Curcumin in Atherogenic Dyslipidemia: Linking Preclinical Mechanistic Insights to Clinical Outcomes.

摘要

Background/Objectives: Atherogenic dyslipidemia is a major cardiometabolic risk factor characterized by elevated circulating triglycerides (TGs), reduced HDL-C, and increased levels of atherogenic lipoproteins. Curcumin, a polyphenolic compound considered the main bioactive component of turmeric (Curcuma longa), has attracted growing interest because of its potential lipid-modifying and anti-inflammatory properties. This scoping review aimed to evaluate evidence from randomized controlled trials (RCTs) on the efficacy of curcumin supplementation in the management of atherogenic dyslipidemia and to summarize current mechanistic evidence related to curcumin absorption, metabolism, and regulation of lipid homeostasis. Methods: A PRISMA-ScR-guided scoping review was performed across five databases (PubMed, Scopus, Web of Science, Cochrane Library, and Embase). RCTs evaluating curcumin supplementation in atherogenic dyslipidemia or related cardiometabolic conditions were systematically identified and synthesized. Mechanistic and preclinical evidence was identified through separate topic-specific searches of PubMed, Scopus, and Web of Science, supplemented by citation searching, and was synthesized narratively. Results: Twenty-two RCTs published between 2008 and 2025 were included. Most studies involved patients with cardiometabolic disorders, including type 2 diabetes mellitus with hyperlipidemia, metabolic syndrome, and polycystic ovary syndrome. Curcumin supplementation, administered in various formulations and dosages, showed overall favorable effects on plasma lipid profiles, particularly TGs and LDL-C, although the magnitude of these effects varied across studies. Mechanistic and preclinical evidence suggested that curcumin may modulate multiple pathways involved in lipid homeostasis, including intestinal cholesterol uptake, hepatic lipogenesis, cholesterol synthesis, fatty acid oxidation, bile acid metabolism, and reverse cholesterol transport. Conclusions: Current evidence suggests that curcumin may improve atherogenic lipid profiles through pleiotropic effects on lipid metabolism and cholesterol homeostasis. The clinical efficacy of curcumin appears to depend substantially on formulation-related bioavailability. Despite inter-study heterogeneity, curcumin shows potential as an adjunctive strategy for the management of atherogenic dyslipidemia and associated metabolic disorders.