**1. Introduction**

The *Monascus*-fermented rice is the fermentation product of non-glutinous white rice with the fungus *Monascus*. It has been used for more than a thousand years in East Asian countries for producing rice wine, for flavoring, coloring and preservation of foods as well as a folk medicine for improving food digestion and blood circulation. Several species other than that isolated in 1895 and named *Monascus purpureus* in recognition of its purple colour, have also been widely used in making red wine and red-coloured foods [1]. These *Monascus* fermentation products are called Red Yeast Rice (RYR) in Western countries although the designation "yeast" is incorrect as *Monascus* is a filamentous fungus and not a yeast [2]. Other more accurate denominations like red fermented rice or red mold rice are also used but much more rarely. Today, the usage of *Monascus* rice products as colorant or flavour in foods, and for brewing red rice wine is permitted in many Asian countries but not in Europe. However, RYR extracts are largely sold in Western countries for their cholesterol-lowering effects.

A multitude of fungal secondary metabolites, phytosterols, isoflavonoids, fatty acids, pigments, monacolins and others, are produced during the fermentation process. Monacolins, in particular

monacolin K (MK), which is, in fact, lovastatin, the first marketed statin drug, inhibit the activity of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase. As a result, the endogenous synthesis of cholesterol is reduced and hence the elevated cholesterol level decreases. Many clinical studies demonstrated the efficacy of RYR in the treatment of hypercholesterolemia and its relative safety [3,4]. For similar cholesterol level reduction, the MK amount in clinically tested RYR is markedly lower than that used with prescription statin drugs [4]. This RYR potency is likely explained by the presence of monacolins other than MK and also by the improved dissolution rate and bioavailability of lovastatin when given as RYR [4,5]. However, adverse effects following RYR consumption have been reported; the nature of the symptoms and the targeted organs and systems are similar to those reported for statin drugs [6–9]. Considering the case reports gathered in the WHO Vigibase (82) [8] and those collected by four national health institutions (FDA (164) [8], French Nutrivigilance system (30) [6], Italian Surveillance system (52) [7] and Netherlands Pharmacovigilance Centre Lareb (74) [9]), the more frequent adverse effects are: (i) myalgias and related neuroskeletal complaints from 30% of FDA cases to 43% of Lareb cases, including cases of rhabdomyolysis in the five registries, (ii) gastrointestinal disorders which concern up to 23% of Italian cases, (iii) hepatobiliary disorders that affect from 9% of the WHO cases to 32% of the French cases, including severe adverse reactions as pancreatitis and acute hepatic failure, and (iv) skin and subcutaneous disorders which concern from 8% of French cases to 17% of Italian cases.

Nowadays, RYR is widely used as a cholesterol-lowering agent by patients with a proven or perceived intolerance to statins or by consumers, even without dyslipidemia or increased cardiovascular risk, interested in complementary and alternative medications to influence their lipid levels, as it is a common belief that "natural" products do not have side effects [4]. The RYR products are registered as dietary supplements (DS) and, despite their ever growing popularity, there is no uniform regulation regarding their content in monacolins, especially in MK, nor strict quality control. So, their efficacy and safety are unpredictable. Therefore, the development of analytical methods for the simultaneous determination of MK and other monacolins in RYR products is of great importance.

High performance or Ultra-high performance liquid chromatography (HPLC or UHPLC) with diode array detection (DAD) and/or mass spectrometry (MS) detection are regarded as the gold standard methods for the accurate identification and quantification of a wide range of components in RYR products, including monacolins and pigments [10–14]. Although sensitive and selective, they are usually time-consuming, require standard reference materials for quantitative analysis and may suffer from the occurrence of co-eluting interferences (matrix effects) which is a major drawback for MS quantification [15]. Proton Nuclear Magnetic Resonance (1H-NMR) is recognized as a method of choice for the analysis of complex mixtures (pharmaceuticals, biological media for instance) [16,17]. Indeed, it is highly reproducible, robust, and nonselective, thus allowing an unbiased overview of the sample composition as all the low molecular weight compounds in the solution (provided they bear 1H nuclei and are present at sufficient concentration) are detected simultaneously in a single run. It is also inherently quantitative because the area of each NMR resonance is directly proportional to the number of corresponding nuclei if spectra are recorded in fully relaxed conditions. Thus, at variance with other techniques, the response factor is not dependent on the molecular structure and there is no need for identical reference materials. Moreover, the sample preparation for NMR analysis is very simple as it requires dissolution (for solid products) or dilution (for liquid products) in an adequate deuterated solvent [16]. Lachenmeyer et al. [18] have already used 1H-NMR for the assay of the total quantity of monacolins in five RYR commercial products. They showed that the inhibitory effect of RYR on HMG-CoA reductase was all the more important as their monacolin content was high, but the monacolin contents they determined were not compared to those measured by an orthogonal analytical method.

The purpose of this study was to validate (or not) the 1H-NMR method for an accurate determination of the monacolin content in RYR DS by comparison with the well-established HPLC method and thus to control their quality. Therefore, 31 RYR DS were analyzed using 1H-NMR to establish their spectral signatures and to determine their monacolin contents based on the quantification of selected protons characteristic of the different monacolin chemical structures usually present. An UHPLC analysis with UV-Visible (UV-Vis) and MS detection was performed in parallel on the same 31 RYR DS in order to determine their chemical profiles and to quantify all the monacolins identified.

#### **2. Results and Discussion**
