Citrus Bergamot Improves Atherogenic Lipoprotein Particle Characteristics in Patients With Non-alcoholic Fatty Liver Disease and Metabolic Syndrome

Background/Synopsis:BPF, a concentrated extract of the bergamot citrus fruit endemic to Calabria, Italy has been shown to be a powerful anti-oxidant and lipid-lowering agent. A “natural statin” (HMG-CoA reductase activity) and an inhibitor of sterol absorption in the gut, it demonstrates significant lipid lowering in patients with dyslipidemia while addressing all the components of the metabolic syndrome. Patients with metabolic syndrome and NAFLD have a preponderance of atherogenic lipoprotein particles and are at elevated risk for atherosclerosis. Objective/Purpose: To determine whether bergamot polyphenolic fraction (BPF), could significantly improve cholesterol levels and lipoprotein particle size, density, and number in patients with metabolic syndrome and NAFLD. Methods: There were 107 patients who met the NCEP-ATP III criteria for metabolic syndrome and had ultrasonic evidence of severe NAFLD (hepato-renal index 2.5-3.5) and were admitted to the study. Before and after 120 days of BPF 650 mg twice/day, all patients had full lipid analysis and lipoprotein fractionation (NMR/Raman spectroscopy). Conclusions: In a group of 107 patients with confirmed NAFLD and metabolic syndrome, BPF given twice per day before meals significantly improved all standard measures of cholesterol concentration. Furthermore, all atherogenic particle characteristics (size, density and number) of LDL and HDL were markedly improved as well as remnant lipoproteins.