title: A systematic review and meta-analysis of the effects of pycnogenol on plasma lipids.
abstract: BACKGROUND
  Pycnogenol, the standardized flavonoid-rich extract from the bark of French maritime pine (Pinus pinaster Ait), has been shown to modify a number of cardiovascular risk factors. However, that Pycnogenol modulates plasma lipid levels is unclear due to the inconsistent findings.
  
  
  OBJECTIVE
  To examine the impact of Pycnogenol on lipid profile through a meta-analysis of available controlled clinical trials.
  
  
  METHODS
  Controlled trials assessing the effects of Pycnogenol on lipid parameters (total cholesterol, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglycerides) were identified by electronic search in Medline and Scopus. Weighed mean difference (WMD) and 95% confidence interval (CI) were calculated as effect size using random-effects meta-analysis. Sensitivity and meta-regression (for Pycnogenol dose and duration of supplementation) analyses were carried out using leave-one-out and unrestricted maximum likelihood methods, respectively.
  
  
  RESULTS
  A total of 7 trials comprising 442 patients (226 in the Pycnogenol and 216 in the control group) were identified. Meta-analysis did not reveal any significant effect of Pycnogenol on lipid parameters: total cholesterol: WMD: -0.03 mmol/L, 95% CI: -0.34 to 0.28, P = .83; LDL-C: WMD: -0.07 mmol/L, 95% CI: -0.29 to 0.15, P = .54; HDL-C: WMD: 0.00 mmol/L, 95% CI: -0.04 to 0.05, P = .86; and triglycerides: WMD: 0.05 mmol/L, 95% CI: -0.12 to 0.23, P = .55. All these effect sizes were robust in sensitivity analyses. Apart from a dose-effect association for the effect of Pycnogenol on LDL-C, there was no other association between Pycnogenol dose or its duration of supplementation with changes in any of the lipid parameters.
  
  
  CONCLUSIONS
  Current clinical evidence does not suggest any significant effect of Pycnogenol on fasting lipid profile.
authors.affiliation: 1Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Amirhossein
authors.initials: A
authors.lastname: Sahebkar
mesh_terms: D002784:Cholesterol / Q000097:blood; D002986:Clinical Trials as Topic; D005419:Flavonoids / Q000494:pharmacology*; D006801:Humans; D008055:Lipids / Q000097:blood*; D010936:Plant Extracts; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D005419:Flavonoids; D008055:Lipids; D010936:Plant Extracts; D014280:Triglycerides; C024070:pycnogenols; D002784:Cholesterol
keywords: Pinus pinaster; cardiovascular disease; dyslipidemia; flavonoid; quantitative data synthesis; randomized controlled trial