25 subjects (mean age 48.2 years) with low to moderate CV risk profile and total cholesterol (TC) levels between 150 and 250 mg/dl. The patients were assigned to receive for one year a tablet/die of a nutraceutical combination containing red yeast rice (RYR) extract (Monacolin 3 mg/tablet) and coenzyme Q10 (30 mg/tablet). Treatment with the nutraceutical compounds led to a significant reduction of TC (from 227 to 201 mg/dl, p < 0.001), LDL-c (from 150 to 130 mg/dl, p = 0.001), triglycerides (from 121 to 109 mg/dl, p = 0.013), non-HDL-cholesterol (from 168 to 141 mg/dl, p < 0.001), hs-CRP (from 1.74 to 1.20 mg/l, p = 0.015), and osteoprotegerin (from 1488 to 1328 pg/ml, p = 0.045). Levels of HDL-c, Lp(a), glucose, liver enzyme, CPK, or creatinine did not change over time. An ultrasound study was performed to assess changes in mean carotid intima-media thickness (IMT) and maximum IMT (M-MAX) as well as modification in local carotid stiffness by means of determining the carotid compliance coefficient (CC) and distensibility coefficient (DC). At the end of the treatment, we observed small but significant reductions in both mean-IMT (from 0.62 to 0.57 mm, p = 0.022) and M-MAX (from 0.79 to 0.73 mm, p = 0.002), and an improvement in carotid elasticity (DC from 22.4 to 24.3 × 10−3/kPa, p = 0.006 and CC from 0.77 to 0.85 mm2/kPa, p = 0.019). Conclusions A long-term treatment with a combination of RYR and coenzyme Q10 showed lipid-lowering activity along with a reduction of inflammatory mediators and an improvement of vascular properties in young subjects with a low-to-moderate CV risk profile.
Highlights
Atherosclerosis represents a leading cause of cardiovascular (CV) morbidity and mortality
While the treatment did not induce significant changes in body mass index (BMI), blood pressure, and heart rate, we observed a significant reduction in total cholesterol (TC) (p < 0:001), low-density lipoprotein cholesterol (LDL-c) (p = 0:001), and TG levels (p = 0:013) as well as non-high-density lipoprotein cholesterol (HDL-c) (p < 0:001)
We investigated by density gradient ultracentrifugation (DGUC) the effect of the treatment on lipoprotein subclass distribution (Figure 1(a))
Summary
Atherosclerosis represents a leading cause of cardiovascular (CV) morbidity and mortality. A combination of effective pharmacological approaches is available and LDL-c target levels have been well defined in the current European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) Guidelines [5], low-risk patients, usually characterized by cholesterol levels slightly above the normal range and limited burden of CV events, are often suboptimally treated. This is probably due to a combination of misperception of the role of CV risk factors; poor compliance to lifestyle measures; and drug adverse effects such as statin-associated muscle symptoms (SAMS), reported as statin intolerance, which make treatment in this group of subjects a matter of debate and often a clinical challenge. A long-term treatment with a combination of RYR and coenzyme Q10 showed lipid-lowering activity along with a reduction of inflammatory mediators and an improvement of vascular properties in young subjects with a low-to-moderate CV risk profile
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