NComb-induced amelioration of lipid profile was not affected by duration of supplementation nor by baseline lipid levels ; conversely , a greater glucose-lowering effect of NComb was found with higher baseline glucose levels and longer duration s of supplementation .
In conclusion , the present results suggest that NComb supplementation is associated with improvement of lipid and glucose profile .
Short-term beneficial effects of NComb supplementation appear to be maintained in the long term
Dyslipidemia and hyperglycemia are associated with an increased risk of  ischemic cardiovascular disease .
Positive effects of a nutraceutical combination comprising red yeast rice , berberine , policosanol , astaxanthin , coenzyme Q10 and folic acid ( NComb ) on plasma lipid and glucose levels have been reported in some but not all clinical trials .
To address this inconsistency , we tried to estimate the size of lipid- and glucose-lowering effects of NComb through a systematic review and meta- analysis of r and omized controlled trials .
Is Hyperglycemia a Cardiovascular Risk Factor?
Patients with diabetes show an increased vascular morbidity and mortality that reduces their life expectancy by ~5–15 years ( depending on the age at diagnosis ) ( 1 ) . There is convincing evidence from epidemiological and pathophysiological studies that hyperglycemia per se is largely responsible for the harmful effects of the disease . As recently shown by clinical trials , treatment of this condition may reduce cardiovascular events and mortality , and several therapies should be considered : initiating early and individualized treatment and avoiding hypoglycemia . As shown in the Multiple Risk Factor Intervention Trial , at any given level of major cardiovascular risk factors , diabetes is associated with an odds ratio of 2–4 for cardiovascular mortality compared with nondiabetic subjects ( 2 ) . These results were confirmed by the European Prospect i ve Investigation of Cancer and Nutrition ( EPIC Norfolk ) study ( 3 ) and a recent analysis of the Atherosclerosis Risk in Communities ( ARIC ) study ( 4 ) . Furthermore , a recently published 18-year follow-up study from Finl and demonstrated a similar impact of type 1 and type 2 diabetes on cardiovascular mortality . The adjusted hazard ratios compared with age-matched subjects without diabetes were 5.2 and 4.9 for type 1 and type 2 diabetes , respectively ( 5 ) . Thus , today evidence exists on long-term follow-up population -based studies in patients with type 1 and type 2 diabetes . This evidence clearly suggests that hyperglycemia is a key risk factor not only for diabetes-related disease , but also for cardiovascular and all-cause mortality . On the basis of these long-term observations , one can assume an increment of cardiovascular disease per increase of 1 unit ( % ) A1C of ~18 % ( 6 ) . As shown in numerous prospect i ve studies , the deleterious effects of dysglycemia ( fasting and postpr and ial hyperglycemia ) develop before diabetes is diagnosed . In the Glucose Tolerance in Acute Myocardial Infa rct ion study of patients with acute coronary syndrome  , abnormal glucose tolerance was the strongest independent
NComb-induced amelioration of lipid profile was not affected by duration of supplementation nor by baseline lipid levels ; conversely , a greater glucose-lowering effect of NComb was found with higher baseline glucose levels and longer duration s of supplementation .
In conclusion , the present results suggest that NComb supplementation is associated with improvement of lipid and glucose profile .
Short-term beneficial effects of NComb supplementation appear to be maintained in the long term
Dyslipidemia and hyperglycemia are associated with an increased risk of  ischemic cardiovascular disease .
Positive effects of a nutraceutical combination comprising red yeast rice , berberine , policosanol , astaxanthin , coenzyme Q10 and folic acid ( NComb ) on plasma lipid and glucose levels have been reported in some but not all clinical trials .
To address this inconsistency , we tried to estimate the size of lipid- and glucose-lowering effects of NComb through a systematic review and meta- analysis of r and omized controlled trials .