Effects of long-term plant sterol or stanol ester consumption on lipid and lipoprotein metabolism in subjects on statin treatment

• Published in: British journal of nutrition Vol. 100; no. 5; pp. 937 - 941
• Main Authors: Jong, Ariënne de, Plat, Jogchum, Lütjohann, Dieter, Mensink, Ronald P.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.11.2008
• Subjects: adults; Alcohol use; Analysis of Variance; Anticholesteremic Agents - administration & dosage; antilipemic agents; apolipoproteins; Bile acid synthesis; Biological and medical sciences; Biomarkers - blood; blood lipids; Blood pressure; blood sampling; Cholestenones - blood; Cholesterol; Cholesterol - administration & dosage; Cholesterol - analogs & derivatives; Cholesterol, LDL - blood; Diabetes; Diet; Double-Blind Method; Esters; Esters - administration & dosage; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hypercholesterolemia - drug therapy; Hypercholesterolemia - metabolism; Lipid Metabolism; lipoproteins; Lipoproteins - metabolism; long term effects; Low density lipoprotein; Male; Margarine; Metabolism; Middle Aged; nutrient intake; Nutrition; Patients; phytosterols; Phytosterols - administration & dosage; Plant stanols; Plant sterols; randomized clinical trials; Sitosterols - administration & dosage; stanol esters; Statins; Stigmasterol - administration & dosage; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Bile acid synthesis; Plant stanols; Plant sterols; Statins; Human; Lipids; Biosynthesis; Lipoprotein; Metabolism; Long term; Ester; Vertebrata; Plant; Plant sterols: Plant stanols: Bile acid synthesis: Statins; Mammalia; Treatment; Food intake; Bile acid; Sterol
• ISSN: 0007-1145; 1475-2662; 1475-2662
• DOI: 10.1017/S0007114508966113

Consumption of plant sterol- or stanol-enriched margarines by statin users results in an additional LDL-cholesterol reduction of approximately 10 %, which may be larger than the average decrease of 3–7 % achieved by doubling the statin dose. However, whether this effect persists in the long term is not known. Therefore, we examined in patients already on stable statin treatment the effects of 85 weeks of plant sterol and stanol ester consumption on the serum lipoprotein profile, cholesterol metabolism, and bile acid synthesis. For this, a double-blind randomised trial was designed in which fifty-four patients consumed a control margarine with no added plant sterols or stanols for 5 weeks (run-in period). For the next 85 weeks, seventeen subjects continued with the control margarine and the other two groups with either a plant sterol (n 18) or plant stanol (n 19) (2·5 g/d each) ester-enriched margarine. Blood was sampled at the end of the run-in period and every 20 weeks during the intervention period. Compared with the control group, plant sterol and stanol ester consumption reduced LDL-cholesterol by 0·28 mmol/l (or 8·7 %; P = 0·08) and 0·42 mmol/l (13·1 %; P = 0·006) respectively after 85 weeks. No effects were found on plasma concentrations of oxysterols or 7α-hydroxy-4-cholesten-3-one, a bile acid synthesis marker. We conclude that long-term consumption of both plant sterol and stanol esters effectively lowered LDL-cholesterol concentrations in statin users.