Serum cholesterol and cholesterol and lipoprotein metabolism in hypercholesterolaemic NIDDM patients before and during sitostanol ester-margarine treatment

Abstract

Summary Cholesterol absorption and metabolism and LDL and HDL kinetics were investigated in 11 hypercholesterolaemic non-insulin-dependent diabetic men off and on a hypolipidaemic treatment with sitostanol ester, (3 g sitostanol daily) dissolved in rapeseed oil margarine, by a double-blind crossover study design. Serum total, VLDL and LDL cholesterol and apoprotein B fell significantly by 6 + 2,12 + 6, 9 + 3 and 6 + 2 %, mean + SEM, and HDL cholesterol was increased by 11 + 4 % (p < 0.05) by sitostanol ester. LDL cholesterol and apoprotein B were significantly decreased in the dense (1.037-1.055 g/ml), but not light, LDL subfraction due to a significantly diminished transport rate for LDL apoprotein B, while the fractional catabolic rate was unchanged. HDL kinetics, measured with autologous apoprotein A I, was unaffected by sitostanol ester. Cholesterol absorption efficiency was markedly reduced from 25 + 2 to 9 + 2 % (p < 0.001) during sitostanol ester followed by proportionately decreased serum plant sterol proportions. Cholesterol precursor sterol proportions in serum, fecal neutral sterol excretion, and cholesterol synthesis, cholesterol transport, and biliary secretion were all significantly increased by sitostanol ester. We conclude that the sitostanol ester-induced decrease in cholesterol absorption compensatorily stimulated cholesterol synthesis, had no effect on fractional catabolic rate, but decreased transport rate for LDL apoprotein B so that serum total, VLDL and LDL cholesterol levels were decreased. Dietary rapeseed oil margarine rich in sitostanol ester was well tolerated, appears to be safe from the nutritional point of view and effective for lowering VLDL and LDL cholesterol and increasing HDL cholesterol in hypercholesterolaemic non-insulin-dependent diabetic subjects. [Diabetologia (1994) 37: 773-780]

Comparative health effects of margarines fortified with plant sterols and stanols on a rat model for hemorrhagic stroke

“…Although structurally similar to plant sterols, several studies (1,24,25) have shown that plant stanols are negligibly absorbed by normal humans and animals. Because of this lack of absorption, we expected that plant stanols would be much safer than plant sterols for SHRSP rats.…”

“…The clinical studies that have examined the cholesterollowering efficacy of plant sterols and stanols so far have reported no adverse side effects with high consumption of these materials (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). This is most likely due to the lack of intestinal absorption of plant sterols and stanols by normal, healthy subjects (14).…”

“…sponding fully saturated derivatives, stanols (campestanol and sitostanol), are being promoted for the treatment of hypercholesterolemia, since they have potent cholesterol-lowering effects by reducing the intestinal absorption of both dietary and biliary cholesterol (1)(2)(3)(4)(5)(6)(7)(8). Typical Western diets provide 160-360 mg plant sterols and 20-50 mg plant stanols per day, and at these levels of consumption, they have very little effect on cholesterol absorption (9).…”

Phytosterols, Cholesterol Absorption and Healthy Diets

“…Reduced delivery of absorbed cholesterol to the liver resulted in increased tissue LDL receptor expression as measured in Taken from [2] peripheral blood mononuclear cells [27]. In some subjects the production rate of LDL was decreased [28]. Further evidence of relative cholesterol deficiency after phytosterol treatment is the measured increase in whole body cholesterol biosynthesis of 38-53% [29].…”

Serum and lipoprotein sitostanol and non-cholesterol sterols after an acute dose of plant stanol ester on its long-term consumption

“…Keywords Plant stanol ester Á Postprandium Á Sitostanol Á Sitosterol Á Cholesterol synthesis Á Cholesterol absorption Background Long-term consumption of food enriched with plant stanols decreases cholesterol absorption and serum plant sterols and increases cholesterol synthesis and serum cholesterol precursor sterols as compared with controls [1][2][3][4][5][6]. However, less is known about the effect of phytosterol consumption on postprandial lipoproteins, markers of atherosclerotic burden, and on non-cholesterol sterols, markers of cholesterol metabolism.…”