Clinical Evidence on Nattokinase and Cholesterol1. Ren et al., 2017 (China, Randomized Trial)
* **Population**: 82 patients with hyperlipidemia
* **Intervention**: Nattokinase 2,000 FU/day for 26 weeks
* **Findings**: Significant reductions in **total cholesterol, LDL, and triglycerides**, with modest increases in HDL.
* **Reference**: Ren, S. et al. *Clin Appl Thromb Hemost.* 2017;23(8):958–965.
2. Huang et al., 2009 (China, Open-Label Trial)
* **Population**: 45 subjects with cardiovascular risk factors
* **Intervention**: Nattokinase 6,000 FU/day for 2 months
* **Findings**: Lowered **total cholesterol and LDL**, improved blood pressure and fibrinolytic activity.
* **Reference**: Huang, Y. et al. *Nutr Res.* 2009;29(3):190–196.
3. Zhang et al., 2022 (Systematic Review & Meta-analysis)
* **Population**: 546 participants across 6 randomized controlled trials
* **Findings**: Nattokinase supplementation showed **reductions in blood pressure** and some lipid improvements, though cholesterol effects were **dose-dependent and inconsistent**.
* **Reference**: Li, X. et al. *Rev Cardiovasc Med.* 2023;24(8):234.
4. Wei et al., 2025 (Review, MDPI Nutrients)
* **Summary**: Reviews clinical and mechanistic evidence that nattokinase can **activate lipases, inhibit HMG-CoA reductase, and reduce atherosclerotic plaque area** in human studies.
* **Reference**: Wei, C. et al. *Nutrients.* 2025;17(11):1784.
5. Large Chinese Cohort Trial (2025, >1,000 Participants)
* **Population**: Adults with mild atherosclerosis and hyperlipidemia
* **Intervention**: High-dose nattokinase (10,800 FU/day) for 12 months
* **Findings**: **LDL and triglycerides decreased significantly**, and carotid plaque size reduced by ~36%.
* **Reference**: Reported in *[NAD.com](https://NAD.com)* summary of trial (2025).