Red yeast rice: a functional food used to reduce hyperlipidemia

ABSTRACT

Cardiovascular diseases (CVD) account for 31% of all deaths, making them the leading cause of death worldwide. Hyperlipidemia is a major risk factor of CVD. Statins, one of the most commonly prescribed type of lipid-lowering drugs in the world, are widely recognized as effective in the prevention and treatment of CVD as they inhibit 3-hydroxy-3-methyl glutaryl coenzyme A reductase, reduce endogenous cholesterol synthesis, and increase LDL clearance by promoting LDL receptor expression. However, adverse reactions to statins and stain-associated symptoms (SAS) (i.e. muscle, metabolic, liver and nervous system) have limited the use of statins. An alternative to statins, red yeast rice (RYR), is a traditional medicine and functional food that has a long history. Relatively small doses of RYR (equivalent to 5–7 mg of lovastatin daily) have been reported to have a similar effect to the 20–40 mg dose of pure lovastatin alone in lowering serum cholesterol, suggesting that RYR contains cholesterol-lowering bioactive substances. This review is the first to summarize the material basis of synergistic enhancing efficacy and reducing adverse reactions in the lipid-lowering effect of RYR, highlight the lipid-lowering advantages of RYR, and provide reference for the development and application of RYR in functional foods and drugs.

KEYWORDS:

• Red yeast rice
• hyperlipidemia
• statins
• 3-Hydroxy-3-Methyl glutaryl coenzyme A
• functional food

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

Conceptualization, X.F. and J.H.; software, X.F.; validation, J.H., F.Z. and W.C.; formal analysis, X.F.; investigation, X.F.; writing—original draft preparation, X.F.; writing—review and editing, J.H. and F.Z.; visualization, X.F.; project administration, W.C.; funding acquisition, F.Z. and W.C. All authors have read and agreed to the published version of the manuscript.

Additional information

Funding

This research was funded by National Natural Science Foundation of China, grant number 81830109; Science and Technology Commission of Shanghai Municipality, grant number 22S21901900; Shanghai Municipal Health Commission, grant number ZYCC2019018, Jin-Zi-Ta Talent project, grant numbers 0806 and 1016, and Innovative Clinical Research Funding Project, grant number 2020YLCYJ -Y25