Meta-Analysis on Effectiveness of Psyllium (Plantago ovata Forsk.) Plus Lipid Lowering Agent on Hyperlipidemic Patients
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Abstract
The psyllium (Plantago ovata Forsk.) is a soluble fibers was used as complementary medicine. The previous studies found that psyllium improved lipid profile in hyperlipidemic patients. Data from The US Food and Drug Administration (FDA) approved for psyllium when included in a low saturated fat and cholesterol diet, also helps to lower total cholesterol (TC) and low density lipoprotein (LDL) levels. However, there were no a meta-analysis of effectiveness of psyllium plus lipid lowering agent for hyperlipidemic patients. The objective of this study was to systematically review literature and conduct the meta-analysis of the effectiveness of psyllium plus lipid lowering agent for controlling blood lipid. Methods: The researcher retrieved articles via electronic databases such as Pubmed, Web of Science, CINAHL, Allied and Alternative Medicine Database (AMED) and Hand searching. Randomized controlled trials (RCT) reported in English or Thai and publish until 31 January 2018 were used in data analysis. Results: The quality of 4 included studies was assessed according to the Jadad criteria. The quality of the most the included studies was high with the score between 3 and 5. The most of studies conducted in moderate hypercholesterolemia with dose of psyllium ranged from 5-15 g/day. The number of participants in the studies ranged from 27-121. The study found that psyllium plus lipid lowering agent (cholestyramine 4 g/day 1 study, Colestipol 2.5 g/day 1 study and HMG CoA reductase inhibitors 2 studies were simvastatin 10, 20 mg/day and Lovastatin 20 mg/day) could statistically significant reduced the level of low density lipoprotein (LDL) 30% from baseline (weight mean difference; WMD= -7.89 mg/dL; 95%CI: -14.63 to -1.15 mg/dL; p=0.02) and total cholesterol (TC) (WMD = -7.10 mg/dL; 95% CI: -11.32 to -2.88 mg/dL; p=0.001). There were no statistically significant differences in high density lipoprotein (HDL) and triglyceride (TG). No serious adverse events (such as nausea, bloating) from psyllium plus lipid lowering agent had been found during the studies. Conclusion: This meta-analysis revealed that psyllium plus lipid lowering agent effectively reduce LDL and TC. However, a large RCT should be conducted to confirm the results of the meta-analysis.
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