Lipid Outpatient Clinic, Second Department of Pediatrics, Athens University, Athens, Greece.
Ital J Pediatr. 2014 May 3;40:42. doi: 10.1186/1824-7288-40-42.
Small dense low density lipoprotein-cholesterol (sdLDL-C) molecules are more atherogenic compared with large buoyant ones. Phytosterols-enriched diets are effective in decreasing total cholesterol (TC) and low density lipoprotein-cholesterol (LDL-C) concentrations in hyperlipidemic children without significant adverse effects. Limited data on the impact of such a diet on sdLDL-C levels is available in adults while there are no reports concerning children. The purpose of this study is to prospectively evaluate the effect of the daily consumption of 2 g of plant sterols on sdLDL-C levels in children with hypercholesterolemia.
Fifty-nine children, 25 with LDL-C ≥ 3.4 mmol/l (130 mg/dl) and 34 with LDL-C < 3.4 mmol/l, aged 4.5-15.9 years, were included in the study. A yogurt-drink enriched with 2 g of plant sterols was added to the daily diet of hypercholesterolemic children and 6-12 months later lipid profiles were reassessed. Direct quantitative methods were used to measure LDL-C and sdLDL-C levels.
The consumption of plant sterols reduced sdLDL-C significantly (p < 0.001), but levels remained higher compared with controls (p < 0.001). TC, LDL-C, non high density lipoprotein-cholesterol (NonHDL-C) and apolipoprotein B (ApoB) levels also decreased significantly (p < 0.05). The median reduction of sdLDL-C and LDL-C was 16.6% and 13%, respectively. These variables decreased >10% in sixteen children (64%), independently from baseline levels, sex, age and body mass index (BMI). High density lipoprotein-cholesterol (HDL-C), lipoprotein a [Lp(a)], and triglycerides (TGs) levels remained unaffected.
Plant sterols decrease sdLDL-C significantly and may be beneficial for children with hypercholesterolemia.
与大而轻的低密度脂蛋白胆固醇（LDL-C）分子相比，小而密的低密度脂蛋白胆固醇（sdLDL-C）分子更具致动脉粥样硬化性。富含植物固醇的饮食可有效降低高脂血症儿童的总胆固醇（TC）和低密度脂蛋白胆固醇（LDL-C）浓度，且无显著不良反应。关于此类饮食对 sdLDL-C 水平的影响，成年人的数据有限，而儿童则没有相关报道。本研究旨在前瞻性评估每天摄入 2 克植物固醇对高胆固醇血症儿童 sdLDL-C 水平的影响。
共纳入 59 名儿童，其中 25 名 LDL-C≥3.4mmol/l（130mg/dl），34 名 LDL-C<3.4mmol/l，年龄 4.5-15.9 岁。在高胆固醇血症儿童的日常饮食中添加富含 2 克植物固醇的酸奶饮料，6-12 个月后重新评估血脂谱。采用直接定量方法测量 LDL-C 和 sdLDL-C 水平。
植物固醇的摄入显著降低了 sdLDL-C（p<0.001），但与对照组相比仍较高（p<0.001）。TC、LDL-C、非高密度脂蛋白胆固醇（NonHDL-C）和载脂蛋白 B（ApoB）水平也显著降低（p<0.05）。sdLDL-C 和 LDL-C 的中位数降幅分别为 16.6%和 13%。16 名儿童（64%）的 sdLDL-C 和 LDL-C 降幅>10%，与基线水平、性别、年龄和体重指数（BMI）无关。高密度脂蛋白胆固醇（HDL-C）、脂蛋白 a [Lp(a)]和甘油三酯（TGs）水平不受影响。
植物固醇可显著降低 sdLDL-C，对高胆固醇血症儿童可能有益。
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