Therapy
Phytosterol supplements modestly lower Lp(a), a meta-analysis of 7 randomised trials (Nutr Metab Cardiovasc Dis 2019)
Original title: Impact of phytosterol supplementation on plasma lipoprotein(a) and free fatty acid (FFA) concentrations: A systematic review and meta-analysis of randomized controlled trials
This systematic review and meta-analysis pooled 12 effect sizes from seven randomised controlled trials assessing the impact of phytosterol (PS) supplementation on plasma Lp(a) and free fatty acid (FFA) concentrations. PS supplementation was associated with a significant reduction in Lp(a) (mean difference -0.025 mg/dL, 95% CI -0.045 to -0.004, P=0.017) without significant heterogeneity among studies (I2=0.0%, P=0.599), and also significantly lowered FFA (mean difference -0.138 mg/dL, 95% CI -0.195 to -0.081, P=0.000). Meta-regression and sensitivity analyses were not significant. The authors conclude oral phytosterol supplementation causes a significant, though small, reduction in serum Lp(a) and FFA.
Original abstract
Background And Aim: Although some earlier studies have indicated the effect of phytosterol (PS) supplementation on serum lipoprotein(a) (Lp(a)) and free fatty acid (FFA) concentration, findings are still conflicting. We aimed to assess the impact of PS supplementation on serum Lp(a) and FFA concentration through a systematic review and meta-analysis of available RCTs.
Methods And Results: We performed a systematic search of all available RCTs conducted up to 21 February 2019 in the following databases: PubMed, Scopus, and Cochrane. The choice of fixed- or random-effect model for analysis was determined according to the I2 statistic. Effect sizes were expressed as weighted mean difference (WMD) and 95% confidence interval (CI). Pooling of 12 effect sizes from seven articles revealed a significant reduction of Lp(a) levels following PS supplementation (MD: -0.025 mg/dl, 95% CI: -0.045, -0.004, p = 0.017) without significant heterogeneity among the studies (I2 = 0.0%, p = 0.599). Also, PS supplementation significantly lowered FFA (MD: -0.138 mg/dl, 95% CI: -0.195, -0.081, p = 0.000) without significant heterogeneity among the studies (I2 = 0.0%, p = 0.911). The results for meta-regression and sensitivity analysis were not significant.
Conclusion: The meta-analysis suggests that oral PS supplementation could cause a significant reduction in serum Lp(a) and FFA.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.