Monacolin K in the treatment of hypercholesterolemia - chance or threat?
DOI:
https://doi.org/10.12775/JEHS.2024.75.56419Keywords
Monacolin K, hypercholesterolemia, Monacolin K in the treatment of hypercholesterolemia, dietary supplement, Cardiovascular riskAbstract
Introduction
Hypercholesterolemia is a primary element leading to the occurrence of cardiovascular diseases, which are the most common cause of death worldwide. One of the most effective drugs used in the treatment of hypercholesterolemia are statins. Monacolin K is a naturally derived substance that exhibits similar effects.
Materials and methods
The review of studies that follows is based on peer-reviewed scientific publications that may be found on PubMed, Google Scholar and CrossRef. The terms "monacolin K," "hypercholesterolemia," and "monacolin K in the treatment of hypercholesterolemia" were among the most searched.
Results
Review of the literature shows that Monacolin K is a promising substance that exhibits similar effects to statins and like them contributes to improving lipid profile. Unfortunately, fermented wild rice preparations lack clear information on the exact content of Monacolin K. Additionally, it is almost exclusively available in the form of dietary supplements on the Polish market, which have not been subjected to rigorous studies, so their therapeutic effects have not been scientifically proven.
Conclusion
The result of the cited studies indicates that It is necessary to regulate the market of preparations containing fermented wild rice. The package should specify the exact content of the active substance and effectiveness should be confirmed by appropriate studies. It would be promising for preparations to be developed at the level of medication rather than dietary supplements
References
Pająk A, Szafraniec K, Polak M i wsp. Changes in the prevalence, treatment, and control of hypercholesterolemia and other dyslipidemias over 10 years in Poland: the WOBASZ study. Pol Arch Med Wewn 2016; 126: 642-652.
Accessible on: http://doi.org/10.20452/pamw.3464
Conroy RM, Pyorala K., Fitzgerald A.P. i wsp.: Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003;24:987-1003.
Accessible on: http://doi.org/10.1016/s0195-668x(03)00114-3
Zdrojewski T, Jankowski P, Bandosz P i wsp. [A new version of cardiovascular risk assessment system and risk charts calibrated for Polish population]. Kardiol Pol 2015; 73: 958-961.
Accessible on: http://doi.org/10.5603/KP.2015.0182
The Working Group on Cardiovascular Prevention in Clinical Practice with representatives of the ESC. ESC Guidelines 2021 on cardiovascular disease prevention in clinical practice Vol 79, Supp. V (2021) - Educational Sheets of Polish Cardiology 5/2021.
Accessible on: https://doi.org/10.1093/eurheartj/ehab484
Catapano AL, Graham I, De Backer G, et al. 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias: The Task Force for the Management of Dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) Developed with the special contribution of the European Assocciation for Cardiovascular Prevention & Rehabilitation (EACPR). Atherosclerosis 2016, 253: 281-344.
Accessible on: https://doi.org/10.1016/j.atherosclerosis.2016.08.018
Piepoli MF, Hoes AW, Agewall S, et al. 2016 European guidelines on cardiovascular disease prevention in clinical practice. The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts). Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation. G Ital Cardiol (Rome) 2017, 18(7): 547-612.
Accessible on: https://doi.org/10.1093/eurheartj/ehw106
Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014, 129(25 Suppl 2): S76-S99.
Accessible on: https://doi.org/10.1161/01.cir.0000437740.48606.d1
Perk J, De Backer G, Gohlke H, et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J 2012, 33(13): 1635-1701.
Accessible on: http://doi.org/10.1093/eurheartj/ehs092
Wożakowska-Kapłon B., Barylski M., Salwa P., Filipiak K.J., Siebert J. Recommendations for the management of dyslipidemia - proposed algorithm for general practitioners. Forum of Family Medicine 2012; 6: 261–282.
Jones P.H., Davidson M.H., Stein E.A. i wsp. Comparison of the efficacy and safety of rosuvastatin versus atorvastatin, simvastatin, and pravastatin across doses (STELLAR Trial). Am. J. Cardiol. 2003; 92: 152–160.
Accessible on: http://doi.org/10.1016/s0002-9149(03)00530-7
Cho L., Rocco M., Colquhoun D. i wsp. Design and rationale of the GAUSS-2 study trial: a double-blind, ezetimibe-controlled phase 3 study of the efficacy and tolerability of evolocumab (AMG 145) in subjects with hypercholesterolemia who are intolerant of statin therapy. Clin. Cardiol. 2014; 37: 131–139
Accessible on: http://doi.org/10.1002/clc.22248
Endo A. Monacolin K, a new hypocholesterolemic agent produced by a Monascus species. J Antibiot (Tokyo) 1979 Aug;32(8):852–4.
Accessible on: https://doi.org/10.7164/antibiotics.32.852
Stuart M.D. Chinese materia medica — vegetable kingdom. Southern Materials Center Inc., Taipei 1979.
Yingxing S. T’ien Jung K’ai Wu. Chinese technology in the seventeenth century. Pennsylvania State University Press, University Park and London 1966: 291–294
X-Li YG, Zhang F, Wang ZT, Hu ZB. Identification and chemical profiling of monacolins in red yeast rice using high-performance liquid chromatography with photodiode array detector and mass spectrometry. J Pharm Biomed Anal. 2004;35(5):1101–12.
Accessible on: https://doi.org/10.1016/j.jpba.2004.04.004
Heber D., Yip I., Ashley J.M. i wsp. Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement. Am. J. Clin. Nutr. 1999; 69: 231–236.
Accessible on: https://doi.org/10.1093/ajcn/69.2.231
Poli A., Barbagallo C.M., Cicero A.F.G., Corsini A., Manzato E., Trimarco B. i in.: Nutraceuticals and functional foods for the control of plasma cholesterol levels. An intersociety position paper. Pharmacol Res. 2018, 134: 51–60.
Accessible on: https://doi.org/10.1016/j.phrs.2018.05.015
Vlachopoulos C., Aznaouridis K., Terentes-Printzios D., Ioakeimidis N., Stefanadis C.: Prediction of cardiovascular events and all-cause mortality with brachial-ankle elasticity index: a systematic review and meta-analysis. Hypertension 2012, 60(2): 556–562.
Accessible on: https://doi.org/10.1161/HYPERTENSIONAHA.112.194779
Gerards MC, Terlou RJ, Yu H, Koks CH, Gerdes VE. Traditional Chinese lipid-lowering agent red yeast rice results in significant LDL reduction but safety is uncertain - a systematic review and meta-analysis. Atherosclerosis. 2015;240(2):415–23.
Accessible on: https://doi.org/10.1016/j.atherosclerosis.2015.04.004
Lin C.C., Li T.C., Lai M.M. Efficacy and safety of Monascus purpureus Went rice in subjects with hyperlipidemia. Eur. J. Endocrinol. 2005; 153: 679–686.
Accessible on: https://doi.org/10.1530/eje.1.02012
Halbert S.C., French B., Gordon R.Y. i wsp. Tolerability of red yeast rice (2400 mg twice daily) versus pravastatin (20 mg twice daily) in patients with previous statin intolerance. Am. J. Cardiol. 2010; 105: 198–204.
Accessible on: https://doi.org/10.1016/j.amjcard.2009.08.672
Directive 2002/46/EC of the European Parliament and of the Council of 10 June 2002 on the approximation of the laws of the Member States relating to food supplements. Off. J. Eur. Communities 2002, L 183, 51–57.
Marketing Food Supplements. Fortified & Functional Foods In Europe. Legislation & Practice. Fourth Edition published by EAS 2005.
Regulation of the Minister of Health of October 9, 2007, on the composition and labeling of dietary supplements. Journal of Laws 2007, No. 196, item 1425.
Gordon RY, Cooperman T, Obermeyer W, Becker DJ. Marked variability of monacolin levels in commercial red yeast rice products: buyer beware! Archives of Internal Medicine. 2010; 170(19): 1722–1727.
Accessible on: https://doi.org/10.1001/archinternmed.2010.382
Singh ND, Sharma AK, Dwivedi P, Patil RD, Kumar M. Experimentally induced citrinin and endosulfan toxicity in pregnant Wistar rats: histopathological alterations in liver and kidneys of fetuses. J Appl Toxicol. 2008;28(7):901–7.
Accessible on: https://doi.org/10.1002/jat.1354
Wawryk-Gawda, B.; Budzyńska, M.; Lis-Sochocka, P.; Chylińska-Wrzos, M.; Zarobkiewicz, B.; Jodłowska-Jędrych, B. Dietary supplements—Consumer assessment based on questionnaire survey. Przegl. Epidemiol. 2018, 72, 93–103.
Accessible on: [Google Scholar]
Karbownik M.S., Horne R., Paul E., Kowalczyk E., Szemraj J. Determinants of knowledge about dietary supplements among Polish Internet users with no medical education: A nationwide cross-sectional study. J. Med. Internet Res. 2021;23:e25228.
Accessible on: http://doi.org/doi:10.2196/25228
Ronis M.J.J., Pedersen K.B., Watt J. Adverse Effects of Nutraceuticals and Dietary Supplements. Annu. Rev. Pharmacol. Toxicol. 2018;58:583–601. doi: 10.1146/annurev-pharmtox-010617-052844.
Accessible on: https://doi.org/10.1146/annurev-pharmtox-010617-052844
Living, working and COVID-19, Eurofund 2020, s. 4, https://www.eurofound.europa.eu/publications/report/2020/living-working-and-covid-19-first-findings-april-2020 (access 5 may 2024 r.)
Mazzanti G, Moro PA, Raschi E, Da Cas R and Menniti-Ippoliti F, 2017. Adverse reactions to dietary supplements containing red yeast rice: assessment of cases from the Italian surveillance system. British Journal of Clinical Pharmacology, 83, 894–908.
Accessible on: http://doi.org/10.1111/bcp.13171
Mueller PS: Symptomatic myopathy due to red yeast rice. Ann Intern Med 2006; 145: 474–475.
Accessible on: https://doi.org/10.7326/0003-4819-145-6-200609190-00021
Kantola T, Kivistö KT, Neuvonen PJ. Grapefruit juice greatly increases serum concentrations of lovastatin and lovastatin acid. Clin Pharmacol Ther. 1998;63(4):397–402.
Accessible on: https://doi.org/10.1016/S0009-9236(98)90034-0
Prasad GV, Wong T, Meliton G, Bhaloo S. Rhabdomyolysis due to red yeast rice in a renal transplant recipient. Transplantation. 2002;74(8):1200–1.
Accessible on: [Google Scholar]
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Katarzyna Krotowska

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 652
Number of citations: 0