Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 1 Shuaifuyuan, Dongcheng District, 100730, Beijing, China.
Central Research Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 1 Shuaifuyuan, Dongcheng District, 100730, Beijing, China.
Eur J Clin Nutr. 2019 Dec;73(12):1579-1593. doi: 10.1038/s41430-019-0504-z. Epub 2019 Sep 27.
The composition of phytosterol (PS) formulations used to enrich food and supplements are typically different due to varying natural sources. Sitosterol and it's hydrogenated form: sitostanol are the major PSs in most of these formulations. This review aimed to investigate whether the proportion of sitosterol plus sitostanol in a PS formulation is a determinant of the hypocholesterolaemic effect of PS products. If the amount of sitosterol plus sitostanol in a PS composition is ≥80%, the product is considered to be high in sitosterol plus sitostanol, otherwise the product is considered to be low in sitosterol plus sitostanol. We conducted a meta-analysis on the cholesterol-lowering potential of PS products that were high or low in sitosterol plus sitostanol. Databases including PubMed, EMBASE, and Cochrane Library were searched, and published RCTs investigating the efficacy of dietary PSs intervention (≥1.5 g/d) on blood lipid profile improvement were selected. After strict screening and quality assessment, a total of 51 RCTs were included. As expected, PSs with all compositions significantly reduced LDL-C (p < 0.00001), while the LDL-C lowering effect associated with the high sitosterol plus sitostanol group was significantly greater than that of the low sitosterol plus sitostanol group (p = 0.002). PSs also significantly reduced TG (p = 0.009) without affecting HDL-C. Thus, the composition might affect the hypocholesterolaemic effect of PS products. PS products with higher sitosterol plus sitostanol proportions might have superior cholesterol-lowering potential than those with lower sitosterol plus sitostanol proportions.
植物甾醇（PS）制剂的组成因天然来源不同而有所差异，用于强化食品和补充剂。在大多数这些制剂中，豆甾醇及其氢化形式：甾烷醇是主要的 PS。本综述旨在探讨 PS 制剂中甾醇加甾烷醇的比例是否是 PS 产品降胆固醇作用的决定因素。如果 PS 组合物中甾醇加甾烷醇的量≥80%，则认为该产品富含甾醇加甾烷醇，否则认为该产品富含甾醇加甾烷醇。我们对富含或缺乏甾醇加甾烷醇的 PS 产品的降胆固醇潜力进行了荟萃分析。检索了包括 PubMed、EMBASE 和 Cochrane Library 在内的数据库，并选择了发表的 RCT，以调查饮食 PS 干预（≥1.5 g/d）对血脂谱改善的疗效。经过严格的筛选和质量评估，共纳入了 51 项 RCT。正如预期的那样，所有组成的 PS 均显著降低 LDL-C（p<0.00001），而富含高甾醇加甾烷醇组的 LDL-C 降低效果明显大于富含低甾醇加甾烷醇组（p=0.002）。PS 还显著降低 TG（p=0.009），而不影响 HDL-C。因此，组成可能会影响 PS 产品的降胆固醇作用。富含较高比例的甾醇加甾烷醇的 PS 产品可能具有比富含较低比例的甾醇加甾烷醇的 PS 产品更好的降胆固醇潜力。
