title: Lipid-modifying effects of krill oil in humans: systematic review and meta-analysis of randomized controlled trials.
abstract: Some experimental and clinical trials have shown that krill oil, extracted from small red crustaceans, might be an effective lipid-modifying agent, but the evidence is not conclusive.
  
  
  
  The effect of krill oil supplements on plasma lipid concentrations was assessed through a systematic review of the literature and a meta-analysis of available randomized controlled trials.
  
  
  
  PubMed and Scopus were searched up to March 25, 2016, to identify RCTs investigating the effect of krill oil supplements on plasma lipids.
  
  
  
  Randomized controlled trials that investigated the impact of at least 2 weeks of supplementation with krill oil on plasma/serum concentrations of at least one of the main lipid parameters (ie, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, or triglycerides) and that reported sufficient information on plasma/serum lipid levels at baseline and at the end of study in both krill oil and control groups were eligible for inclusion.
  
  
  
  Two reviewers independently extracted the following data: first author's name, year of publication, study location, study design, number of participants in the krill oil and control groups, dosage of krill oil, type of control allocation, treatment duration, demographic characteristics of study participants, and baseline and follow-up plasma concentrations of lipids. Effect size was expressed as the weighted mean difference (WMD) and 95% confidence interval (95%CI).
  
  
  
  Meta-analysis of data from 7 eligible trials (14 treatment arms) with 662 participants showed a significant reduction in plasma concentrations of low-density lipoprotein cholesterol (WMD, -15.52 mg/dL; 95%CI, -28.43 to -2.61; P = 0.018) and triglycerides (WMD, -14.03 mg/dL; 95%CI, -21.38 to -6.67; P < 0.001) following supplementation with krill oil. A significant elevation in plasma concentrations of high-density lipoprotein cholesterol was also observed (WMD, 6.65 mg/dL; 95%CI, 2.30 to 10.99; P = 0.003), while a reduction in plasma concentrations of total cholesterol did not reach statistical significance (WMD, -7.50 mg/dL; 95%CI, -17.94 to 2.93; P = 0.159).
  
  
  
  Krill oil supplementation can reduce low-density lipoprotein cholesterol and triglycerides. Additional clinical studies with more participants are needed to assess the impact of krill oil supplementation on other indices of cardiometabolic risk and on the risk of cardiovascular outcomes.
authors.affiliation: S. Ursoniu is with the Department of Functional Sciences, Discipline of Public Health, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. A. Sahebkar is with the Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. M.-C. Serban is with the Department of Functional Sciences, Discipline of Pathophysiology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D. Antal is with the Discipline of Pharmaceutical Botany, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D.P. Mikhailidis is with the Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London, London, United Kingdom. A. Cicero is with the Medical & Surgical Sciences Department, Alma Mater Studiorum - University of Bologna, Bologna, Italy. V. Athyros is with the Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration General Hospital, Thessaloniki, Greece. M. Rizzo is with the Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy. J. Rysz and M. Banach are with the Department of Hypertension, Medical University of Lodz, Lodz, Poland.
authors.forename: Sorin
authors.initials: S
authors.lastname: Ursoniu
authors.affiliation: S. Ursoniu is with the Department of Functional Sciences, Discipline of Public Health, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. A. Sahebkar is with the Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. M.-C. Serban is with the Department of Functional Sciences, Discipline of Pathophysiology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D. Antal is with the Discipline of Pharmaceutical Botany, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D.P. Mikhailidis is with the Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London, London, United Kingdom. A. Cicero is with the Medical & Surgical Sciences Department, Alma Mater Studiorum - University of Bologna, Bologna, Italy. V. Athyros is with the Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration General Hospital, Thessaloniki, Greece. M. Rizzo is with the Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy. J. Rysz and M. Banach are with the Department of Hypertension, Medical University of Lodz, Lodz, Poland.
authors.forename: Amirhossein
authors.initials: A
authors.lastname: Sahebkar
authors.affiliation: S. Ursoniu is with the Department of Functional Sciences, Discipline of Public Health, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. A. Sahebkar is with the Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. M.-C. Serban is with the Department of Functional Sciences, Discipline of Pathophysiology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D. Antal is with the Discipline of Pharmaceutical Botany, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D.P. Mikhailidis is with the Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London, London, United Kingdom. A. Cicero is with the Medical & Surgical Sciences Department, Alma Mater Studiorum - University of Bologna, Bologna, Italy. V. Athyros is with the Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration General Hospital, Thessaloniki, Greece. M. Rizzo is with the Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy. J. Rysz and M. Banach are with the Department of Hypertension, Medical University of Lodz, Lodz, Poland.
authors.forename: Maria-Corina
authors.initials: MC
authors.lastname: Serban
authors.affiliation: S. Ursoniu is with the Department of Functional Sciences, Discipline of Public Health, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. A. Sahebkar is with the Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. M.-C. Serban is with the Department of Functional Sciences, Discipline of Pathophysiology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D. Antal is with the Discipline of Pharmaceutical Botany, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D.P. Mikhailidis is with the Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London, London, United Kingdom. A. Cicero is with the Medical & Surgical Sciences Department, Alma Mater Studiorum - University of Bologna, Bologna, Italy. V. Athyros is with the Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration General Hospital, Thessaloniki, Greece. M. Rizzo is with the Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy. J. Rysz and M. Banach are with the Department of Hypertension, Medical University of Lodz, Lodz, Poland.
authors.forename: Diana
authors.initials: D
authors.lastname: Antal
authors.affiliation: S. Ursoniu is with the Department of Functional Sciences, Discipline of Public Health, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. A. Sahebkar is with the Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. M.-C. Serban is with the Department of Functional Sciences, Discipline of Pathophysiology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D. Antal is with the Discipline of Pharmaceutical Botany, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D.P. Mikhailidis is with the Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London, London, United Kingdom. A. Cicero is with the Medical & Surgical Sciences Department, Alma Mater Studiorum - University of Bologna, Bologna, Italy. V. Athyros is with the Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration General Hospital, Thessaloniki, Greece. M. Rizzo is with the Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy. J. Rysz and M. Banach are with the Department of Hypertension, Medical University of Lodz, Lodz, Poland.
authors.forename: Dimitri P
authors.initials: DP
authors.lastname: Mikhailidis
authors.affiliation: S. Ursoniu is with the Department of Functional Sciences, Discipline of Public Health, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. A. Sahebkar is with the Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. M.-C. Serban is with the Department of Functional Sciences, Discipline of Pathophysiology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D. Antal is with the Discipline of Pharmaceutical Botany, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D.P. Mikhailidis is with the Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London, London, United Kingdom. A. Cicero is with the Medical & Surgical Sciences Department, Alma Mater Studiorum - University of Bologna, Bologna, Italy. V. Athyros is with the Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration General Hospital, Thessaloniki, Greece. M. Rizzo is with the Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy. J. Rysz and M. Banach are with the Department of Hypertension, Medical University of Lodz, Lodz, Poland.
authors.forename: Arrigo
authors.initials: A
authors.lastname: Cicero
authors.affiliation: S. Ursoniu is with the Department of Functional Sciences, Discipline of Public Health, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. A. Sahebkar is with the Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. M.-C. Serban is with the Department of Functional Sciences, Discipline of Pathophysiology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D. Antal is with the Discipline of Pharmaceutical Botany, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D.P. Mikhailidis is with the Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London, London, United Kingdom. A. Cicero is with the Medical & Surgical Sciences Department, Alma Mater Studiorum - University of Bologna, Bologna, Italy. V. Athyros is with the Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration General Hospital, Thessaloniki, Greece. M. Rizzo is with the Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy. J. Rysz and M. Banach are with the Department of Hypertension, Medical University of Lodz, Lodz, Poland.
authors.forename: Vasilios
authors.initials: V
authors.lastname: Athyros
authors.affiliation: S. Ursoniu is with the Department of Functional Sciences, Discipline of Public Health, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. A. Sahebkar is with the Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. M.-C. Serban is with the Department of Functional Sciences, Discipline of Pathophysiology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D. Antal is with the Discipline of Pharmaceutical Botany, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D.P. Mikhailidis is with the Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London, London, United Kingdom. A. Cicero is with the Medical & Surgical Sciences Department, Alma Mater Studiorum - University of Bologna, Bologna, Italy. V. Athyros is with the Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration General Hospital, Thessaloniki, Greece. M. Rizzo is with the Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy. J. Rysz and M. Banach are with the Department of Hypertension, Medical University of Lodz, Lodz, Poland.
authors.forename: Manfredi
authors.initials: M
authors.lastname: Rizzo
authors.affiliation: S. Ursoniu is with the Department of Functional Sciences, Discipline of Public Health, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. A. Sahebkar is with the Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. M.-C. Serban is with the Department of Functional Sciences, Discipline of Pathophysiology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D. Antal is with the Discipline of Pharmaceutical Botany, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D.P. Mikhailidis is with the Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London, London, United Kingdom. A. Cicero is with the Medical & Surgical Sciences Department, Alma Mater Studiorum - University of Bologna, Bologna, Italy. V. Athyros is with the Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration General Hospital, Thessaloniki, Greece. M. Rizzo is with the Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy. J. Rysz and M. Banach are with the Department of Hypertension, Medical University of Lodz, Lodz, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Rysz
authors.affiliation: S. Ursoniu is with the Department of Functional Sciences, Discipline of Public Health, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. A. Sahebkar is with the Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. M.-C. Serban is with the Department of Functional Sciences, Discipline of Pathophysiology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D. Antal is with the Discipline of Pharmaceutical Botany, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. D.P. Mikhailidis is with the Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London, London, United Kingdom. A. Cicero is with the Medical & Surgical Sciences Department, Alma Mater Studiorum - University of Bologna, Bologna, Italy. V. Athyros is with the Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration General Hospital, Thessaloniki, Greece. M. Rizzo is with the Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy. J. Rysz and M. Banach are with the Department of Hypertension, Medical University of Lodz, Lodz, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Banach
mesh_terms: D000818:Animals; D004042:Dietary Fats, Unsaturated; D019587:Dietary Supplements; D033201:Euphausiacea; D006801:Humans; D050356:Lipid Metabolism / Q000187:drug effects*; D016032:Randomized Controlled Trials as Topic
chemical_list: D004042:Dietary Fats, Unsaturated
keywords: Euphausiacea krill; krill oil; meta-analysis; plasma lipids