Comparison of the Reductions in LDL-C and non-HDL-C Induced by the Red Yeast Rice Extract Xuezhikang between Fasting and Nonfasting States in Patients with Coronary Heart Disease

Abstract Background: Xuezhikang, an extract of red yeast rice, effectively lowers fasting blood lipid levels. However, the influence of Xuezhikang on the nonfasting levels of low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) has not been explored in Chinese patients with coronary heart disease (CHD).Methods: Fifty CHD patients were enrolled and randomly divided into two groups (n = 25 each) to receive 1200 mg/d of Xuezhikang or a placebo for six weeks as routine therapy. Blood lipids were repeatedly measured before and after six weeks of treatment at 0, 2, 4 and 6 hour (h) after a standard breakfast containing 800 kcal and 50 g of fat.Results: The serum LDL-C levels significantly decreased, from a fasting level of 3.88 mmol/L to nonfasting levels of 2.99, 2.83 and 3.23 mmol/L at 2, 4 and 6 h, respectively, after breakfast (P < 0.05). However, no significant difference was found in the total cholesterol (TC) levels between the fasting value and values at any nonfasting time points. The serum non-HDL-C level slightly increased from a fasting level of 4.29 mmol/L to nonfasting levels of 4.32, 4.38 and 4.34 mmol/L at 2, 4 and 6 h postprandially, respectively, and the difference reached statistical significance only at 4 and 6 h after breakfast (P < 0.05). No difference was observed in the fasting and nonfasting blood lipids between the two groups at baseline. After six weeks of Xuezhikang treatment, the patients had significantly lower fasting and nonfasting serum levels of LDL-C and non-HDL-C (P < 0.05) than at pretreatment. The LDL-C levels were reduced by 27.8%, 28.1%, 26.2% and 25.3% at 0, 2, 4 and 6 h, respectively, and the non-HDL-C levels were reduced by 27.6%, 28.7%, 29.0% and 28.0% at 0, 2, 4 and 6 h, respectively, after breakfast. No significant difference was found in the percent reductions in the LDL-C and non-HDL-C levels among the four different time points.Conclusions: Six weeks of Xuezhikang treatment significantly decreased LDL-C and non-HDL-C levels, with similar percent reductions in the fasting and nonfasting states in CHD patients, indicating that the percent change in nonfasting LDL-C or non-HDL-C could replace that in the fasting state for evaluation of the efficacy of cholesterol control in CHD patients who are unwilling or unable to fast.