Gynostemma pentaphyllum for dyslipidemia: A systematic review of randomized controlled trials
What this study found
Very low certainty evidence suggests Gynostemma pentaphyllum can improve lipid outcomes, but the size and reliability of the effect are uncertain. As a stand-alone treatment, it appeared comparable to lipid-lowering agents for total cholesterol, triglycerides, and HDL-C, but inferior to red yeast rice for total cholesterol, triglycerides, and HDL-C. As an add-on to lipid-lowering therapy, it may produce greater improvements in triglycerides, LDL-C, and HDL-C than lipid-lowering therapy alone. Safety data favored Gynostemma pentaphyllum, with fewer adverse events than lipid-lowering drugs and…
- Study & population
- Systematic review of 22 randomized controlled trials including 2,407 adults with dyslipidemia.
- Intervention
- Gynostemma pentaphyllum was tested in multiple forms across trials, including gypenosides tablets or capsules, Gynostemma tea, and one adjunctive regimen combined with fenofibrate.
- Key limitation
- The certainty of evidence was very low to low, limiting confidence in the findings.
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Open PDFOriginal abstract
Objective: To evaluate the lipid-lowering effect and safety of Gynostemma pentaphyllum (GP) used alone or as adjunctive therapy for dyslipidemia. Methods: Eight databases and three clinical trial registries were searched until January 2022. Randomized controlled trials (RCTs) assessing the effectiveness of GP for dyslipidemia were included. Trial quality was assessed using the Cochrane Risk of Bias Tool 2.0. Data were analyzed by RevMan 5.4 with effects estimated as risk ratio (RR) or mean difference (MD) with 95% confidence intervals (CI). Results: Twenty-two RCTs involving 2,407 dyslipidemia participants were included. Regarding the risk of bias, 14 RCTs had some concerns, seven RCTs were high, and one trial was low. GP was comparable to n-3 fatty acids (RR 0.89, 95% CI 0.62–1.28) and red yeast rice (RR 0.33, 95% CI 0.1–1.12) on normalization of serum lipids. GP plus n-3 fatty acid was superior in normalization of triglycerides (TG) and total cholesterol (TC) than n-3 fatty acids (RR 1.34, 95% CI 1.01–1.77). GP was similar to lipid-lowering agents (statins, fibrates, and n-3 fatty acids) in regulating TG, TC, and high-density lipoprotein cholesterol (HDL-C). GP plus lipid-lowering agents were superior to lipid-lowering agents in TG (MD −0.65 mmol/L, 95% CI −1.03 to −0.28), LDL-C (MD −0.57 mmol/L, 95% CI −1.07 to −0.08), and HDL-C (MD 0.15 mmol/L, 95% CI 0.11–0.20). GP was inferior to red yeast rice in TC (MD 0.64 mmol/L, 95% CI 0.15–1.13), TG (MD 0.43 mmol/L, 95% CI 0.15–0.71), and HDL-C (MD −0.25 mmol/L, 95% CI −0.47 to −0.04). GP had fewer adverse events than lipid-lowering drugs. Conclusion: Very low certainty evidence showed that GP’s effects on TC, TG, and HDL-C were comparable to that of lipid-lowering agents. Low certainty evidence showed that red yeast rice was superior to GP in TC, TG, and HDL-C. Low to moderate certainty evidence showed that the effects of GP plus lipid-lowering agents were superior to that of lipid-lowering agents on TG, LDL-C, and HDL-C. GP use for more than 8 weeks appears safe. Systematic Review Registration: https://inplasy.com/, identifier INPLASY202210135.