Comparison of the Reductions in LDL-C and Non-HDL-C Induced by the Red Yeast Rice Extract Xuezhikang Between Fasting and Nonfasting States in Patients With Coronary Heart Disease

Abstract

Background: Xuezhikang, an extract of red yeast rice, effectively lowers fasting blood lipid levels. However, the influence of Xuezhikang on nonfasting levels of low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) has not been explored in Chinese patients with coronary heart disease (CHD).Methods: Fifty CHD patients were enrolled and randomly divided into two groups (each n = 25) to receive 1200 mg/d Xuezhikang or not for six weeks as routine therapy. Blood lipids were measured repeatedly before and after six weeks of treatment at 0, 2, 4 and 6 hours (h) after a standard breakfast containing 800 kcal and 50 g fat.Result: Serum LDL-C levels significantly decreased, from a fasting level of 3.88 mmol/L to nonfasting levels of 2.99, 2.83 and 3.23 mmol/L at 2, 4 and 6 h, respectively, after breakfast (P<0.05), while there was no significant difference in total cholesterol (TC) levels between the fasting value and the values at any nonfasting time-points. The serum non-HDL-C level mildly increased from a fasting level of 4.29 mmol/L to nonfasting levels of 4.32, 4.38 and 4.34 mmol/L at 2, 4 and 6 h postprandially, respectively, and the difference reached statistical significance only at 4 and 6 h after breakfast (P < 0.05). There was no difference in fasting and nonfasting blood lipids between the two groups at baseline. After six weeks of Xuezhikang treatment, patients had significantly lower fasting and nonfasting serum levels of LDL-C and HDL-C (P < 0.05) than they did pretreatment. LDL-C levels were reduced by 27.8%, 28.1%, 26.2% and 25.3% at 0, 2, 4 and 6 h, respectively, and non-HDL-C levels were reduced by 27.6%, 28.7%, 29.0% and 28.0% at 0, 2, 4 and 6 h, respectively, after breakfast. There was no significant difference in the percent reductions in LDL-C and non-HDL-C levels among the four different time-points.Conclusions: A six-week Xuezhikang (1200 mg/d) treatment significantly decreased LDL-C and non-HDL-C levels, with similar percent reductions in fasting and nonfasting states in CHD patients. This may indicate that nonfasting blood lipids detected at the same time point after a standard meal could replace fasting blood lipids when evaluating the efficacy of cholesterol control in CHD patients who are unwilling or unable to fast.