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.

中文翻译：

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莫纳可林K，小ber碱和水飞蓟素的营养组合对一组高胆固醇血症患者的血脂谱和PCSK9血浆水平的影响。

血脂异常的治疗指南包括使用营养保健品（NUT）与改变生活方式以达到治疗目的。在NUT药丸中，可能会结合不同的物质。在这项研究中，我们研究了包含莫纳可林K（MonK）+ KA（1：1），小ber碱（BBR）和水飞蓟素的组合NUT。这项研究的目的是评估53名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，其特征是使用SCORE算法计算出的中/低心血管风险。将含有MonK + KA（1：1），BBR和sylimarin的NUT治疗2个月对脂质分布的影响与对照组的阿托伐他汀（ATO）10 mg进行比较。在NUT治疗组中，在基线和研究结束时测定血清前蛋白转化酶枯草杆菌蛋白酶/ kexin 9型（PCSK9）水平和胆固醇负荷能力（CLC）。评估变异。NUT是有效的降脂药，个体反应差异大（平均LDL-C从170.8±19.9到123.8±20.0，变化为-47.0±21.5 mg / dL；P  <.001），其作用与ATO诱导的相似。NUT的使用显着改变了PCSK9水平（P  <.01）和CLC（P  <.001），最终抑制了直接在人类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，其作用类似于10 mg ATO所诱导的作用，并且离体改善具有抗动脉粥样硬化作用的脂蛋白的功能特性。