EFFECTS OF ARTICHOKE EXTRACT ON TOTAL CHOLESTEROL: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

Resumo

Dyslipidaemia is a major modifiable risk factor for atherosclerotic cardiovascular disease, and non- pharmacological interventions have been investigated as complementary strategies for lipid management. Artichoke extract (Cynara scolymus) has been widely used as a nutraceutical; however, findings from randomised controlled trials on its lipid -lowering effects remain heterogeneous. This study a imed to synthesise the available evidence on the effect of Cynara scolymus supplementation on total cholesterol in adults. A systematic review with meta -analysis of randomised controlled trials was conducted in accordance with PRISMA guidelines and registered in PROSPERO. Searches were performed in EMBASE, LILACS, CINAHL, MEDLINE/PubMed, Cochrane Library, Scopus and Web of Science, from database inception to December 2025. Studies involving adults receiving Cynara scolymus in any form, compared with placebo, and reporting total cholesterol were eligible. Study selection, data extraction and risk of bias assessment were conducted by independent reviewers. The meta -analysis used a random - effects model, with standardised mean difference and 95% confidence inter vals. A total of 604 records were identified, of which 13 randomised controlled trials met the criteria for the systematic review, and 9 contributed to the meta -analysis of total cholesterol. The pooled analysis showed a significant reduction in total chol esterol favouring artichoke extract supplementation, with a standardised mean difference of -0.73, 95% confidence interval from -1.36 to -0.11, and p=0.02. However, considerable heterogeneity was observed across the included studies, with I²=89%, and the certainty of evidence was rated as low. In conclusion, Cynara scolymus supplementation may reduce total cholesterol in adults, suggesting a potential cardiometabolic benefit. Nevertheless, the high heterogeneity and methodological limitations of the available trials indicate that these findings should be interpreted cautiously, and more robust randomised controlled trials using standardised preparations are required to clarify the clinical relevance of this effect.