The Effect of Nattokinase-Monascus Supplements on Dyslipidemia: A Four-Month Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Nutrients. 2023 Sep 30;15(19):4239. doi: 10.3390/nu15194239.


Dyslipidemia, a condition implying high cardiovascular risks, has been widely studied on its potential nutrition interventions, including functional foods. This study aims to examine the effect of nattokinase monascus supplements (NMSs) on cardiovascular biomarkers and carotid intima-media thickness (CIMT) in patients with dyslipidemia. A total of 113 eligible subjects were randomly assigned to receive either NMSs or a placebo (55 and 58, respectively). After a 120-day intervention, there were significant mean absolute changes in total cholesterol (TC), low-density cholesterol (LDL-C), non-high-density cholesterol (non-HDL-C), and low-density cholesterol to high-density cholesterol ratio (LDL-C to HDL-C ratio), with values of -0.52 (95% CI: -0.51 to -0.54) mmol/L, -0.43 (95% CI: -0.45 to -0.41) mmol/L, -0.52 (95% CI: -0.52 to -0.52) mmol/L, and -0.29 (95% CI: -0.30 to -0.28) mmol/L, respectively, between the two groups. However, no significant differences were found in triglycerides (TGs), high-density cholesterol (HDL-C), and CIMT. Furthermore, the results for lipids and CIMT remained essentially unchanged after adjusting for various confounding factors using the analysis of covariance model. There were no significant differences in coagulation, liver function, renal function, or other indicators. No intervention-related adverse events, such as mouth ulcers, drooling, and stomach pain, were reported. The study results demonstrate that NMSs can ameliorate lipid levels (TC, LDL-C, non-HDL-C, and the LDL-C to HDL-C ratio) without the occurrence of adverse events. However, it did not significantly affect serum TG, HDL-C, and CIMT.

Keywords: dyslipidemia; lovastatin; nattokinase; nattokinase-monascus supplements; red yeast rice.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Carotid Intima-Media Thickness
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Double-Blind Method
  • Dyslipidemias* / drug therapy
  • Humans
  • Hypercholesterolemia* / epidemiology
  • Hyperlipidemias*
  • Monascus*
  • Triglycerides


  • Cholesterol, LDL
  • nattokinase
  • Cholesterol, HDL
  • Triglycerides