Table 3.
Detailed characteristics of the included studies on hyperlipidemic patients.
| References | Patients’ Cohort | Dose of Spirulina |
Duration Treatment (Weeks/Months) |
Outcomes in Spirulina Group; (p-Value) |
Outcomes in Control Group; (p-Value) |
p-Value |
|---|---|---|---|---|---|---|
| TG (mg/dL) | TG (mg/dL) | |||||
| Baseline 144.13 ± 57.57 | Baseline 156.14 ± 79.01 | 0.486 | ||||
| End 136.65 ± 60.80 | End 140.88 ± 72.73 | NA | ||||
| p = 0.365 | p = 0.052 | |||||
| LDL-C (mg/dL) | LDL-C (mg/dL) | |||||
| Baseline 116.27 ± 34.79 | Baseline 119.90 ± 21.69 | 0.725 | ||||
| End 115.42 ± 28.61 | End 116.68 ± 21.31 | NA | ||||
| Zeinalian et al., 2017 [84] | Spirulina group; | 1 g/day | 12 weeks | p = 0.886 | p = 0.196 | |
| Control group | HDL-C (mg/dL) | HDL-C (mg/dL) | ||||
| Baseline 36.55 ± 10.21 | Baseline 34.88 ± 11.56 | 0.385 | ||||
| End 38.75 ± 8.84 | End 38.37 ± 9.44 | NA | ||||
| p = 0.05 | p = 0.001 | |||||
| TC (mg/dL) | TC (mg/dL) | |||||
| Baseline 190.48 ± 35.25 | Baseline 187.25 ± 27.10 | 0.123 | ||||
| End 180.10 ± 31.13 | End 183.03 ± 28.07 | NA | ||||
| p = 0.002 | p = 0.09 | |||||
| TG (mmol/L) | TG (mmol/L) | |||||
| Baseline 1.9 ± 1.0 | Baseline 2.0 ± 1.2 | 0.334 | ||||
| End 1.8 ± 0.9 | End 2.1 ± 1.1 | 0.224 | ||||
| p = 0.633 | p = 0.981 | |||||
| LDL-C(mmol/L) | LDL-C (mmol/L) | 0.412 | ||||
| Baseline 3.5 ± 0.9 | Baseline 3.6 ±0.9 | <0.001 | ||||
| End 3.0 ± 0.6 | End 3.6 ± 0.9 | |||||
| Szulinska et al., 2017 [85] | Spirulina group; | 2 g/day | 3 months | p < 0.001 | p = 0.223 | |
| Placebo group | HDL-C (mmol/L) | HDL-C (mmol/L) | ||||
| Baseline 1.4 ± 0.3 | Baseline 1.3 ± 0.4 | 0.357 | ||||
| End 1.4 ± 0.3 | End 1.2 ± 0.3 | 0.002 | ||||
| p = 0.227 | p = 0.204 | |||||
| TC (mmol/L) | TC (mmol/L) | |||||
| Baseline 5.5 ± 1.1 | Baseline 5.2± 0.9 | 0.191 | ||||
| End 5.2± 0.9 | End 5.4± 0.8 | 0.150 | ||||
| p < 0.001 | p = 0.306 | |||||
| TG (mg/dL) | TG (mg/dL) | |||||
| Baseline Sp 167 ± 11 Sp + exercise 184 ± 40 |
Baseline Placebo 160 ± 6. Placebo + exercise 180 ± 25 |
NA | ||||
| End Sp 148 ± 19 Sp + exercise 156 ± 29 |
End Placebo 153 ± 12 Placebo + exercise 164 ± 21 |
NA | ||||
| Spirulina group; |
Sp p < 0.05 Sp + exercise p < 0.05 |
Placebo p = 0.156 Placebo + exercise p = 0.096 |
||||
| Spirulina + exercise group; | LDL-C (mg/dL) | LDL-C (mg/dL) | ||||
|
Hernández-Lepe et al., 2019 [86] |
Control group; | 4.5 g/day | 6 weeks | Baseline Sp 148 ± 33 Sp + exercise 141 ± 29 |
Baseline Placebo 140 ± 29 Placebo + exercise 148 ± 33 |
NA |
| Control + exercise group | End Sp 128 ± 32 Sp + exercise 101 ± 34 |
End Placebo 135 ± 27 Placebo + exercise 124 ± 33 |
NA | |||
|
Sp p = 0.060 Sp + exercise p < 0.05 |
Placebo p = 0.650 Placebo + exercise p < 0.05 |
|||||
| HDL-C (mg/dL) | HDL-C (mg/dL) | |||||
| Baseline Sp 29 ± 6 Sp + exercise 30 ± 6 |
Baseline Placebo 28 ± 8 Placebo + exercise 28 ± 6 |
NA | ||||
| End Sp 35 ± 10 Sp + exercise 40 ± 10 |
End Placebo 31 ± 5 Placebo + exercise 33 ± 6 |
NA | ||||
|
Sp p < 0.05 Sp + exercise p < 0.05 |
Placebo p = 0.172 Placebo + exercise p < 0.05 |
|||||
| TC (mg/dL) | TC (mg/dL) | |||||
| Baseline Sp 233 ± 21 Sp + exercise 226 ± 22 |
Baseline Placebo 219 ± 16 Placebo + exercise 232 ± 23 |
NA | ||||
| End Sp 212 ± 23 Sp + exercise 189 ± 20 |
End Placebo 213 ± 18 Placebo + exercise 208 ± 28 |
NA | ||||
|
Sp p < 0.05 Sp + exercise p < 0.05 |
Placebo p = 0.412 Placebo + exercise p < 0.05 |
|||||
| TG (mg/dL) | TG (mg/dL) | |||||
| Baseline 94.09 ± 61.44 | Baseline 86.57 ± 33.26 | NA | ||||
| End 93.82 ± 55.29 | End 74.76 ± 18.41 | NA | ||||
| HIIT+ Spirulina group; | p = 0.97 | p = 0.22 | ||||
|
Golestani et al., 2021 [87] |
HIIT+ Placebo group | 1 g/day | 4 weeks | LDL-C (mg/dL) | LDL-C (mg/dL) | |
| Baseline 132.43 ± 19.80 | Baseline 130.93 ± 17.23 | NA | ||||
| End 125.32 ± 30.59 | End 123.04 ± 10.90 | NA | ||||
| p = 0.37 | p = 0.21 | |||||
| HDL-C (mg/dL) | HDL-C (mg/dL) | |||||
| Baseline 54.23 ± 6.97 | Baseline 59.49 ± 3.85 | |||||
| End 57.62 ± 5.18 | End 60.37 ± 5.39 | |||||
| p = 0.15 | p = 0.65 | |||||
| TC (mg/dL) | TC (mg/dL) | |||||
| Baseline 167.35 ± 39.48 | Baseline 170.81 ± 26.62 | NA | ||||
| End 163.24 ± 38.85 | End 159.13 ± 23.85 | NA | ||||
| p = 0.69 | p = 0.14 | |||||
| TG (mg/dL) | TG (mg/dL) | |||||
| Baseline 184 ± 12.9 | Baseline 181 ± 11.7 | 0.96 | ||||
| End 113.63 ± 40.56 | End 180.37 ± 63.76 | NA | ||||
| p = 0.001 | p = 0.001 | |||||
| LDL-C (mg/dL) | LDL-C (mg/dL) | |||||
| Baseline 112 ± 9.12 | Baseline 110 ± 8.6 | 0.87 | ||||
| End 73.47 ± 37.4 | End 110.97 ± 47.54 | NA | ||||
|
Karizi et al., 2022 [65] |
Spirulina + Metformin group; | 2 g/day | 3 months | p = 0.001 | p = 0.001 | |
| Placebo + Metformin group |
HDL-C (mg/dL) | HDL-C (mg/dL) | ||||
| Baseline 42 ± 1.3 | Baseline 42 ± 1.3 | 0.78 | ||||
| End 45.1 ± 6.83 | End 40.5 ± 6.25 | NA | ||||
| p = 0.001 | p = 0.001 | |||||
| TC (mg/dL) | TC (mg/dl) | |||||
| Baseline 190 ± 8.8 | Baseline 186 ± 8.0 | 0.78 | ||||
| End 149.07 ± 40.02 | End 187.63 ± 43.39 | NA | ||||
| p = 0.001 | p = 0.001 | |||||
| TG (mg/dL) | ||||||
| Baseline 184.8 ± 16.8 | ||||||
| End 138.9 ± 23.8 | ||||||
| p < 0.0001 | ||||||
| LDL-C (mg/dL) | ||||||
| Baseline 200.6 ± 27.6 | ||||||
| Mazokopakis et al., 2014 [88] | Spirulina group | 1 g/day | 3 months | End 183 ± 23.6 | NA | |
| p < 0.0001 | ||||||
| HDL-C (mg/dL) | ||||||
| Baseline 38 ± 6.9 | ||||||
| End 39.6 ± 6.3 | ||||||
| p = 0.0002 | ||||||
| TC (mg/dL) | ||||||
| Baseline 275.5 ± 29.9 | ||||||
| End 250.3 ± 26.7 | ||||||
| p < 0.0001 | ||||||
| TG (mg/dL) | TG (mg/dL) | |||||
| Baseline 195.77 ± 16.74 | Baseline 161.21 ± 15.26 | 0.07 | ||||
| End 175.13 ± 16.46 | End 155.42 ± 16.51 | 0.29 | ||||
| p = 0.01 | p = 0.44 | |||||
| LDL-C (mg/dL) | LDL-C (mg/dL) | |||||
| Baseline 108.22 ± 5.62 | Baseline 108.57 ± 5.61 | 0.96 | ||||
| End 106.13 ± 5.66 | End 113.63 ± 5.46 | 0.35 | ||||
| Ghaem Far et al., 2021 [39] | Spirulina group; | 2 g/day | 8 weeks | p = 0.55 | p = 0.28 | |
| Placebo group | HDL-C (mg/dL) | HDL-C (mg/dL) | ||||
| Baseline 38.59 ± 1.68 | Baseline 42.31 ± 2.22 | 0.18 | ||||
| End 39.81 ± 1.89 | End 41.57 ± 2.09 | 0.33 | ||||
| p = 0.17 | p = 0.38 | |||||
| TC (mg/dL) | TC (mg/dL) | |||||
| Baseline 187.00 ± 7.48 | Baseline 186.26 ± 7.8 | 0.94 | ||||
| End 183.68 ± 7.06 | End 190.57 ± 6.95 | 0.49 | ||||
| p = 0.47 | p = 0.51 | |||||
| TG (mg/dL) | TG (mg/dL) | |||||
| Baseline 165.30 ± 41.20 | Baseline 152.83 ± 21.12 | 0.20 | ||||
| End 138.65 ± 41.70 | End 164.89 ± 38.82 | |||||
| p = 0.03 | p = 0.05 | |||||
| LDL-C (mg/dL) | LDL-C (mg/dL) | |||||
| Baseline 126.96 ± 45.18 | Baseline 117.70 ± 40.62 | 0.46 | ||||
| End 116.60 ± 41.76 | End 123.53 ± 23.76 | |||||
| Mazloomi et al., 2021 [89] | Spirulina sauce group; | 2 g/day | 8 weeks | p = 0.11 | p = 0.71 | |
| Placebo group | HDL-C (mg/dL) | HDL-C (mg/dL) | ||||
| Baseline 42.43 ± 8.29 | Baseline 37.61 ± 11.27 | 0.10 | ||||
| End 46.40 ± 11.64 | End 38.58 ± 10.65 | |||||
| p = 0.02 | p = 0.86 | |||||
| TC (mg/dL) | TC (mg/dL) | |||||
| Baseline 202.48 ± 45 | Baseline 185.96 ± 39.90 | 0.19 | ||||
| End 186.75 ± 49.86 | End 195.11 ± 24.86 | |||||
| p = 0.14 | p = 0.42 | |||||
| TG (g/L) | TG (g/L) | |||||
| Baseline 1.35 ± 0.4 | Baseline 1.83 ± 0.82 | 0.11 | ||||
| End 1.23 ± 0.57 | End 1.97 ± 0.80 | 0.003 | ||||
| NA | NA | |||||
| LDL-C (g/L) | LDL-C (g/L) | |||||
| Baseline 1.52 ± 0.33 | Baseline 1.53 ± 0.36 | 0.88 | ||||
| End 1.49 ± 0.33 | End 1.43 ± 0.38 | 0.22 | ||||
| Koite et al., 2022 [90] | Spirulysat® group; | Arthrospira Liquid Extract |
12 weeks | NA | NA | |
| Placebo group | (Spirulysat®) | HDL-C (g/L) | HDL-C (g/L) | |||
| Baseline 0.54 ± 0.09 | Baseline 0.47 ± 0.13 | 0.004 | ||||
| End 0.55 ± 0.14 | End 0.48 ± 0.18 | 0.031 | ||||
| NA | NA | |||||
| TC (g/L) | TC (g/L) | |||||
| Baseline 2.33 ± 0.36 | Baseline 2.36 ± 0.46 | 0.96 | ||||
| End 2.30 ± 0.34 | End 2.31 ± 0.43 | 0.57 | ||||
| NA | NA | |||||
| TG (mmol/L) | TG (mmol/L) | |||||
| Baseline NA | Baseline NA | NA | ||||
| End 1.09 ± 0.63 | End 1.06 ± 0.61 | 0.684 | ||||
| NA | NA | |||||
| LDL-C (mmol/L) | LDL-C (mmol/L) | |||||
| Baseline NA | Baseline NA | NA | ||||
| End 2.75 ± 0.97 | End 2.77 ± 1.07 | 0.677 | ||||
| van den Driessche et al., 2020 [43] | Spirulina group; | 4.5 g/day | 17 days | NA | NA | |
| Placebo group | HDL-C (mmol/L) | HDL-C (mmol/L) | ||||
| Baseline NA | Baseline NA | NA | ||||
| End 1.52 ± 0.43 | End 1.56 ± 0.49 | 0.273 | ||||
| NA | NA | |||||
| TC (mmol/L) | TC (mmol/L) | |||||
| Baseline NA | Baseline NA | NA | ||||
| End 4.75 ± 1.00 | End 4.81 ± 1.09 | 0.443 | ||||
| NA | NA |
Abbreviations: TG, triglyceride; LDL, low-density lipoprotein; HDL, high-density lipoprotein; TC, total cholesterol; HIIT, high-intensity interval training; Sp, Spirulina; NA, not available.