Dyslipidemia

Last Updated: December 15, 2022

Dyslipidemia is an imbalance in blood lipids in the body including cholesterol and triglycerides. Poor diet, tobacco use, and genetic factors can all contribute to dyslipidemia.

Dyslipidemia falls under theCardiovascular Healthcategory.

What is dyslipidemia?

Dyslipidemia is a condition where a person exhibits altered blood lipid metabolism. This shows up on bloodwork as abnormal levels of various cholesterols and/or fats, such as high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol, and triglycerides.[1] Non-HDL cholesterol (Non-HDL-C), apolipoprotein B, and the ratio of total cholesterol to HDL-C may also be important metrics to examine in dyslipidemia.[2][3] Abnormalities in these markers and/or ratios are associated with increased risk of cardiovascular disease.[4] Changing certain markers may result in stronger clinical outcomes (non-HDL-C) than others (HDL-C).[5]

What are the main signs and symptoms of dyslipidemia?

Signs of dyslipidemia are easily found on routine blood work. Symptoms of dyslipidemia on its own are rare. Infrequently, people may find xanthomas (hard fatty deposits of tissue on the skin or just under the skin) on their palms, eyelids, or tendons.[6]

Due to the rarity of dyslipidemia symptoms, and the common presence of other cardiovascular disease risk factors, clinicians will also often examine for high blood pressure, high blood sugar, and obesity if dyslipidemia is suspected.[7]

How is dyslipidemia diagnosed?

Diagnosis of dyslipidemia is based on blood lipid levels. Dyslipidemia includes a wide range of abnormalities of lipid metabolism, and may be diagnosed by a combination of the following:

  • Total cholesterol over 240 mg/dL
  • LDL-C over 160 mg/dL
  • Triglycerides over 200 mg/dL
  • HDL-C under 40 mg/dL [7]
What are some of the main medical treatments for dyslipidemia?

What are some of the main medical treatments for dyslipidemia? First-line medical treatments for dyslipidemia include lifestyle-based interventions; nutrition, exercise, avoiding tobacco, and weight loss are important first considerations when discussing dyslipidemia treatment.[7]

Some of the following drugs and therapeutics may be recommended based on a patient's overall risk of cardiovascular disease and individual presentation:[7]

  • Statins are very effective at reducing LDL-C, and have shown a reduction in cardiovascular events (i.e., heart attacks and strokes)[8]
  • PCSK9 inhibitors have also shown these effects, but are more expensive, and have a smaller body of research[9]
  • Ezetimibe may be useful in addition to a statin if further risk reduction is required [10]
  • Fibrates are recommended for moderate and severe elevations of triglycerides (> 400 to 500 mg/dL)[11]
  • Bile acid sequestrants, such as cholestyramine, may effectively lower LDL-C; however, they may raise triglycerides, there is sparse data for cardiovascular event reductions when used in conjunction with statins, and poor adherence has been noted[12]
  • Folic acid may lower triglycerides and total cholesterol, and was found to increase HDL in a dose-response fashion[13]
  • Niacin may cause robust improvements in HDL-C of 21%; however, there is mostly consistent evidence showing a lack of reduction in cardiovascular events or mortality[14][15][16]
  • Bempedoic acid shows promise for further reducing LDL-C when patients are on a maximally tolerated dose of statins, while not worsening muscular adverse events typical of statins[17][18][19][20]
Have any supplements been studied for dyslipidemia?

Omega-3 fatty acid supplements, like fish oil, have been studied for dyslipidemia. They have reliably been found to result in relatively large reductions in triglycerides, and inconsistently increase LDL-C and HDL-C to a minor degree.[21][22][23] They may increase bleeding risk, so those on anticoagulant drugs should be cautious of taking these supplements.[7]

Another supplement that has been studied for dyslipidemia is red yeast rice. Red yeast rice sometimes contains monacolin K, which is identical to the statin lovastatin. For this reason, red yeast rice products containing non-negligible amounts of monacolin K are banned by the FDA since they are a “non-approved drug”.[24][25] If monacolin K is present, red yeast rice may have similar effects and safety profiles to statins.[26][27] However, the methodology for assessing safety in trials is often poor.[27]

Additionally, garlic supplements decrease total cholesterol and LDL-C, though not consistently, with unclear impacts on HDL-C.[28][29] Effects on LDL-C and HDL-C may occur less often when garlic supplements are given alongside a lipid-lowering diet.[30][31][32].

Finally, psyllium fiber can have beneficial effects not only on LDL-C, but on non-HDL-C and apolipoprotein B levels, which may be more predictive of cardiovascular disease than LDL-C.[3]

How could diet affect dyslipidemia?

Dietary changes can substantially impact a range of lipid markers, including total cholesterol, LDL-C, and triglycerides.[1][33][34] Dietary changes may also alter HDL-C levels, but how this impacts cardiovascular health is unclear.[35]

Generally, dietary changes to improve dyslipidemia encompass encouragement of a caloric deficit (if weight loss is indicated), reduction of saturated fat to <10% of daily calories, increase in monounsaturated fatty acids (MUFA), increase in polyunsaturated fatty acids (PUFA), and an increase in soluble fiber intake.[1][7] Curtailing heavy alcohol consumption is also recommended, if applicable.[36]

Are there any other treatments for dyslipidemia?

Exercise can impact several markers of dyslipidemia. Exercise is a commonly recommended therapy to increase HDL-C, but it also can lower LDL-C and triglycerides. [37][38]

HDL-C may increase with activity level in a dose-response manner. Decreases in LDL-C and triglycerides may require higher intensity exercise. Aerobic exercise generally has a larger evidence base for encouraging these changes, though resistance exercise may be equally effective as long as it is of a similar caloric expenditure (generally requiring lower weight, more repetitions, and more sets).[39]

Tobacco smokers have higher levels of triglycerides, LDL-C, and lower levels of HDL-C.[40] Smoking cessation tends to improve HDL-C within about a year.[41] There are mixed results as to whether, when, and by how much other blood lipids levels may improve.[42][4][40] However, smoking cessation clearly does ultimately reduce cardiovascular disease risk.

Obstructive sleep apnea generally increases risk for dyslipidemia.[43] Fortunately, the gold standard treatment for sleep apnea, continuous positive airway pressure (CPAP) therapy, improves total cholesterol, LDL-C, and HDL-C levels.[44]

What causes dyslipidemia?

Dyslipidemia can have many causes, including diabetes, tobacco usage, liver and kidney disease, and hypothyroidism.[7]

There are also different drugs that can cause dyslipidemia:

  • Thiazide diuretics
  • β-blockers
  • Cyclosporine
  • Glucocorticoids
  • Oral estrogens [45]

Finally, there are genetic conditions that can cause dyslipidemia. For example, familial hypercholesterolemia causes high levels of cholesterol from an inability to metabolize LDL-C properly.[46]

Examine Database: Dyslipidemia
What works and what doesn't?

Unlock the full potential of Examine

Get started

Don't miss out on the latest research

References
  1. ^Mohr AE, Hatem C, Sikand G, Rozga M, Moloney L, Sullivan J, De Waal D, Handu DEffectiveness of medical nutrition therapy in the management of adult dyslipidemia: A systematic review and meta-analysis.J Clin Lipidol.(2022)
  2. ^Benoit J Arsenault, Jamal S Rana, Erik S G Stroes, Jean-Pierre Després, Prediman K Shah, John J P Kastelein, Nicholas J Wareham, S Matthijs Boekholdt, Kay-Tee KhawBeyond low-density lipoprotein cholesterol: respective contributions of non-high-density lipoprotein cholesterol levels, triglycerides, and the total cholesterol/high-density lipoprotein cholesterol ratio to coronary heart disease risk in apparently healthy men and womenJ Am Coll Cardiol.(2009 Dec 29)
  3. ^Jovanovski E, Yashpal S, Komishon A, Zurbau A, Blanco Mejia S, Ho HVT, Li D, Sievenpiper J, Duvnjak L, Vuksan VEffect of psyllium (Plantago ovata) fiber on LDL cholesterol and alternative lipid targets, non-HDL cholesterol and apolipoprotein B: a systematic review and meta-analysis of randomized controlled trials.Am J Clin Nutr.(2018-Nov-01)
  4. ^H J Engels, J C WirthNo ergogenic effects of ginseng (Panax ginseng C.A. Meyer) during graded maximal aerobic exerciseJ Am Diet Assoc.(1997 Oct)
  5. ^Jacobson TA, Maki KC, Orringer CE, Jones PH, Kris-Etherton P, Sikand G, La Forge R, Daniels SR, Wilson DP, Morris PB, Wild RA, Grundy SM, Daviglus M, Ferdinand KC, Vijayaraghavan K, Deedwania PC, Aberg JA, Liao KP, McKenney JM, Ross JL, Braun LT, Ito MK, Bays HE, Brown WV, Underberg JA,National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 2.J Clin Lipidol.(2015)
  6. ^Lugo-Somolinos A, Sánchez JEXanthomas: a marker for hyperlipidemias.Bol Asoc Med P R.(2003)
  7. ^Kopin L, Lowenstein CDyslipidemia.Ann Intern Med.(2017-Dec-05)
  8. ^Dujovne CA, Ettinger MP, McNeer JF, Lipka LJ, LeBeaut AP, Suresh R, Yang B, Veltri EP,Efficacy and safety of a potent new selective cholesterol absorption inhibitor, ezetimibe, in patients with primary hypercholesterolemia.Am J Cardiol.(2002-Nov-15)
  9. ^Stein EA, Mellis S, Yancopoulos GD, Stahl N, Logan D, Smith WB, Lisbon E, Gutierrez M, Webb C, Wu R, Du Y, Kranz T, Gasparino E, Swergold GDEffect of a monoclonal antibody to PCSK9 on LDL cholesterol.N Engl J Med.(2012-Mar-22)
  10. ^Cannon CP, Blazing MA, Giugliano RP, McCagg A, White JA, Theroux P, Darius H, Lewis BS, Ophuis TO, Jukema JW, De Ferrari GM, Ruzyllo W, De Lucca P, Im K, Bohula EA, Reist C, Wiviott SD, Tershakovec AM, Musliner TA, Braunwald E, Califf RM,Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes.N Engl J Med.(2015-Jun-18)
  11. ^Preiss D, Tikkanen MJ, Welsh P, Ford I, Lovato LC, Elam MB, LaRosa JC, DeMicco DA, Colhoun HM, Goldenberg I, Murphy MJ, MacDonald TM, Pedersen TR, Keech AC, Ridker PM, Kjekshus J, Sattar N, McMurray JJLipid-modifying therapies and risk of pancreatitis: a meta-analysis.JAMA.(2012-Aug-22)
  12. ^Reiner ZCombined therapy in the treatment of dyslipidemia.Fundam Clin Pharmacol.(2010-Feb)
  13. ^Asbaghi O, Ashtary-Larky D, Bagheri R, Nazarian B, Pourmirzaei Olyaei H, Rezaei Kelishadi M, Nordvall M, Wong A, Dutheil F, Naeini AABeneficial effects of folic acid supplementation on lipid markers in adults: A GRADE-assessed systematic review and dose-response meta-analysis of data from 21,787 participants in 34 randomized controlled trials.Crit Rev Food Sci Nutr.(2022)
  14. ^Garg A, Sharma A, Krishnamoorthy P, Garg J, Virmani D, Sharma T, Stefanini G, Kostis JB, Mukherjee D, Sikorskaya ERole of Niacin in Current Clinical Practice: A Systematic Review.Am J Med.(2017-Feb)
  15. ^Schandelmaier S, Briel M, Saccilotto R, Olu KK, Arpagaus A, Hemkens LG, Nordmann AJNiacin for primary and secondary prevention of cardiovascular events.Cochrane Database Syst Rev.(2017-Jun-14)
  16. ^Wilson PWF, Polonsky TS, Miedema MD, Khera A, Kosinski AS, Kuvin JTSystematic Review for the 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Circulation.(2019-Jun-18)
  17. ^Whitney KRBempedoic acid: LDL-C lowering without adverse reactions.JAAPA.(2021-Dec-01)
  18. ^Yang JBempedoic acid for the treatment of hypercholesterolemia.Expert Rev Cardiovasc Ther.(2020-Jul)
  19. ^Banach M, Duell PB, Gotto AM, Laufs U, Leiter LA, Mancini GBJ, Ray KK, Flaim J, Ye Z, Catapano ALAssociation of Bempedoic Acid Administration With Atherogenic Lipid Levels in Phase 3 Randomized Clinical Trials of Patients With Hypercholesterolemia.JAMA Cardiol.(2020-Oct-01)
  20. ^Ray KK, Bays HE, Catapano AL, Lalwani ND, Bloedon LT, Sterling LR, Robinson PL, Ballantyne CM,Safety and Efficacy of Bempedoic Acid to Reduce LDL Cholesterol.N Engl J Med.(2019-Mar-14)
  21. ^Eslick GD, Howe PR, Smith C, Priest R, Bensoussan ABenefits of fish oil supplementation in hyperlipidemia: a systematic review and meta-analysisInt J Cardiol.(2009 Jul 24)
  22. ^Wei MY, Jacobson TAEffects of eicosapentaenoic acid versus docosahexaenoic acid on serum lipids: a systematic review and meta-analysisCurr Atheroscler Rep.(2011 Dec)
  23. ^Oliveira JM, Rondó PHOmega-3 fatty acids and hypertriglyceridemia in HIV-infected subjects on antiretroviral therapy: systematic review and meta-analysisHIV Clin Trials.(2011 Sep-Oct)
  24. ^Correspondence
  25. ^FDA Warns Consumers to Avoid Red Yeast Rice Products Promoted on Internet as Treatments for High Cholesterol Products found to contain unauthorized drug
  26. ^Osadnik T, Goławski M, Lewandowski P, Morze J, Osadnik K, Pawlas N, Lejawa M, Jakubiak GK, Mazur A, Schwingschackl L, Gąsior M, Banach MA network meta-analysis on the comparative effect of nutraceuticals on lipid profile in adults.Pharmacol Res.(2022-Sep)
  27. ^Gerards MC, Terlou RJ, Yu H, Koks CH, Gerdes VETraditional Chinese lipid-lowering agent red yeast rice results in significant LDL reduction but safety is uncertain - a systematic review and meta-analysis.Atherosclerosis.(2015-Jun)
  28. ^Yue-E Sun, Weidong Wang, Jie QinAnti-hyperlipidemia of garlic by reducing the level of total cholesterol and low-density lipoprotein: A meta-analysisMedicine (Baltimore).(2018 May)
  29. ^Ried K, Toben C, Fakler PEffect of garlic on serum lipids: an updated meta-analysisNutr Rev.(2013 May)
  30. ^Isaacsohn JL, Moser M, Stein EA, Dudley K, Davey JA, Liskov E, Black HRGarlic powder and plasma lipids and lipoproteins: a multicenter, randomized, placebo-controlled trial.Arch Intern Med.(1998-Jun-08)
  31. ^Neil HA, Silagy CA, Lancaster T, Hodgeman J, Vos K, Moore JW, Jones L, Cahill J, Fowler GHGarlic powder in the treatment of moderate hyperlipidaemia: a controlled trial and meta-analysis.J R Coll Physicians Lond.(1996)
  32. ^Simons LA, Balasubramaniam S, von Konigsmark M, Parfitt A, Simons J, Peters WOn the effect of garlic on plasma lipids and lipoproteins in mild hypercholesterolaemiaAtherosclerosis.(1995 Mar)
  33. ^Sikand G, Cole RE, Handu D, deWaal D, Christaldi J, Johnson EQ, Arpino LM, Ekvall SMClinical and cost benefits of medical nutrition therapy by registered dietitian nutritionists for management of dyslipidemia: A systematic review and meta-analysis.J Clin Lipidol.(2018)
  34. ^National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final reportCirculation.(2002 Dec 17)
  35. ^Stadler JT, Marsche GDietary Strategies to Improve Cardiovascular Health: Focus on Increasing High-Density Lipoprotein Functionality.Front Nutr.(2021)
  36. ^Rhee EJ, Kim HC, Kim JH, Lee EY, Kim BJ, Kim EM, Song Y, Lim JH, Kim HJ, Choi S, Moon MK, Na JO, Park KY, Oh MS, Han SY, Noh J, Yi KH, Lee SH, Hong SC, Jeong IK2018 Guidelines for the management of dyslipidemia.Korean J Intern Med.(2019-Jul)
  37. ^Hayashino Y, Jackson JL, Fukumori N, Nakamura F, Fukuhara SEffects of supervised exercise on lipid profiles and blood pressure control in people with type 2 diabetes mellitus: a meta-analysis of randomized controlled trials.Diabetes Res Clin Pract.(2012-Dec)
  38. ^Lin X, Zhang X, Guo J, Roberts CK, McKenzie S, Wu WC, Liu S, Song YEffects of Exercise Training on Cardiorespiratory Fitness and Biomarkers of Cardiometabolic Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.J Am Heart Assoc.(2015-Jun-26)
  39. ^Steven Mann, Christopher Beedie, Alfonso JimenezDifferential effects of aerobic exercise, resistance training and combined exercise modalities on cholesterol and the lipid profile: review, synthesis and recommendationsSports Med.(2014 Feb)
  40. ^Nakamura M, Yamamoto Y, Imaoka W, Kuroshima T, Toragai R, Ito Y, Kanda E, J Schaefer E, Ai MRelationships between Smoking Status, Cardiovascular Risk Factors, and Lipoproteins in a Large Japanese Population.J Atheroscler Thromb.(2021-Sep-01)
  41. ^Forey BA, Fry JS, Lee PN, Thornton AJ, Coombs KJThe effect of quitting smoking on HDL-cholesterol - a review based on within-subject changes.Biomark Res.(2013-Sep-13)
  42. ^Maeda K, Noguchi Y, Fukui TThe effects of cessation from cigarette smoking on the lipid and lipoprotein profiles: a meta-analysis.Prev Med.(2003-Oct)
  43. ^Patinkin ZW, Feinn R, Santos MMetabolic Consequences of Obstructive Sleep Apnea in Adolescents with Obesity: A Systematic Literature Review and Meta-Analysis.Child Obes.(2017-Apr)
  44. ^Nadeem R, Singh M, Nida M, Kwon S, Sajid H, Witkowski J, Pahomov E, Shah K, Park W, Champeau DEffect of CPAP treatment for obstructive sleep apnea hypopnea syndrome on lipid profile: a meta-regression analysis.J Clin Sleep Med.(2014-Dec-15)
  45. ^Cicero AFG, Landolfo M, Ventura F, Borghi CCurrent pharmacotherapeutic options for primary dyslipidemia in adults.Expert Opin Pharmacother.(2019-Jul)
  46. ^Cuchel M, Bruckert E, Ginsberg HN, Raal FJ, Santos RD, Hegele RA, Kuivenhoven JA, Nordestgaard BG, Descamps OS, Steinhagen-Thiessen E, Tybjærg-Hansen A, Watts GF, Averna M, Boileau C, Borén J, Catapano AL, Defesche JC, Hovingh GK, Humphries SE, Kovanen PT, Masana L, Pajukanta P, Parhofer KG, Ray KK, Stalenhoef AF, Stroes E, Taskinen MR, Wiegman A, Wiklund O, Chapman MJ,Homozygous familial hypercholesterolaemia: new insights and guidance for clinicians to improve detection and clinical management. A position paper from the Consensus Panel on Familial Hypercholesterolaemia of the European Atherosclerosis Society.Eur Heart J.(2014-Aug-21)
Examine Database References
  1. HbA1c - Jing Guo, Hongdong Chen, Xueqin Zhang, Wenjiao Lou, Pingna Zhang, Yuheng Qiu, Chao Zhang, Yaoxian Wang, Wei Jing LiuThe Effect of Berberine on Metabolic Profiles in Type 2 Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsOxid Med Cell Longev.(2021 Dec 15)
  2. HbA1c - Zamani M, Zarei M, Nikbaf-Shandiz M, Hosseini S, Shiraseb F, Asbaghi OThe effects of berberine supplementation on cardiovascular risk factors in adults: A systematic review and dose-response meta-analysis.Front Nutr.(2022)
  3. High-density lipoprotein (HDL) - Osadnik T, Goławski M, Lewandowski P, Morze J, Osadnik K, Pawlas N, Lejawa M, Jakubiak GK, Mazur A, Schwingschackl L, Gąsior M, Banach MA network meta-analysis on the comparative effect of nutraceuticals on lipid profile in adults.Pharmacol Res.(2022-Sep)
  4. High-density lipoprotein (HDL) - Blais JE, Huang X, Zhao JVOverall and Sex-Specific Effect of Berberine for the Treatment of Dyslipidemia in Adults: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials.Drugs.(2023-Apr)
  5. HbA1c - Neal D Barnard, Jihad Alwarith, Emilie Rembert, Liz Brandon, Minh Nguyen, Andrea Goergen, Taylor Horne, Gabriel F do Nascimento, Kundanika Lakkadi, Andrea Tura, Richard Holubkov, Hana KahleovaA Mediterranean Diet and Low-Fat Vegan Diet to Improve Body Weight and Cardiometabolic Risk Factors: A Randomized, Cross-over TrialJ Am Coll Nutr.(2021 Feb 5)
  6. C-Reactive Protein (CRP) - Rami S Najjar, Carolyn E Moore, Baxter D MontgomeryConsumption of a defined, plant-based diet reduces lipoprotein(a), inflammation, and other atherogenic lipoproteins and particles within 4 weeksClin Cardiol.(2018 Aug)
  7. Blood Pressure - Hope R Ferdowsian, Neal D Barnard, Valerie J Hoover, Heather I Katcher, Susan M Levin, Amber A Green, Joshua L CohenA multicomponent intervention reduces body weight and cardiovascular risk at a GEICO corporate siteAm J Health Promot.(Jul-Aug 2010)
  8. HbA1c - Boden G, Sargrad K, Homko C, Mozzoli M, Stein TPEffect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetesAnn Intern Med.(2005 Mar 15)
  9. High-density lipoprotein (HDL) - Brehm BJ, Seeley RJ, Daniels SR, D'Alessio DAA randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy womenJ Clin Endocrinol Metab.(2003 Apr)
  10. HbA1c - Shidfar F, Keshavarz A, Hosseyni S, Ameri A, Yarahmadi SEffects of omega-3 fatty acid supplements on serum lipids, apolipoproteins and malondialdehyde in type 2 diabetes patientsEast Mediterr Health J.(2008 Mar-Apr)
  11. High-density lipoprotein (HDL) - Maki KC, Lawless AL, Kelley KM, Dicklin MR, Kaden VN, Schild AL, Rains TM, Marshall JWEffects of prescription omega-3-acid ethyl esters on fasting lipid profile in subjects with primary hypercholesterolemiaJ Cardiovasc Pharmacol.(2011 Apr)
  12. High-density lipoprotein (HDL) - Schuchardt JP, Neubronner J, Kressel G, Merkel M, von Schacky C, Hahn AModerate doses of EPA and DHA from re-esterified triacylglycerols but not from ethyl-esters lower fasting serum triacylglycerols in statin-treated dyslipidemic subjects: Results from a six month randomized controlled trialProstaglandins Leukot Essent Fatty Acids.(2011 Dec)
  13. High-density lipoprotein (HDL) - Thusgaard M, Christensen JH, Mørn B, Andersen TS, Vige R, Arildsen H, Schmidt EB, Nielsen HEffect of fish oil (n-3 polyunsaturated fatty acids) on plasma lipids, lipoproteins and inflammatory markers in HIV-infected patients treated with antiretroviral therapy: a randomized, double-blind, placebo-controlled studyScand J Infect Dis.(2009)
  14. High-density lipoprotein (HDL) - Dawczynski C, Martin L, Wagner A, Jahreis Gn-3 LC-PUFA-enriched dairy products are able to reduce cardiovascular risk factors: a double-blind, cross-over studyClin Nutr.(2010 Oct)
  15. High-density lipoprotein (HDL) - Schirmer SH, Werner CM, Binder SB, Faas ME, Custodis F, Böhm M, Laufs UEffects of omega-3 fatty acids on postprandial triglycerides and monocyte activationAtherosclerosis.(2012 Nov)
  16. High-density lipoprotein (HDL) - Cazzola R, Russo-Volpe S, Miles EA, Rees D, Banerjee T, Roynette CE, Wells SJ, Goua M, Wahle KW, Calder PC, Cestaro BAge- and dose-dependent effects of an eicosapentaenoic acid-rich oil on cardiovascular risk factors in healthy male subjectsAtherosclerosis.(2007 Jul)
  17. C-Reactive Protein (CRP) - Yusof HM, Miles EA, Calder PInfluence of very long-chain n-3 fatty acids on plasma markers of inflammation in middle-aged menProstaglandins Leukot Essent Fatty Acids.(2008 Mar)
  18. Blood glucose - Luo J, Rizkalla SW, Vidal H, Oppert JM, Colas C, Boussairi A, Guerre-Millo M, Chapuis AS, Chevalier A, Durand G, Slama GModerate intake of n-3 fatty acids for 2 months has no detrimental effect on glucose metabolism and could ameliorate the lipid profile in type 2 diabetic men. Results of a controlled studyDiabetes Care.(1998 May)
  19. Triglycerides - Oliveira JM, Rondó PHOmega-3 fatty acids and hypertriglyceridemia in HIV-infected subjects on antiretroviral therapy: systematic review and meta-analysisHIV Clin Trials.(2011 Sep-Oct)
  20. Weight - Bays HE, Maki KC, Doyle RT, Stein EThe effect of prescription omega-3 fatty acids on body weight after 8 to 16 weeks of treatment for very high triglyceride levelsPostgrad Med.(2009 Sep)
  21. Platelet Aggregation - Serebruany VL, Miller M, Pokov AN, Lynch D, Jensen JK, Hallén J, Atar DEarly impact of prescription Omega-3 fatty acids on platelet biomarkers in patients with coronary artery disease and hypertriglyceridemiaCardiology.(2011)
  22. HbA1c - Panahi Y, Kianpour P, Mohtashami R, Jafari R, Simental-Mendía LE, Sahebkar ACurcumin Lowers Serum Lipids and Uric Acid in Subjects With Nonalcoholic Fatty Liver Disease: A Randomized Controlled TrialJ Cardiovasc Pharmacol.(2016 Sep)
  23. HbA1c - Maithili Karpaga Selvi N, Sridhar MG, Swaminathan RP, Sripradha REfficacy of Turmeric as Adjuvant Therapy in Type 2 Diabetic PatientsIndian J Clin Biochem.(2015 Apr)
  24. High-density lipoprotein (HDL) - Mirzabeigi P, Mohammadpour AH, Salarifar M, Gholami K, Mojtahedzadeh M, Javadi MRThe Effect of Curcumin on some of Traditional and Non-traditional Cardiovascular Risk Factors: A Pilot Randomized, Double-blind, Placebo-controlled TrialIran J Pharm Res.(2015 Spring)
  25. High-density lipoprotein (HDL) - Ferguson JJA, Wolska A, Remaley AT, Stojanovski E, MacDonald-Wicks L, Garg MLBread enriched with phytosterols with or without curcumin modulates lipoprotein profiles in hypercholesterolaemic individuals. A randomised controlled trialFood Funct.(2019 May 22)
  26. High-density lipoprotein (HDL) - Kocher A, Bohnert L, Schiborr C, Frank JHighly bioavailable micellar curcuminoids accumulate in blood, are safe and do not reduce blood lipids and inflammation markers in moderately hyperlipidemic individualsMol Nutr Food Res.(2016 Jul)
  27. High-density lipoprotein (HDL) - Dehzad MJ, Ghalandari H, Amini MR, Askarpour MEffects of curcumin/turmeric supplementation on lipid profile: A GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials.Complement Ther Med.(2023-Aug)
  28. HbA1c - Barbara Frączek, Aleksandra Pięta, Adrian Burda, Paulina Mazur-Kurach, Florentyna TyrałaPaleolithic Diet-Effect on the Health Status and Performance of Athletes?Nutrients.(2021 Mar 21)
  29. High-density lipoprotein (HDL) - Ehsan Ghaedi, Mohammad Mohammadi, Hamed Mohammadi, Nahid Ramezani-Jolfaie, Janmohamad Malekzadeh, Mahdieh Hosseinzadeh, Amin Salehi-AbargoueiEffects of a Paleolithic Diet on Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsAdv Nutr.(2019 Jul 1)
  30. HbA1c - A R Rahbar, R Shakerhosseini, N Saadat, F Taleban, A Pordal, B GollestanEffect of L-carnitine on plasma glycemic and lipidemic profile in patients with type II diabetes mellitusEur J Clin Nutr.(2005 Apr)
  31. High-density lipoprotein (HDL) - M Florentin, M S Elisaf, C V Rizos, V Nikolaou, E Bilianou, C Pitsavos, E N LiberopoulosL-Carnitine/Simvastatin Reduces Lipoprotein (a) Levels Compared with Simvastatin Monotherapy: A Randomized Double-Blind Placebo-Controlled StudyLipids.(2017 Jan)
  32. High-density lipoprotein (HDL) - Sani Hlais, Dana R Abou Reslan, Hiba K Sarieddine, Lara Nasreddine, Ghazi Taan, Sami Azar, Omar A ObeidEffect of lysine, vitamin B(6), and carnitine supplementation on the lipid profile of male patients with hypertriglyceridemia: a 12-week, open-label, randomized, placebo-controlled trialClin Ther.(2012 Aug)
  33. Apolipoprotein B - Ali Sheikhi, Kurosh Djafarian, Moein Askarpour, Sakineh Shab-BidarThe effects of supplementation with L-carnitine on apolipoproteins: A systematic review and meta-analysis of randomized trialsEur J Pharmacol.(2019 Sep 5)
  34. Total cholesterol - González-Ortiz M, Hernández-González SO, Hernández-Salazar E, Martínez-Abundis EEffect of oral L-carnitine administration on insulin sensitivity and lipid profile in type 2 diabetes mellitus patientsAnn Nutr Metab.(2008)
  35. HbA1c - Qian Zhou, Yanmei Wang, Xuke Han, Shunlian Fu, Chan Zhu, Qiu ChenEfficacy of Resveratrol Supplementation on Glucose and Lipid Metabolism: A Meta-Analysis and Systematic ReviewFront Physiol.(2022 Mar 31)
  36. High-density lipoprotein (HDL) - Maryam Akbari, Omid Reza Tamtaji, Kamran B Lankarani, Reza Tabrizi, Ehsan Dadgostar, Neda Haghighat, Fariba Kolahdooz, Amir Ghaderi, Mohammad Ali Mansournia, Zatollah AsemiThe effects of resveratrol on lipid profiles and liver enzymes in patients with metabolic syndrome and related disorders: a systematic review and meta-analysis of randomized controlled trialsLipids Health Dis.(2020 Feb 17)
  37. High-density lipoprotein (HDL) - Cao X, Liao W, Xia H, Wang S, Sun GThe Effect of Resveratrol on Blood Lipid Profile: A Dose-Response Meta-Analysis of Randomized Controlled Trials.Nutrients.(2022-Sep-11)
  38. Total Antioxidant Capacity (TAC) - Koushki M, Lakzaei M, Khodabandehloo H, Hosseini H, Meshkani R, Panahi GTherapeutic effect of resveratrol supplementation on oxidative stress: a systematic review and meta-analysis of randomised controlled trials.Postgrad Med J.(2020-Apr)
  39. HbA1c - Król E, Krejpcio Z, Byks H, Bogdański P, Pupek-Musialik DEffects of chromium brewer's yeast supplementation on body mass, blood carbohydrates, and lipids and minerals in type 2 diabetic patientsBiol Trace Elem Res.(2011 Nov)
  40. High-density lipoprotein (HDL) - Vajdi M, Musazadeh V, Karimi A, Heidari H, Tarrahi MJ, Askari GEffects of Chromium Supplementation on Lipid Profile: an Umbrella of Systematic Review and Meta-analysis.Biol Trace Elem Res.(2023-Aug)
  41. Apolipoprotein B - Shahinfar H, Amini MR, Sheikhhossein F, Djafari F, Jafari A, Shab-Bidar SThe effect of chromium supplementation on apolipoproteins: A systematic review and meta-analysis of randomized clinical trials.Clin Nutr ESPEN.(2020-Dec)
  42. HbA1c - Effects of Panax ginseng on hyperglycemia, hypertension, and hyperlipidemia: A systematic review and meta-analysis.()
  43. Fasting Glucose - Lin Guan, Peng MiaoThe effects of taurine supplementation on obesity, blood pressure and lipid profile: A meta-analysis of randomized controlled trialsEur J Pharmacol.(2020 Oct 15)
  44. Fasting Glucose - Ding KX, Gao TL, Xu R, Cai J, Zhang HQ, Sun YY, Zhong F, Ma AGQuantifying the Effect of Supplementation with Algae and Its Extracts on Glycolipid Metabolism: A Meta-Analysis of Randomized Controlled Trials.Nutrients.(2020-Jun-08)
  45. Fasting Glucose - Fallah AA, Sarmast E, Habibian Dehkordi S, Engardeh J, Mahmoodnia L, Khaledifar A, Jafari TEffect of Chlorella supplementation on cardiovascular risk factors: A meta-analysis of randomized controlled trials.Clin Nutr.(2018-Dec)
  46. High-density lipoprotein (HDL) - Sherafati N, Bideshki MV, Behzadi M, Mobarak S, Asadi M, Sadeghi OEffect of supplementation with Chlorella vulgaris on lipid profile in adults: A systematic review and dose-response meta-analysis of randomized controlled trials.Complement Ther Med.(2022-Jun)
  47. High-density lipoprotein (HDL) - Clifton-Bligh PB, Baber RJ, Fulcher GR, Nery ML, Moreton TThe effect of isoflavones extracted from red clover (Rimostil) on lipid and bone metabolismMenopause.(2001 Jul-Aug)
  48. High-density lipoprotein (HDL) - Rogoveanu OC, Mogoşanu GD, Bejenaru C, Bejenaru LE, Croitoru O, Neamţu J, Pietrzkowski Z, Reyes-Izquierdo T, Biţă A, Scorei ID, Scorei RIEffects of Calcium Fructoborate on Levels of C-Reactive Protein, Total Cholesterol, Low-Density Lipoprotein, Triglycerides, IL-1β, IL-6, and MCP-1: a Double-blind, Placebo-controlled Clinical StudyBiol Trace Elem Res.(2015 Feb)
  49. High-density lipoprotein (HDL) - Hee-Jung Park, Hyun-Sook LeeThe influence of obesity on the effects of spirulina supplementation in the human metabolic response of Korean elderlyNutr Res Pract.(2016 Aug)
  50. High-density lipoprotein (HDL) - Ferreira-Hermosillo A, Torres-Duran PV, Juarez-Oropeza MAHepatoprotective effects of Spirulina maxima in patients with non-alcoholic fatty liver disease: a case seriesJ Med Case Rep.(2010 Apr 7)
  51. High-density lipoprotein (HDL) - Rahnama I, Arabi SM, Chambari M, Bahrami LS, Hadi V, Mirghazanfari SM, Rizzo M, Hadi S, Sahebkar AThe effect of Spirulina supplementation on lipid profile: GRADE-assessed systematic review and dose-response meta-analysis of data from randomized controlled trials.Pharmacol Res.(2023-Jul)
  52. High-density lipoprotein (HDL) - Kim MK, Sasaki S, Sasazuki S, Okubo S, Hayashi M, Tsugane SLong-term vitamin C supplementation has no markedly favourable effect on serum lipids in middle-aged Japanese subjectsBr J Nutr.(2004 Jan)
  53. High-density lipoprotein (HDL) - T Sakai, V S Kamanna, M L KashyapNiacin, but not gemfibrozil, selectively increases LP-AI, a cardioprotective subfraction of HDL, in patients with low HDL cholesterolArterioscler Thromb Vasc Biol.(2001 Nov)
  54. High-density lipoprotein (HDL) - Valeria Nasser Figueiredo, Felipe Vendrame, Bruno A Colontoni, Thiago Quinaglia, Jose Roberto Matos-Souza, Filipe Azevedo Moura, Otavio R Coelho, Eliana C de Faria, Andrei C SpositoShort-term effects of extended-release niacin with and without the addition of laropiprant on endothelial function in individuals with low HDL-C: a randomized, controlled crossover trialClin Ther.(2014 Jun 1)
  55. High-density lipoprotein (HDL) - Francini-Pesenti F, Brocadello F, Beltramolli D, Nardi M, Caregaro LSugar cane policosanol failed to lower plasma cholesterol in primitive, diet-resistant hypercholesterolaemia: a double blind, controlled studyComplement Ther Med.(2008 Apr)
  56. Low-density lipoprotein (LDL) - Kassis AN, Jones PJChanges in cholesterol kinetics following sugar cane policosanol supplementation: a randomized control trialLipids Health Dis.(2008 Apr 30)
  57. LDL Oxidation - Menéndez R, Más R, Amor AM, González RM, Fernández JC, Rodeiro I, Zayas M, Jiménez SEffects of policosanol treatment on the susceptibility of low density lipoprotein (LDL) isolated from healthy volunteers to oxidative modification in vitroBr J Clin Pharmacol.(2000 Sep)
  58. High-density lipoprotein (HDL) - Earnest CP, Almada AL, Mitchell TLHigh-performance capillary electrophoresis-pure creatine monohydrate reduces blood lipids in men and womenClin Sci (Lond).(1996 Jul)
  59. High-density lipoprotein (HDL) - Hao Yue, Bin Qiu, Min Jia, Wei Liu, Xiao-Fei Guo, Na Li, Zhi-Xiang Xu, Fang-Ling Du, Tongcheng Xu, Duo LiEffects of α-linolenic acid intake on blood lipid profiles:a systematic review and meta-analysis of randomized controlled trialsCrit Rev Food Sci Nutr.(2021)
  60. High-density lipoprotein (HDL) - Bin Sayeed MS, Asaduzzaman M, Morshed H, Hossain MM, Kadir MF, Rahman MRThe effect of Nigella sativa Linn. seed on memory, attention and cognition in healthy human volunteersJ Ethnopharmacol.(2013 Jul 30)
  61. High-density lipoprotein (HDL) - Qidwai W, Hamza HB, Qureshi R, Gilani AEffectiveness, safety, and tolerability of powdered Nigella sativa (kalonji) seed in capsules on serum lipid levels, blood sugar, blood pressure, and body weight in adults: results of a randomized, double-blind controlled trialJ Altern Complement Med.(2009 Jun)
  62. High-density lipoprotein (HDL) - Batista Gde A, Cunha CL, Scartezini M, von der Heyde R, Bitencourt MG, Melo SFProspective double-blind crossover study of Camellia sinensis (green tea) in dyslipidemiasArq Bras Cardiol.(2009 Aug)
  63. Blood glucose - Wu AH, Spicer D, Stanczyk FZ, Tseng CC, Yang CS, Pike MCEffect of 2-month controlled green tea intervention on lipoprotein cholesterol, glucose, and hormone levels in healthy postmenopausal womenCancer Prev Res (Phila).(2012 Mar)
  64. High-density lipoprotein (HDL) - Kim JE, Jeon SM, Park KH, Lee WS, Jeong TS, McGregor RA, Choi MSDoes Glycine max leaves or Garcinia Cambogia promote weight-loss or lower plasma cholesterol in overweight individuals: a randomized control trialNutr J.(2011 Sep 21)
  65. High-density lipoprotein (HDL) - de Morais EC, Stefanuto A, Klein GA, Boaventura BC, de Andrade F, Wazlawik E, Di Pietro PF, Maraschin M, da Silva ELConsumption of yerba mate ( Ilex paraguariensis ) improves serum lipid parameters in healthy dyslipidemic subjects and provides an additional LDL-cholesterol reduction in individuals on statin therapyJ Agric Food Chem.(2009 Sep 23)
  66. Low-density lipoprotein (LDL) - Brunna Cristina Bremer Boaventura, Patrícia Faria Di Pietro, Aliny Stefanuto, Graziela Alessandra Klein, Elayne Cristina de Morais, Fernanda de Andrade, Elisabeth Wazlawik, Edson Luiz da SilvaAssociation of mate tea (Ilex paraguariensis) intake and dietary intervention and effects on oxidative stress biomarkers of dyslipidemic subjectsNutrition.(2012 Jun)
  67. High-density lipoprotein (HDL) - Muhammad Shoaib Akhtar, Ayesha Ramzan, Amanat Ali, Maqsood AhmadEffect of Amla fruit (Emblica officinalis Gaertn.) on blood glucose and lipid profile of normal subjects and type 2 diabetic patientsInt J Food Sci Nutr.(2011 Sep)
  68. High-density lipoprotein (HDL) - Gimeno E, de la Torre-Carbot K, Lamuela-Raventós RM, Castellote AI, Fitó M, de la Torre R, Covas MI, López-Sabater MCChanges in the phenolic content of low density lipoprotein after olive oil consumption in men. A randomized crossover controlled trialBr J Nutr.(2007 Dec)
  69. High-density lipoprotein (HDL) - Rahbar AR, Nabipour IThe hypolipidemic effect of Citrullus colocynthis on patients with hyperlipidemiaPak J Biol Sci.(2010 Dec 15)
  70. High-density lipoprotein (HDL) - Hadi A, Pourmasoumi M, Mohammadi H, Javaheri A, Rouhani MHThe impact of pycnogenol supplementation on plasma lipids in humans: A systematic review and meta-analysis of clinical trials.Phytother Res.(2019-Feb)
  71. High-density lipoprotein (HDL) - Asbaghi O, Sadeghian M, Fouladvand F, Panahande B, Nasiri M, Khodadost M, Shokri A, Pirouzi A, Sadeghi OEffects of zinc supplementation on lipid profile in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials.Nutr Metab Cardiovasc Dis.(2020-Jul-24)
  72. High-density lipoprotein (HDL) - Tabrizi R, Ostadmohammadi V, Lankarani KB, Peymani P, Akbari M, Kolahdooz F, Asemi ZThe effects of inositol supplementation on lipid profiles among patients with metabolic diseases: a systematic review and meta-analysis of randomized controlled trials.Lipids Health Dis.(2018-May-24)
  73. High-density lipoprotein (HDL) - Liu F, Prabhakar M, Ju J, Long H, Zhou HWEffect of inulin-type fructans on blood lipid profile and glucose level: a systematic review and meta-analysis of randomized controlled trials.Eur J Clin Nutr.(2017-Jan)
  74. High-density lipoprotein (HDL) - Khorshidi M, Zarezadeh M, Moradi Moghaddam O, Emami MR, Kord-Varkaneh H, Mousavi SM, Alizadeh S, Heshmati J, Olang B, Aryaeian NEffect of evening primrose oil supplementation on lipid profile: A systematic review and meta-analysis of randomized clinical trials.Phytother Res.(2020-Oct)
  75. High-density lipoprotein (HDL) - Li P, Wang Q, Chen K, Zou S, Shu S, Lu C, Wang S, Jiang Y, Fan C, Luo YRed Yeast Rice for Hyperlipidemia: A Meta-Analysis of 15 High-Quality Randomized Controlled Trials.Front Pharmacol.(2021)
  76. C-Reactive Protein (CRP) - Verhoeven MO, Teerlink T, Kenemans P, Zuijdgeest-van Leeuwen SD, van der Mooren MJEffects of a supplement containing isoflavones and Actaea racemosa L. on asymmetric dimethylarginine, lipids, and C-reactive protein in menopausal womenFertil Steril.(2007 Apr)
  77. Blood glucose - Bell LP, Hectorn KJ, Reynolds H, Hunninghake DBCholesterol-lowering effects of soluble-fiber cereals as part of a prudent diet for patients with mild to moderate hypercholesterolemiaAm J Clin Nutr.(1990 Dec)
  78. Blood glucose - Abdel-Barry JA, Abdel-Hassan IA, Jawad AM, al-Hakiem MHHypoglycaemic effect of aqueous extract of the leaves of Trigonella foenum-graecum in healthy volunteersEast Mediterr Health J.(2000 Jan)
  79. Blood glucose - Revilla-Monsalve C, Zendejas-Ruiz I, Islas-Andrade S, Báez-Saldaña A, Palomino-Garibay MA, Hernández-Quiróz PM, Fernandez-Mejia CBiotin supplementation reduces plasma triacylglycerol and VLDL in type 2 diabetic patients and in nondiabetic subjects with hypertriglyceridemiaBiomed Pharmacother.(2006 May)
  80. Total cholesterol - Dayal M, Sammel MD, Zhao J, Hummel AC, Vandenbourne K, Barnhart KTSupplementation with DHEA: effect on muscle size, strength, quality of life, and lipidsJ Womens Health (Larchmt).(2005 Jun)
  81. Total cholesterol - Murkovic M, Abuja PM, Bergmann AR, Zirngast A, Adam U, Winklhofer-Roob BM, Toplak HEffects of elderberry juice on fasting and postprandial serum lipids and low-density lipoprotein oxidation in healthy volunteers: a randomized, double-blind, placebo-controlled study.Eur J Clin Nutr.(2004-Feb)
  82. Weight - Caitlin A Dow, Scott B Going, Hsiao-Hui S Chow, Bhimanagouda S Patil, Cynthia A ThomsonThe effects of daily consumption of grapefruit on body weight, lipids, and blood pressure in healthy, overweight adultsMetabolism.(2012 Jul)
  83. Blood Pressure - Feringa HH, Laskey DA, Dickson JE, Coleman CIThe effect of grape seed extract on cardiovascular risk markers: a meta-analysis of randomized controlled trialsJ Am Diet Assoc.(2011 Aug)
  84. Body Fat - Koh-Banerjee PK, Ferreira MP, Greenwood M, Bowden RG, Cowan PN, Almada AL, Kreider RBEffects of calcium pyruvate supplementation during training on body composition, exercise capacity, and metabolic responses to exerciseNutrition.(2005 Mar)
  85. Estrogen - Sierksma A, Sarkola T, Eriksson CJ, van der Gaag MS, Grobbee DE, Hendriks HFEffect of moderate alcohol consumption on plasma dehydroepiandrosterone sulfate, testosterone, and estradiol levels in middle-aged men and postmenopausal women: a diet-controlled intervention studyAlcohol Clin Exp Res.(2004 May)
  86. Platelet Aggregation - Steiner M, Lin RSChanges in platelet function and susceptibility of lipoproteins to oxidation associated with administration of aged garlic extractJ Cardiovasc Pharmacol.(1998 Jun)
  87. Depression Symptoms - Omid Asbaghi, Sepideh Soltani, Noushin Norouzi, Alireza Milajerdi, Saeed Choobkar, Zatollah AsemiThe effect of saffron supplementation on blood glucose and lipid profile: A systematic review and meta-analysis of randomized controlled trialsComplement Ther Med.(2019 Dec)