Gylling Helena, Hallikainen Maarit, Rajaratnam Radhakrishnan A, Simonen Piia, Pihlajamäki Jussi, Laakso Markku, Miettinen Tatu A
Department of Clinical Nutrition, University of Kuopio, FIN-70211 Kuopio, Finland.
Metabolism. 2009 Mar;58(3):401-7. doi: 10.1016/j.metabol.2008.10.015.
In postmenopausal coronary artery disease (CAD) women, serum plant sterols are elevated. Thus, we investigated further whether serum plant sterols reflect absolute cholesterol metabolism in CAD as in other populations and whether the ABCG5 and ABCG8 genes, associated with plant sterol metabolism, were related to the risk of CAD. In free-living postmenopausal women with (n = 47) and without (n = 62) CAD, serum noncholesterol sterols including plant sterols were analyzed with gas-liquid chromatography, cholesterol absorption with peroral isotopes, absolute cholesterol synthesis with sterol balance technique, and bile acid synthesis with quantitating fecal bile acids. In CAD women, serum plant sterol ratios to cholesterol were 21% to 26% (P < .05) higher than in controls despite similar cholesterol absorption efficiency. Absolute cholesterol and bile acid synthesis were reduced. Only in controls were serum plant sterols related to cholesterol absorption (eg, sitosterol; in controls: r = 0.533, P < .001; in CAD: r = 0.296, P = not significant). However, even in CAD women, serum lathosterol (relative synthesis marker) and lathosterol-cholestanol (relative synthesis-absorption marker) were related to absolute synthesis and absorption percentage (P range from .05 to <.001) similarly to controls. Frequencies of the common polymorphisms of ABCG5 and ABCG8 genes did not differ between coronary and control women. In conclusion, plant sterol metabolism is disturbed in CAD women; so serum plant sterols only tended to reflect absolute cholesterol absorption. Other relative markers of cholesterol metabolism were related to the absolute ones in both groups. ABCG5 and ABCG8 genes were not associated with the risk of CAD.
在绝经后冠心病（CAD）女性中，血清植物甾醇水平升高。因此，我们进一步研究血清植物甾醇是否像在其他人群中那样反映CAD中的绝对胆固醇代谢，以及与植物甾醇代谢相关的ABCG5和ABCG8基因是否与CAD风险相关。在有（n = 47）和无（n = 62）CAD的自由生活绝经后女性中，采用气液色谱法分析包括植物甾醇在内的血清非胆固醇甾醇，采用口服同位素法测定胆固醇吸收，采用甾醇平衡技术测定绝对胆固醇合成，采用定量粪便胆汁酸法测定胆汁酸合成。在CAD女性中，尽管胆固醇吸收效率相似，但血清植物甾醇与胆固醇的比值比对照组高21%至26%（P <.05）。绝对胆固醇和胆汁酸合成减少。仅在对照组中，血清植物甾醇与胆固醇吸收相关（例如，谷甾醇；在对照组中：r = 0.533，P <.001；在CAD组中：r = 0.296，P无统计学意义）。然而，即使在CAD女性中，血清羊毛甾醇（相对合成标志物）和羊毛甾醇 - 胆甾烷醇（相对合成 - 吸收标志物）与绝对合成和吸收百分比的相关性（P范围为.05至<.001）与对照组相似。ABCG5和ABCG8基因常见多态性的频率在冠心病女性和对照女性之间没有差异。总之，CAD女性的植物甾醇代谢受到干扰；因此血清植物甾醇仅倾向于反映绝对胆固醇吸收。两组中胆固醇代谢的其他相对标志物与绝对标志物相关。ABCG5和ABCG8基因与CAD风险无关。
