Lipid Clinic, Endocrinology and Nutrition Service, Biomedical Research Institute August Pi i Sunyer, Hospital Clínic, Barcelona, Spain.
Nutr Metab Cardiovasc Dis. 2011 Sep;21(9):651-7. doi: 10.1016/j.numecd.2010.01.005. Epub 2010 May 31.
Increased plasma phytosterols, which reflect enhanced cholesterol absorption, have been related to an increased risk of cardiovascular disease (CVD). However, high CVD risk conditions, such as obesity, diabetes and the metabolic syndrome (MetS) have been associated with reduced cholesterol absorption. We investigated associations between plasma noncholesterol sterols and MetS components.
With a cross-sectional design, we related MetS components to plasma noncholesterol sterol-to-cholesterol ratios measured by gas chromatography in 674 dyslipidemic patients and 361 healthy subjects participating in a prospective cohort study. Plasma phytosterol-to-cholesterol ratios were inversely associated with all components of the MetS. In the dyslipidemic group, multivariable analyses showed that a 1-SD increase in sitosterol-to-cholesterol ratio was associated with a reduced risk for any MetS feature, ranging from 0.57 (95% CI, 0.45 to 0.71) for visceral adiposity to 0.82 (95% CI, 0.69 to 0.98) for high blood pressure. The risk of having MetS was nearly halved, with ORs of 0.49 (95% CI, 0.38 to 0.64) or 0.56 (95% CI, 0.44-0.70), depending on the definition. Results were opposed for plasma lathosterol, a marker of cholesterol synthesis. Most findings were reproduced in the healthy cohort. ApoE genotype was unrelated to plasma noncholesterol sterols.
In both dyslipidemic and healthy populations, MetS is associated with increased plasma lathosterol, a cholesterol synthesis marker, and decreased plasma sitosterol, a marker of cholesterol absorption. Elevated plasma phytosterols related to a lower frequency of cardiometabolic risk factors, suggesting that they are associated with a reduced CVD risk.
血浆植物甾醇增加反映胆固醇吸收增强，与心血管疾病（CVD）风险增加有关。然而，肥胖、糖尿病和代谢综合征（MetS）等高 CVD 风险情况与胆固醇吸收减少有关。我们研究了血浆非胆固醇甾醇与 MetS 成分之间的关系。
采用横断面设计，我们将 MetS 成分与 674 名血脂异常患者和 361 名健康受试者的血浆非胆固醇甾醇-胆固醇比值进行气相色谱分析，这些患者和受试者参加了一项前瞻性队列研究。血浆植物甾醇-胆固醇比值与 MetS 的所有成分呈负相关。在血脂异常组中，多变量分析显示，甾醇-胆固醇比值增加 1 个标准差与任何 MetS 特征的风险降低相关，范围从内脏肥胖的 0.57（95%CI，0.45 至 0.71）到高血压的 0.82（95%CI，0.69 至 0.98）。MetS 的风险几乎减半，OR 值分别为 0.49（95%CI，0.38 至 0.64）或 0.56（95%CI，0.44 至 0.70），具体取决于定义。这些结果与胆固醇合成标志物血浆羊毛固醇相反。在健康队列中，大多数发现都得到了重现。载脂蛋白 E 基因型与血浆非胆固醇甾醇无关。
在血脂异常和健康人群中，MetS 与增加的血浆羊毛固醇（胆固醇合成标志物）和减少的血浆谷固醇（胆固醇吸收标志物）相关。升高的血浆植物甾醇与较低的心血管代谢危险因素频率相关，表明它们与降低的 CVD 风险相关。
