| Lutein is an essential carotenoid commonly consumed in the diet; however, its dietary intake does not usually
reach the minimum recommended intake to decrease the incidence of chronic diseases. Experimental and epidemiological
evidence suggests an anti-atherosclerotic effect for lutein-rich foods or lutein supplementation.
This systematic review aimed to assess the mechanistic pathways of lutein in the prevention of atherosclerosis.
Electronic databases, including PubMed, SCOPUS, ProQuest, Embase, and Google Scholar were searched to May
2019. Original studies published in English-language journals that investigated the effects of lutein on atherosclerosis
and related risk factors, including lipid profile, hemodynamic, glycemic and inflammatory measurements,
and endothelial function indices, were considered. Two reviewers independently extracted data on study
characteristics, methods and outcomes. The review protocol has been registered at PROSPERO database of
Systematic Reviews (registration number: CRD42019121381). A total of 5818 articles were found in the first
phase of the search; from these, 19 met the inclusion criteria: 3 in vitro, 1 ex vivo, 11 animal, and 4 human
studies. Nine of ten studies showed positive effects of lutein on endothelial function by reducing blood pressure,
arterial thickness, monocyte migration, and vascular smooth muscle cell migration. Twelve studies examined the
anti-inflammatory properties of lutein and found a significant decrease in proinflammatory cytokines. Although
few studies investigated the anti-hyperlipidemic effects of lutein, three animal studies and one clinical trial
found a beneficial effect of lutein on lipid profile. Evidence supports positive effects of lutein on atherosclerosis
development and some common risk factors of atherosclerosis, including inflammation and endothelial dysfunction.
Further studies focused on the effects of lutein on hyperglycemia, lipid profile, blood pressure and
coagulation are required. |