Decreasing the Cholesterol Burden in Heterozygous Familial Hypercholesterolemia Children by Dietary Plant Stanol Esters

Vuorio, Alpo; Kovanen, Petri T.

doi:10.3390/nu10121842

Cited by 9 publications

(8 citation statements)

References 57 publications

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“…Considering the linear association between LDL-C and CVD risk reduction noticed in that analysis, the addition of plant sterols or stanols lowering LDL-C by~0.50 mmol/L in the FH patients would reduce their CVD risk by~12.5% according to our results [47]. In addition, it has been proposed that phytosterols are cost-effective in reducing lifetime LDL-C burden in FH children [48]. Therefore, despite their small cholesterol-lowering effect, phytosterols could attenuate the efficacy of lipid-lowering drugs on CVD prevention in such individuals.…”

Section: Discussionsupporting

confidence: 60%

Diet and Cardiovascular Disease Risk Among Individuals with Familial Hypercholesterolemia: Systematic Review and Meta-Analysis

et al. 2020

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Background: Although a cholesterol-lowering diet and the addition of plant sterols and stanols are suggested for the lipid management of children and adults with familial hypercholesterolemia, there is limited evidence evaluating such interventions in this population. Objectives: To investigate the impact of cholesterol-lowering diet and other dietary interventions on the incidence or mortality of cardiovascular disease and lipid profile of patients with familial hypercholesterolemia. Search methods: Relevant trials were identified by searching US National Library of Medicine National Institutes of Health Metabolism Trials Register and clinicaltrials.gov.gr using the following terms: diet, dietary, plant sterols, stanols, omega-3 fatty acids, fiber and familial hypercholesterolemia. Selection criteria: Randomized controlled trials evaluating the effect of cholesterol-lowering diet or other dietary interventions in children and adults with familial hypercholesterolemia were included. Data collection and analysis: Two authors independently assessed the eligibility of the included trials and their bias risk and extracted the data which was independently verified by other colleagues. Results: A total of 17 trials were finally included, with a total of 376 participants across 8 comparison groups. The included trials had either a low or unclear bias risk for most of the assessed risk parameters. Cardiovascular incidence or mortality were not evaluated in any of the included trials. Among the planned comparisons regarding patients’ lipidemic profile, a significant difference was noticed for the following comparisons and outcomes: omega-3 fatty acids reduced triglycerides (mean difference (MD): −0.27 mmol/L, 95% confidence interval (CI): −0.47 to −0.07, p < 0.01) when compared with placebo. A non-significant trend towards a reduction in subjects’ total cholesterol (MD: −0.34, 95% CI: −0.68 to 0, mmol/L, p = 0.05) and low-density lipoprotein cholesterol (MD: −0.31, 95% CI: −0.61 to 0, mmol/L, p = 0.05) was noticed. In comparison with cholesterol-lowering diet, the additional consumption of plant stanols decreased total cholesterol (MD: −0.62 mmol/L, 95% CI: −1.13 to −0.11, p = 0.02) and low-density lipoprotein cholesterol (MD: −0.58 mmol/L, 95% CI: −1.08 to −0.09, p = 0.02). The same was by plant sterols (MD: −0.46 mmol/L, 95% CI: −0.76 to −0.17, p < 0.01 for cholesterol and MD: −0.45 mmol/L, 95% CI: −0.74 to −0.16, p < 0.01 for low-density lipoprotein cholesterol). No heterogeneity was noticed among the studies included in these analyses. Conclusions: Available trials confirm that the addition of plant sterols or stanols has a cholesterol-lowering effect on such individuals. On the other hand, supplementation with omega-3 fatty acids effectively reduces triglycerides and might have a role in lowering the cholesterol of patients with familial hypercholesterolemia. Additional studies are needed to investigate the efficacy of cholesterol-lowering diet or the addition of soya protein and dietary fibers to a cholesterol-lowering diet in patients with familial hypercholesterolemia.

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Section: Discussionsupporting

confidence: 60%

Diet and Cardiovascular Disease Risk Among Individuals with Familial Hypercholesterolemia: Systematic Review and Meta-Analysis

et al. 2020

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“…The cumulative exposure of coronary arteries to the lifelong LDL-C elevation can be estimated by calculating the LDL-C burden (LDL-C concentration x age in years), which can also be used to demonstrate the potential usefulness of dietary stanol/sterol treatment. Compared to untreated FH patients, the LDL-C burden from the age of 10 years was reduced by 15% on a statin and by 21% on a statin and dietary plant stanol [33]. Longer-term studies are required to confirm these positive findings.…”

Section: Diet and Life-stylementioning

confidence: 99%

Current management of children and young people with heterozygous familial hypercholesterolaemia - HEART UK statement of care

et al. 2019

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Children with heterozygous familial hypercholesterolaemia (FH) should be managed by paediatric health professionals with expertise in FH.• Statin to be considered by the age of 10 years and use age appropriate target LDL-C level in children with FH.• Dietary and life style advice should begin in early childhood.• From the age of 14 years, consider joint review with adult lipidologist in transition clinic with transfer to adult lipid clinic at 16 to 18 years.

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“…CHD is a common cardiovascular disease in middle-aged and elderly people, which is mainly caused by coronary atherosclerosis which is the most common type of arteriosclerosis. 14 Possibly, CHD occurs because the branches of coronary arteries are multi-directional and close to the ventricle, and bear huge blood flow shear stress and systolic pressure impact. 15 Considerable complex carbohydrates and lipids are deposited in the intima of the involved artery, inducing fibrous tissue hyperplasia and calcium deposition, and even vascular occlusion and wall rupture and bleeding.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Values of Epicardial Adipose Tissue Thickness with Right Common Carotid Artery Elasticity and Intima-Media Thickness for Middle-Aged and Elderly Patients with Coronary Heart Disease

Qian¹,

Sun²,

Jiang³

2021

IJGM

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Background Coronary heart disease (CHD) is the most common cardiovascular disease which greatly threatens the health of middle-aged and elderly people. Objective To explore the correlations of epicardial adipose tissue (EAT) thickness with right common carotid artery elasticity and intima-media thickness (IMT) in middle-aged and elderly patients with CHD by ultrasound. Methods A total of 132 patients diagnosed with CHD by coronary angiography (CAG) from February 2019 to August 2020 were enrolled and divided into single-vessel disease group (n=38), double-vessel disease group (n=52), and three-vessel disease group (n=42), and 52 healthy subjects were selected as control group. Their general data, biochemical indices, EAT thickness, right common carotid artery elasticity indices, and IMT were compared. The correlations of EAT thickness with right common carotid artery elasticity indices and IMT were studied by Pearson’s analysis. The predictive values of EAT thickness and IMT for CHD were analyzed by receiver operating characteristic curves. Results With increasing number of diseased branches, EAT thickness, stiffness parameters β (β), strain elastic modulus (Ep), pulse wave velocity β (PWV-β) and IMT increased, arterial compliance (AC) decreased (P<0.05), but argumentation index (AI) did not change significantly. EAT thickness had significant positive correlations with β, Ep, PWV-β and IMT, negative correlation with AC, and no significant correlation with AI. The areas under the curves of EAT thickness and IMT for predicting CHD were 0.806 and 0.784, respectively. Conclusion EAT thickness is significantly correlated with right common carotid artery elasticity and IMT in middle-aged and elderly patients with CHD, and EAT thickness and IMT have high predictive values. The three indices are crucial for CHD diagnosis.

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Decreasing the Cholesterol Burden in Heterozygous Familial Hypercholesterolemia Children by Dietary Plant Stanol Esters

Cited by 9 publications

References 57 publications

Diet and Cardiovascular Disease Risk Among Individuals with Familial Hypercholesterolemia: Systematic Review and Meta-Analysis

Diet and Cardiovascular Disease Risk Among Individuals with Familial Hypercholesterolemia: Systematic Review and Meta-Analysis

Current management of children and young people with heterozygous familial hypercholesterolaemia - HEART UK statement of care

Diagnostic Values of Epicardial Adipose Tissue Thickness with Right Common Carotid Artery Elasticity and Intima-Media Thickness for Middle-Aged and Elderly Patients with Coronary Heart Disease

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