Fuentes F, López-Miranda J, García A, Pérez-Martínez P, Moreno J, Cofan M, Caballero J, Paniagua J A, Ros E, Pérez-Jiménez F
Lipids and Atherosclerosis Unit, Hospital Universitario Reina Sofía, Ciber Fisiopatología Obesidad y Nutrición Instituto de Salud Carlos III, Córdoba, Spain.
Eur J Clin Nutr. 2008 Apr;62(4):495-501. doi: 10.1038/sj.ejcn.1602731. Epub 2007 Apr 18.
Familial hypercholesterolemia (FH) is associated with a high risk of coronary heart disease. Pharmacological treatment and diet are both essential for the management of FH. Foods rich in plant sterols (PS) may play an important role in the treatment of patients with these disorders.
To test the effect of the intake of PS on low-density lipoprotein (LDL) concentration, endothelial function (EF) and LDL particle size in 30 patients with FH.
Randomized and crossover dietary intervention study.
Tertiary outpatient care.
Thirty-eight were recruited, but only 30 were subjected to four low-fat dietary intervention periods, each of 4 weeks.
Each intervention had a different content of cholesterol (<150 or 300 mg/day) and sitosterol (<1 or 2 g/day). Lipid response, EF and LDL particle size were analysed after the intervention.
Plasma sitosterol/cholesterol ratio was higher during both plant sterol-rich periods than during the low plant sterols periods. Basal sitosterol concentrations predicted the LDL-cholesterol response during the intake of plant sterol-enriched diets. The change in LDL-cholesterol was significantly greater in subjects in the upper and intermediate tertiles of basal plasma sitosterol concentrations (-21+/-8 mg/dl, P=0.03; -19+/-7 mg/dl, P=0.04, respectively) than in subjects in the lower tertile (8+/-5 mg/dl) when they changed from a low cholesterol diet to a low cholesterol plus plant sterol diet.
Our study demonstrates that basal sitosterol values can predict hypolipidemic response in patients with FH.
家族性高胆固醇血症（FH）与冠心病的高风险相关。药物治疗和饮食对于FH的管理都至关重要。富含植物甾醇（PS）的食物可能在这些疾病患者的治疗中发挥重要作用。
测试30例FH患者摄入PS对低密度脂蛋白（LDL）浓度、内皮功能（EF）和LDL颗粒大小的影响。
随机交叉饮食干预研究。
三级门诊护理。
招募了38例，但只有30例接受了4个为期4周的低脂饮食干预阶段。
每次干预的胆固醇含量（<150或300mg/天）和谷甾醇含量（<1或2g/天）不同。干预后分析血脂反应、EF和LDL颗粒大小。
在两个富含植物甾醇的阶段，血浆谷甾醇/胆固醇比值均高于低植物甾醇阶段。基础谷甾醇浓度可预测富含植物甾醇饮食摄入期间的LDL胆固醇反应。当从低胆固醇饮食改为低胆固醇加植物甾醇饮食时，基础血浆谷甾醇浓度处于上三分位数和中三分位数的受试者的LDL胆固醇变化（分别为-21±8mg/dl，P=0.03；-19±7mg/dl，P=0.04）显著大于下三分位数的受试者（8±5mg/dl）。
我们的研究表明，基础谷甾醇值可预测FH患者的降血脂反应。
