2022台灣血脂治療指引(英文版)下面中文使用google自動翻譯
膳食補充劑
一些膳食補充劑被認為有益於健康。
魚油或海洋ω-3脂肪酸補充劑可劑量依賴性地降低三酸甘油酯（TG），這主要歸因於二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）的作用，但對總膽固醇（TC）、低密度脂蛋白膽固醇（LDL-C）或高密度脂蛋白膽固醇（HDL-C）沒有明顯影響。
紅麴萃取物已被用作降低膽固醇的營養保健品。在紅麴發酵過程中，主要生物活性化合物莫納可林K是一種弱的可逆性3-羥基-3-甲基戊二醯輔酶A（HMG-CoA）還原酶抑制劑。一項統合分析研究表明，每日服用1200毫克至4800毫克紅麴米（RYR）可使低密度脂蛋白膽固醇（LDL-C）水平較安慰劑組降低18.4毫克/分升。 然而，市面上紅麴產品品質參差不齊，且可能存在潛在的藥物交互作用風險，其安全性尚未充分研究。
可可製品中的黃酮類化合物可抑制膽固醇吸收。一項統合分析顯示，食用黑巧克力2至12週可顯著降低總膽固醇（TC）和低密度脂蛋白膽固醇（LDL-C）水平（分別降低6.2毫克/分升和5.9毫克/分升）。 然而，令人擔憂的是，黑巧克力製品中飽和脂肪和添加糖的含量各不相同。
維生素D可能透過調節維生素D受體和胰島素誘導基因2（IG2）的轉錄活性來影響循環膽固醇水平，IG2抑制HMG-CoA還原酶的表達。 臨床研究表明，補充維生素D有助於降低總膽固醇（TC）、低密度脂蛋白膽固醇（LDL-C）和三酸甘油酯（TG）水平，但對高密度脂蛋白膽固醇（HDL-C）水平無影響。
一項包含14項隨機對照試驗的統合分析顯示，飲用綠茶或其萃取物可適度降低TC和LDL-C濃度，但對HDL-C無影響。 然而，一項為期6年的縱向隊列研究表明，經常飲茶（包括紅茶和綠茶）與HDL-C濃度隨年齡增長而下降的速度減緩相關。
Dietary supplements Some dietary supplements are considered to be beneficial for health. Fish oil, or marine omega-3 fatty acid supplementation, yields a dose-dependent reduction in TG from the effect of eicosapentenoic acid (EPA) and docosahexenoic acid (DHA), but no overt changes in TC, LDL-C or HDL-C.60,61 Red yeast rice (RYR) extract has been applied as a cholesterol-lowering nutraceutical. During the rice fermentation, the main bioactive compound, monacolin K, is a weak reversible inhibitor of 3-hydroxy-3- methylglutaryl-coenzyme A (HMG-CoA) reductase. In a metaanalysis study, using RYR from 1200 mg/day to 4800 mg/ day, LDL-C was lowered with 18.4 mg/dL compared to placebo.62 However, the quality of RYR products in the market varied and RYR may possess a potential risk of pharmacological interactions and its safety outcomes have not been extensively studied yet. The flavonoids in cocoa products inhibit cholesterol absorption. A meta-analysis showed that consumption of dark chocolate for 2e12 weeks significantly reduced TC and LDL-C (6.2 and 5.9 mg/ dL), respectively.63 Nonetheless, it is a concern that dark chocolate products contained varied amount of saturated fats and added sugar. Vitamin D may affect circulating cholesterol levels by modulating the transcription activity of vitamin D receptor and insulin-induced gene-2 activity which inhibits HMG-CoA reductase expression.64,65 Clinical study indicated that vitamin D supplementation has benefits on reducing TC, LDL-C, and TG but no influence on HDLC level.64 A meta-analysis of 14 randomized controlled trials showed that consumption of green tea or its extracts resulted in a moderate reduction in TC and LDL-C concentrations, but no change in HDL-C.66 However, a longitudinal cohort study with 6-year follow-up showed that frequent tea consumption, including black tea and green tea, was associated with a slower age-related decrease in HDL-C concentrations.67
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