The effect of phytosterol supplementation on lipid profile: A critical umbrella review of interventional meta‐analyses
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 umb...
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| Veröffentlicht in: | Phytotherapy research 2024-02, Vol.38 (2), p.507-519 |
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| creator | Wang, Le Feng, Li Prabahar, Kousalya Hernández‐Wolters, Benjamin Wang, Zhenxing |
| description | 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 |
| doi_str_mv | 10.1002/ptr.8052 |
| format | Article |
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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.</description><identifier>ISSN: 0951-418X</identifier><identifier>ISSN: 1099-1573</identifier><identifier>EISSN: 1099-1573</identifier><identifier>DOI: 10.1002/ptr.8052</identifier><identifier>PMID: 37905579</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Cardiovascular diseases ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Dietary Supplements ; Dyslipidemia ; HDL‐C ; Health risks ; Heterogeneity ; High density lipoprotein ; Humans ; LDL‐C ; lipid profile ; Lipids ; Low density lipoprotein ; Meta-analysis ; phytostanols ; Phytosterols ; Phytosterols - pharmacology ; Risk management ; Statistical analysis ; Subgroups ; Supplements ; systematic review ; Triglycerides ; umbrella meta‐analysis</subject><ispartof>Phytotherapy research, 2024-02, Vol.38 (2), p.507-519</ispartof><rights>2023 John Wiley & Sons Ltd.</rights><rights>2024 John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3832-64ca6dd7863bc4068c0de91bb7b65f6acc324480dd542142507f7df8a5bddb4e3</citedby><cites>FETCH-LOGICAL-c3832-64ca6dd7863bc4068c0de91bb7b65f6acc324480dd542142507f7df8a5bddb4e3</cites><orcidid>0009-0008-1985-5064 ; 0009-0007-9558-1037 ; 0000-0001-8224-4276 ; 0009-0009-6302-7650 ; 0009-0000-5444-7930</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fptr.8052$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fptr.8052$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37905579$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Le</creatorcontrib><creatorcontrib>Feng, Li</creatorcontrib><creatorcontrib>Prabahar, Kousalya</creatorcontrib><creatorcontrib>Hernández‐Wolters, Benjamin</creatorcontrib><creatorcontrib>Wang, Zhenxing</creatorcontrib><title>The effect of phytosterol supplementation on lipid profile: A critical umbrella review of interventional meta‐analyses</title><title>Phytotherapy research</title><addtitle>Phytother Res</addtitle><description>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.</description><subject>Cardiovascular diseases</subject><subject>Cholesterol</subject><subject>Cholesterol, HDL</subject><subject>Cholesterol, LDL</subject><subject>Dietary Supplements</subject><subject>Dyslipidemia</subject><subject>HDL‐C</subject><subject>Health risks</subject><subject>Heterogeneity</subject><subject>High density lipoprotein</subject><subject>Humans</subject><subject>LDL‐C</subject><subject>lipid profile</subject><subject>Lipids</subject><subject>Low density lipoprotein</subject><subject>Meta-analysis</subject><subject>phytostanols</subject><subject>Phytosterols</subject><subject>Phytosterols - pharmacology</subject><subject>Risk management</subject><subject>Statistical analysis</subject><subject>Subgroups</subject><subject>Supplements</subject><subject>systematic review</subject><subject>Triglycerides</subject><subject>umbrella meta‐analysis</subject><issn>0951-418X</issn><issn>1099-1573</issn><issn>1099-1573</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kdtqFTEUhoModlsFn0AC3ngzdeU0yXhXiicoKLIF74ZMskJTZvaMSabtvvMRfEafxGxbFQQhsHLxrY-f9RPylMEJA-Avl5JODCh-j2wYdF3DlBb3yQY6xRrJzJcj8ijnSwDoOMiH5EjoDpTS3YbcbC-QYgjoCp0DXS72Zc4F0zzSvC7LiBPuii1x3tH6xrhET5c0hzjiK3pKXYolOjvSdRoSjqOlCa8iXh9ccVc9V3W9LldiwmJ_fPtu63-fMT8mD4IdMz65m8fk85vX27N3zfmHt-_PTs8bJ4zgTSudbb3XphWDk9AaBx47Ngx6aFVorXOCS2nAeyU5k1yBDtoHY9Xg_SBRHJMXt96a-uuKufRTzO4QdYfzmntujGy14kxU9Pk_6OW8ppq3Uh1XWkkl4K_QpTnnhKFfUpxs2vcM-kMbfW2jP7RR0Wd3wnWY0P8Bf5-_As0tcF3vuf-vqP-4_fRL-BPv-Jaw</recordid><startdate>202402</startdate><enddate>202402</enddate><creator>Wang, Le</creator><creator>Feng, Li</creator><creator>Prabahar, Kousalya</creator><creator>Hernández‐Wolters, Benjamin</creator><creator>Wang, Zhenxing</creator><general>John Wiley & Sons, Ltd</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7QP</scope><scope>7QR</scope><scope>7TK</scope><scope>7TM</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0009-0008-1985-5064</orcidid><orcidid>https://orcid.org/0009-0007-9558-1037</orcidid><orcidid>https://orcid.org/0000-0001-8224-4276</orcidid><orcidid>https://orcid.org/0009-0009-6302-7650</orcidid><orcidid>https://orcid.org/0009-0000-5444-7930</orcidid></search><sort><creationdate>202402</creationdate><title>The effect of phytosterol supplementation on lipid profile: A critical umbrella review of interventional meta‐analyses</title><author>Wang, Le ; Feng, Li ; Prabahar, Kousalya ; Hernández‐Wolters, Benjamin ; Wang, Zhenxing</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3832-64ca6dd7863bc4068c0de91bb7b65f6acc324480dd542142507f7df8a5bddb4e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Cardiovascular diseases</topic><topic>Cholesterol</topic><topic>Cholesterol, HDL</topic><topic>Cholesterol, LDL</topic><topic>Dietary Supplements</topic><topic>Dyslipidemia</topic><topic>HDL‐C</topic><topic>Health risks</topic><topic>Heterogeneity</topic><topic>High density lipoprotein</topic><topic>Humans</topic><topic>LDL‐C</topic><topic>lipid profile</topic><topic>Lipids</topic><topic>Low density lipoprotein</topic><topic>Meta-analysis</topic><topic>phytostanols</topic><topic>Phytosterols</topic><topic>Phytosterols - pharmacology</topic><topic>Risk management</topic><topic>Statistical analysis</topic><topic>Subgroups</topic><topic>Supplements</topic><topic>systematic review</topic><topic>Triglycerides</topic><topic>umbrella meta‐analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Le</creatorcontrib><creatorcontrib>Feng, Li</creatorcontrib><creatorcontrib>Prabahar, Kousalya</creatorcontrib><creatorcontrib>Hernández‐Wolters, Benjamin</creatorcontrib><creatorcontrib>Wang, Zhenxing</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Phytotherapy research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Le</au><au>Feng, Li</au><au>Prabahar, Kousalya</au><au>Hernández‐Wolters, Benjamin</au><au>Wang, Zhenxing</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effect of phytosterol supplementation on lipid profile: A critical umbrella review of interventional meta‐analyses</atitle><jtitle>Phytotherapy research</jtitle><addtitle>Phytother Res</addtitle><date>2024-02</date><risdate>2024</risdate><volume>38</volume><issue>2</issue><spage>507</spage><epage>519</epage><pages>507-519</pages><issn>0951-418X</issn><issn>1099-1573</issn><eissn>1099-1573</eissn><abstract>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.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>37905579</pmid><doi>10.1002/ptr.8052</doi><tpages>13</tpages><orcidid>https://orcid.org/0009-0008-1985-5064</orcidid><orcidid>https://orcid.org/0009-0007-9558-1037</orcidid><orcidid>https://orcid.org/0000-0001-8224-4276</orcidid><orcidid>https://orcid.org/0009-0009-6302-7650</orcidid><orcidid>https://orcid.org/0009-0000-5444-7930</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Cardiovascular diseases Cholesterol Cholesterol, HDL Cholesterol, LDL Dietary Supplements Dyslipidemia HDL‐C Health risks Heterogeneity High density lipoprotein Humans LDL‐C lipid profile Lipids Low density lipoprotein Meta-analysis phytostanols Phytosterols Phytosterols - pharmacology Risk management Statistical analysis Subgroups Supplements systematic review Triglycerides umbrella meta‐analysis |
| title | The effect of phytosterol supplementation on lipid profile: A critical umbrella review of interventional meta‐analyses |
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