PDF(Pubmed)
Abstract：
Reducing low-density lipoprotein cholesterol (LDL-C) levels is a key target for lowering cardiovascular risk and preventing atherosclerotic cardiovascular disease (ASCVD). Red yeast rice (RYR) is a nutraceutical widely used as a lipid-lowering dietary supplement. The main cholesterol-lowering components of RYR are monacolins, particularly monacolin K, which is structurally identical to lovastatin and targets the same key enzyme of cholesterol biosynthesis. RYR supplementation reduces LDL-C levels by approximately 15-34% versus placebo, with a similar effect to low-dose, first-generation statins in subjects with mild-to-moderate dyslipidemia. RYR has also demonstrated beneficial reductions of up to 45% versus placebo in the risk of ASCVD events in secondary prevention studies. RYR at a dose that provides about 3 mg/d of monacolin K is well tolerated, with an adverse event profile similar to that of low-dose statins. RYR is therefore a treatment option for lowering LDL-C levels and ASCVD risk for people with mild-to-moderate hypercholesterolemia who are ineligible for statin therapy, particularly those who are unable to implement lifestyle modifications, and also for people who are eligible for statin therapy but who are unwilling to take a pharmacologic therapy.
摘要：
降低低密度脂蛋白胆固醇（LDL-C）水平是降低心血管风险和预防动脉粥样硬化性心血管疾病（ASCVD）的关键目标。红曲米（RYR）是一种广泛用作降脂膳食补充剂的营养食品。RYR的主要降胆固醇成分是monacolins，特别是monacolinK,它在结构上与洛伐他汀相同，并且靶向胆固醇生物合成的相同关键酶。与安慰剂相比，RYR补充剂可将LDL-C水平降低约15-34％，具有类似于低剂量的效果，第一代他汀类药物在轻度至中度血脂异常患者中的应用。在二级预防研究中，与安慰剂相比，RYR还显示出ASCVD事件风险的有益降低高达45％。RYR在提供约3mg/d的monacolinK的剂量下具有良好的耐受性，不良事件概况与低剂量他汀类药物相似。因此，对于不适合他汀类药物治疗的轻度至中度高胆固醇血症患者，RYR是降低LDL-C水平和ASCVD风险的治疗选择。特别是那些无法实施生活方式改变的人，也适用于有资格接受他汀类药物治疗但不愿意接受药物治疗的人。
