Atherosclerosis and Metabolic Syndrome Units, 2nd Propedeutic Department of Internal Medicine, Aristotelian University, Hippocration Hospital, 49 Konstantinoupoleos St, Thessaloniki 546 42, Greece.
Nutr Metab Cardiovasc Dis. 2011 Mar;21(3):213-21. doi: 10.1016/j.numecd.2009.08.014. Epub 2009 Nov 25.
Mediterranean diet is associated with a reduced risk for cardiovascular disease (CVD). Use of plant stanols decreases low density lipoprotein cholesterol (LDL-C) concentrations. We compared the effects of the Mediterranean diet and plant stanol esters on vascular risk factors and estimated CVD (eCVD) risk.
In this prospective, randomized, placebo-controlled study, 150 mildly hypercholesterolaemic subjects were randomized to Mediterranean diet, a spread containing plant stanol esters (2 g/day) or a placebo spread. Vascular risk factors were assessed every month for 4 months and the eCVD risk was calculated using the PROspective- Cardiovascular-Munster (PROCAM), Framingham, and Reynolds risk engines. Placebo had no significant effect on risk factors or eCVD risk. Mediterranean diet gradually induced a significant reduction in total cholesterol (TC), LDL-C, triglycerides, high sensitivity C-reactive protein (hsCRP), blood pressure and eCVD risk (24-32%). The plant stanol ester spread reduced (by 1 month) TC (-14%), LDL-C (-16%), hsCRP (-17%), and estimated CVD risk (26-30%). eCVD risk reduction was sustained at 4th months when the gradual Mediterranean diet eCVD risk reduction became comparable to that of the stanol group.
Plant stanol esters yielded an early, by 1st treatment month, reduction of eCVD risk that resulted from a TC, LDL-C, and hsCRP decrease. eCVD risk reduction on the Mediterranean diet resulted from a change in several CVD risk factors and equaled that of plant stanol at 4 months. The consumption of plant stanol esters by moderately hypercholesterolaemic patients may be a useful option to reduce CVD risk in those who do not adopt a Mediterranean diet.
地中海饮食与降低心血管疾病（CVD）风险相关。植物固醇的使用可降低低密度脂蛋白胆固醇（LDL-C）浓度。我们比较了地中海饮食和植物固醇酯对血管危险因素和估计的 CVD（eCVD）风险的影响。
在这项前瞻性、随机、安慰剂对照研究中，150 名轻度高胆固醇血症患者被随机分为地中海饮食组、含有植物固醇酯（2 g/天）的涂抹酱组或安慰剂涂抹酱组。在 4 个月内，每月评估血管危险因素，并使用 PROspective-Cardiovascular-Munster（PROCAM）、Framingham 和 Reynolds 风险引擎计算 eCVD 风险。安慰剂对危险因素或 eCVD 风险没有显著影响。地中海饮食逐渐导致总胆固醇（TC）、LDL-C、甘油三酯、高敏 C 反应蛋白（hsCRP）、血压和 eCVD 风险（24-32%）显著降低。植物固醇酯涂抹酱在 1 个月时降低了 TC（-14%）、LDL-C（-16%）、hsCRP（-17%）和估计的 CVD 风险（26-30%）。当地中海饮食的 eCVD 风险逐渐降低与 stanol 组相当时，在第 4 个月时，eCVD 风险的降低得以维持。
植物固醇酯通过在第 1 个治疗月降低 TC、LDL-C 和 hsCRP 导致 eCVD 风险的早期降低。地中海饮食的 eCVD 风险降低来自于几种 CVD 危险因素的改变，在 4 个月时与植物固醇酯相当。对于中度高胆固醇血症患者，食用植物固醇酯可能是一种有用的选择，可以降低那些不采用地中海饮食的人的 CVD 风险。
