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Additive effects of plant sterols supplementation in addition to different lipid-lowering regimens.
J Clin Lipidol. 2015 Jul-Aug; 9(4):542-52.JC

Abstract

OBJECTIVE

Plant sterol (PS) supplementation has been widely used alone or combined with lipid-lowering therapies (LLTs) to reduce low-density lipoprotein (LDL) cholesterol. The effects of PS added to high-intensity LLT are less reported, especially regarding the effects on cholesterol synthesis and absorption.

METHODS

A prospective, randomized, open-label study, with parallel arms and blinded end points was designed to evaluate the effects of addition of PS to LLT on LDL cholesterol, markers of cholesterol synthesis, and absorption. Eighty-six patients of both genders were submitted to a 4-wk run-in period with atorvastatin 10 mg (baseline). Following, subjects received atorvastatin 40 mg, ezetimibe 10 mg, or combination of both drugs for another 4-wk period (phase I). In phase II, capsules containing 2.0 g of PSs were added to previous assigned treatments for 4 wk. Lipids, apolipoproteins, plasma campesterol, β-sitosterol, and desmosterol levels were assayed at all time points. Within and between-group analyses were performed.

RESULTS

Compared with baseline, atorvastatin 40 mg reduced total and LDL cholesterol (3% and 22%, respectively, P < .05), increased β-sitosterol, campesterol/cholesterol, and β-sitosterol/cholesterol ratios (39%, 47%, and 32%, respectively, P < .05); ezetimibe 10 mg reduced campesterol and campesterol/cholesterol ratio (67% and 70%, respectively, P < .05), and the combined therapy decreased total and LDL cholesterol (22% and 38%, respectively, P < .05), campesterol, β-sitosterol, and campesterol/cholesterol ratio (54%, 40%, and 27%, P < .05). Addition of PS further reduced total and LDL cholesterol by ∼ 7.7 and 6.5%, respectively, in the atorvastatin therapy group and 5.0 and 4.0% in the combined therapy group (P < .05, for all), with no further effects in absorption or synthesis markers.

CONCLUSIONS

PS added to LLT can further improve lipid profile, without additional effects on intestinal sterol absorption or synthesis.

Authors+Show Affiliations

Cardiology Division, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil.Cardiology Division, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil.Cardiology Division, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil.Cardiology Division, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil.Cardiology Division, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil.Health Sciences Post-Graduation Division, University of Santo Amaro-UNISA, Sao Paulo, Brazil.Synchrophar, Campinas, Sao Paulo, Brazil.Synchrophar, Campinas, Sao Paulo, Brazil.Cardiology Division, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil. Electronic address: mcoizar@terra.com.br.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

26228672

Citation

Malina, Daniela M T., et al. "Additive Effects of Plant Sterols Supplementation in Addition to Different Lipid-lowering Regimens." Journal of Clinical Lipidology, vol. 9, no. 4, 2015, pp. 542-52.
Malina DM, Fonseca FA, Barbosa SA, et al. Additive effects of plant sterols supplementation in addition to different lipid-lowering regimens. J Clin Lipidol. 2015;9(4):542-52.
Malina, D. M., Fonseca, F. A., Barbosa, S. A., Kasmas, S. H., Machado, V. A., França, C. N., Borges, N. C., Moreno, R. A., & Izar, M. C. (2015). Additive effects of plant sterols supplementation in addition to different lipid-lowering regimens. Journal of Clinical Lipidology, 9(4), 542-52. https://doi.org/10.1016/j.jacl.2015.04.003
Malina DM, et al. Additive Effects of Plant Sterols Supplementation in Addition to Different Lipid-lowering Regimens. J Clin Lipidol. 2015 Jul-Aug;9(4):542-52. PubMed PMID: 26228672.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Additive effects of plant sterols supplementation in addition to different lipid-lowering regimens. AU - Malina,Daniela M T, AU - Fonseca,Francisco A, AU - Barbosa,Sílvio A, AU - Kasmas,Soraia H, AU - Machado,Valéria A, AU - França,Carolina N, AU - Borges,Ney C, AU - Moreno,Ronilson A, AU - Izar,Maria C, Y1 - 2015/04/25/ PY - 2015/03/02/received PY - 2015/04/06/revised PY - 2015/04/21/accepted PY - 2015/8/1/entrez PY - 2015/8/1/pubmed PY - 2016/5/31/medline KW - Atorvastatin KW - Cholesterol absorption KW - Cholesterol synthesis KW - Ezetimibe KW - Phytosterols SP - 542 EP - 52 JF - Journal of clinical lipidology JO - J Clin Lipidol VL - 9 IS - 4 N2 - OBJECTIVE: Plant sterol (PS) supplementation has been widely used alone or combined with lipid-lowering therapies (LLTs) to reduce low-density lipoprotein (LDL) cholesterol. The effects of PS added to high-intensity LLT are less reported, especially regarding the effects on cholesterol synthesis and absorption. METHODS: A prospective, randomized, open-label study, with parallel arms and blinded end points was designed to evaluate the effects of addition of PS to LLT on LDL cholesterol, markers of cholesterol synthesis, and absorption. Eighty-six patients of both genders were submitted to a 4-wk run-in period with atorvastatin 10 mg (baseline). Following, subjects received atorvastatin 40 mg, ezetimibe 10 mg, or combination of both drugs for another 4-wk period (phase I). In phase II, capsules containing 2.0 g of PSs were added to previous assigned treatments for 4 wk. Lipids, apolipoproteins, plasma campesterol, β-sitosterol, and desmosterol levels were assayed at all time points. Within and between-group analyses were performed. RESULTS: Compared with baseline, atorvastatin 40 mg reduced total and LDL cholesterol (3% and 22%, respectively, P < .05), increased β-sitosterol, campesterol/cholesterol, and β-sitosterol/cholesterol ratios (39%, 47%, and 32%, respectively, P < .05); ezetimibe 10 mg reduced campesterol and campesterol/cholesterol ratio (67% and 70%, respectively, P < .05), and the combined therapy decreased total and LDL cholesterol (22% and 38%, respectively, P < .05), campesterol, β-sitosterol, and campesterol/cholesterol ratio (54%, 40%, and 27%, P < .05). Addition of PS further reduced total and LDL cholesterol by ∼ 7.7 and 6.5%, respectively, in the atorvastatin therapy group and 5.0 and 4.0% in the combined therapy group (P < .05, for all), with no further effects in absorption or synthesis markers. CONCLUSIONS: PS added to LLT can further improve lipid profile, without additional effects on intestinal sterol absorption or synthesis. SN - 1933-2874 UR - https://www.unboundmedicine.com/medline/citation/26228672/Additive_effects_of_plant_sterols_supplementation_in_addition_to_different_lipid_lowering_regimens_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1933-2874(15)00205-6 DB - PRIME DP - Unbound Medicine ER -