Anthocyanin supplementation at different doses improves cholesterol efflux capacity in subjects with dyslipidemia—a randomized controlled trial

Background/objectives Numerous clinical trials have confirmed that supplementation with purified anthocyanins has favorable effects on metabolic diseases, but the dose–response of dyslipidemia to anthocyanin supplementation remains unclear. This study aimed to investigate the effect of anthocyanin supplementation in different doses on lipid profile. Subjects/methods We randomly assigned 176 dyslipidemic subjects aged 35–70 to three purified anthocyanin groups (40 mg/day, n = 45; 80 mg/day, n = 42; 320 mg/day, n = 43) and a placebo group ( n = 46). Anthropometric parameters, serum lipid profiles, and cholesterol efflux capacity (CEC) were measured at baseline, and at the end of 6 and 12 weeks. Results After 12 weeks of supplementation, significant differences in CEC ( P = 0.033), high-density lipoprotein cholesterol (HDL-C) ( P = 0.043), and apolipoprotein A-I (ApoA-I) ( P = 0.022) were observed between four groups. Compared with placebo, 320 mg/day anthocyanin significantly increased CEC (35.8%, 95% CI: 11.5–60.2%; P = 0.004), HDL-C (0.07 mmol/L, 95% CI: 0.01–0.14; P = 0.003), and ApoA-I (0.07 g/L, 95% CI: 0.01–0.12; P = 0.008). Linear trend analysis showed that anthocyanin supplementation has a strong dose–response relationship with CEC ( P = 0.002), HDL-C ( P = 0.038), and ApoA-I ( P = 0.023). Moreover, the enhancement of CEC showed positive correlations with the increase in HDL-C ( r = 0.215, P < 0.01) and APOA-I ( r = 0.327, P < 0.01). Conclusions Anthocyanin supplementation at 0–320 mg/day for 12 weeks enhances CEC in a dose–response manner in dyslipidemic subjects. Anthocyanin supplementation doses of 80–320 mg/day can improve serum HDL-C levels and HDL-induced CEC.