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Updated: Oct 21, 2025

Network Pharmacology Prediction and Metabolomics Validation of the Mechanism of Fructus Phyllanthi against Hyperlipidemia
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Phytosterols and Cardiovascular Disease.

Umidakhon Makhmudova1, P Christian Schulze1, Dieter Lütjohann2

  • 1Klinik Für Innere Medizin I, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany.

Current Atherosclerosis Reports
|September 1, 2021
PubMed
Summary

Plant sterols in functional foods can lower cholesterol but may be atherogenic. This review examines the evidence and controversy surrounding their use for cardiovascular health.

Keywords:
ABCG5/G8AtherosclerosisCholesterol metabolismNPC1L1Phytosterols

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Area of Science:

  • Cardiovascular Medicine
  • Nutritional Science
  • Biochemistry

Background:

  • Coronary heart disease (CHD) is a leading global cause of mortality.
  • Elevated blood cholesterol is a major, modifiable cardiovascular risk factor.
  • Dietary interventions, including functional foods, are key to lipid management.

Purpose of the Study:

  • To review the role of plant sterols in lowering blood cholesterol.
  • To discuss the controversy regarding plant sterol atherogenicity.
  • To analyze evidence from various study types on plant sterols and cardiovascular outcomes.

Main Methods:

  • In vitro and in vivo studies.
  • Clinical trials.
  • Genetic evidence analysis.
  • Review of current dyslipidemia guidelines (ESC/EAS 2019).

Main Results:

  • Plant sterol-supplemented foods can reduce blood cholesterol by 10-15%.
  • Recent guidelines recommend plant sterols as adjunct therapy.
  • Emerging evidence suggests plant sterols may be atherogenic, prompting critical review.

Conclusions:

  • Plant sterols offer a modest cholesterol-lowering effect.
  • A debate exists regarding their net cardiovascular benefit versus potential risks.
  • Further research, including trials on hard cardiovascular outcomes, is warranted.