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Carnosine and histidine-containing dipeptides improve dyslipidemia: a systematic review and meta-analysis of
Kirthi Menon1, Clara Marquina1, Pernille Hoj1
1School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Insights
Histidine-containing dipeptides (HCDs), including carnosine, may improve cardiovascular health by lowering total cholesterol and triglyceride levels. Further research is needed to confirm these benefits for cardiovascular disease prevention.
Area of Science:
- Nutritional Biochemistry
- Cardiovascular Health
- Metabolic Syndrome
Background:
- Cardiovascular disease (CVD) is a leading global health concern.
- Lifestyle interventions have limitations in managing CVD risk factors.
- Novel therapeutic strategies are needed to address the growing burden of CVD.
Purpose of the Study:
- To systematically review and meta-analyze the effects of histidine-containing dipeptides (HCDs) on cardiovascular outcomes.
- To evaluate the efficacy of HCDs in modifying cardiovascular risk factors.
Main Methods:
- Systematic review and meta-analysis conducted according to PRISMA guidelines.
- Searched multiple databases (Medline, Embase, etc.) for randomized controlled trials (RCTs).
- Assessed evidence quality using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.
Main Results:
- 21 studies were included; 18 were pooled for meta-analysis (n=913).
- HCD supplementation significantly reduced total cholesterol (WMD: -0.32 mmol/L) and triglyceride levels (WMD: -0.14 mmol/L) in low risk of bias studies.
- Carnosine supplementation specifically lowered triglyceride levels (P<0.001).
Conclusions:
- Carnosine and other HCDs show potential in improving lipid profiles.
- Larger, long-term studies are required to confirm these findings.
- Further research should explore HCDs for CVD prevention.
Context:
Cardiovascular disease is a major public health problem and represents a significant burden of disease globally. Lifestyle interventions have their limitations and an intervention that will effectively address cardiovascular risk factors to help reduce this growing burden of disease is required.
Objective:
Carnosine and other histidine-containing dipeptides (HCDs) have exerted positive effects on cardiovascular risk factors and diseases in animal and human studies. The authors conducted a systematic review and meta-analysis examining the effects of HCDs on cardiovascular outcomes in line with the PRISMA guidelines.
Data Sources:
The Medline, Medline in process, Embase, Cumulative Index of Nursing and Allied Health, and All EBM databases were searched from inception until January 25, 2019, for randomized controlled trials (RCTs) examining the effects of HCDs on cardiovascular outcomes, compared with placebo or controls.
Data Extraction:
Basic characteristics of the study and populations, interventions, and study results were extracted. The grading of recommendations assessment, development, and evaluation approach was used to assess the quality of evidence for each outcome.
Data Analysis:
A total of 21 studies were included. Of these, 18 were pooled for meta-analysis (n = 913). In low risk of bias studies, HCD-supplemented groups had lower total cholesterol (n = 6 RCTs; n = 401; weighted mean difference [WMD], -0.32 mmol/L [95%CI, -0.57 to -0.07], P = 0.01) and triglyceride levels (n = 6 RCTs; n = 401; WMD, -0.14 mmol/L [95%CI, -0.20 to -0.08], P < 0.001) compared with controls. In studies using carnosine, triglycerides levels were also lower in the intervention group vs controls (n = 5 RCTS; n = 309; P < 0.001). There were no significant differences in blood pressure, heart rate, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C) or the total cholesterol to HDL-C ratio between groups.
Conclusions:
Carnosine and other HCDs may have a role in improving lipid profiles. Larger studies with sufficient follow-up are necessary to confirm these findings and explore the use of HCDs in the prevention of cardiovascular diseases.
Systemic Review Registration:
PROSPERO registration no.: CRD42017075354.
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