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Accepted manuscript

The Effect of Ginseng Supplementation on Cardiovascular Disease Risk Factors: A Comprehensive Systematic Review and Dose-Response Meta-Analysis

Published online by Cambridge University Press:  09 September 2025

Ali Jafari ,
Helia Mardani ,
Maryam Abbastabar ,
Fatemeh Mehdipoor ,
Bahare Parsi Nezhad ,
Kosar Kordkatuli ,
Pardis Bakhtiari Jami ,
Amir Hossein Faghfouri ,
Vali Musazadeh Open the ORCID record for Vali Musazadeh [Opens in a new window]  and
Alireza Alaghi
Ali Jafari
Affiliation:
Student Research Committee, Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
Helia Mardani
Affiliation:
Student Research Committee, Department of Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
Maryam Abbastabar
Affiliation:
Department of Clinical Biochemistry, School of Medicine, Babol University of Medical Sciences, Babol, Iran.
Fatemeh Mehdipoor
Affiliation:
Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
Bahare Parsi Nezhad
Affiliation:
Student Research Committee, Department of Nutrition, School of Health, Golestan University of Medical Sciences, Gorgan, Iran
Kosar Kordkatuli
Affiliation:
Student Research Committee, Department of Surgical Technology, School of Paramedical Sciences, Golestan University of Medical Sciences, Gorgan, Iran
Pardis Bakhtiari Jami
Affiliation:
Student Research Committee, Department of Nutrition, School of Health, Golestan University of Medical Sciences, Gorgan, Iran
Amir Hossein Faghfouri
Affiliation:
Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran.
Vali Musazadeh*
Affiliation:
Student Research Committee, School of Public Health, Iran University of Medical Sciences, Tehran, Iran Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
Alireza Alaghi*
Affiliation:
Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
*
*Corresponding authors: Vali Musazadeh: Iran University of Medical Sciences, Tehran, Iran. Email: Mosazadeh.vali05@gmail.com; Alireza Alaghi: Golestan Research Center of Gastroenterology and Hepatology, 3rd floor, Heart Complex, Sayyad-e-Shirazi Hospital, Sayyad-e-Shirazi Boulevard, Gorgan city, Golestan province, Iran, Telefax: +981732251910, Email: alirezaalaghi@gmail.com.
*Corresponding authors: Vali Musazadeh: Iran University of Medical Sciences, Tehran, Iran. Email: Mosazadeh.vali05@gmail.com; Alireza Alaghi: Golestan Research Center of Gastroenterology and Hepatology, 3rd floor, Heart Complex, Sayyad-e-Shirazi Hospital, Sayyad-e-Shirazi Boulevard, Gorgan city, Golestan province, Iran, Telefax: +981732251910, Email: alirezaalaghi@gmail.com.
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Abstract

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Although numerous clinical studies suggest that ginseng supplementation may benefit cardiovascular disease (CVD) risk factors, results remain inconclusive. This systematic review and meta-analysis evaluated the effects of ginseng supplementation on CVD-related risk factors. Relevant studies were identified through electronic searches in Embase, Web of Science, Scopus, PubMed, and CENTRAL up to August 2024. Statistical analyses, including a random-effects model, meta-regression, and non-linear modeling, were used to assess heterogeneity, dose-response relationships, and the overall effects of ginseng supplementation. A total of 70 studies, published between 1998 and 2024 and involving 4,506 participants, were included. Ginseng supplementation significantly affected several biochemical markers, including high-sensitivity C-reactive protein (hs-CRP) (SMD: -0.23; 95% CI: -0.38, -0.08; P = 0.002), gamma-glutamyl transferase (GGT) (SMD: -0.20; 95% CI: -0.36, -0.04; P = 0.015), glutathione reductase (GSH-Rd) (SMD: 0.90; 95% CI: 0.38, 1.42; P = 0.001), reactive oxygen species (ROS) (SMD: -0.94; 95% CI: -1.27, -0.60; P < 0.001), and superoxide dismutase (SOD) (SMD: 0.48; 95% CI: 0.10, 0.87; P = 0.014). Meta-regression analysis showed significant linear associations between ginseng dosage and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (P = 0.044), and between supplementation duration and malondialdehyde (MDA) (P = 0.007). Dose-response analysis revealed significant associations between ginseng dose and fasting blood glucose (FBG) (P < 0.001), hs-CRP (P = 0.043), Interleukin-6 (IL-6) (P = 0.041), diastolic blood pressure (DBP) (P = 0.022), Interleukin-10 (IL-10) (P = 0.048), fasting insulin (P = 0.012), and total protein (P = 0.010). Supplementation duration was positively associated with MDA levels (P = 0.008). Ginseng supplementation was associated with improvements in inflammatory markers, liver function, and oxidative stress parameters. No significant effects were observed on anthropometric indices, blood pressure, glycemic profile, lipid profile, adipokines, or heart rate.

Keywords

Ginsenginflammatory markersoxidative stressliver functionmeta-analysis

Information

Type
Systematic Review and Meta-Analysis
Information
British Journal of Nutrition , Accepted manuscript , pp. 1 - 107
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Nutrition Society