Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil.
Faculdade de Saúde Pública, Universidade de São Paulo, Brazil.
Nutr Metab Cardiovasc Dis. 2021 Jun 7;31(6):1756-1766. doi: 10.1016/j.numecd.2021.02.031. Epub 2021 Mar 20.
Phytosterol (PS) consumption is associated with lower total and LDL-cholesterol (LDL-c) concentrations, but its impact on cardiovascular risk is unclear. This study assessed the effect of usual intake of PS on markers of subclinical atherosclerosis in the Longitudinal Study of Adult Health (ELSA-Brasil).
This cross-sectional study included 2560 participants of ELSA-Brasil, aged 48 (43-54) years, with available food frequency questionnaires (FFQ), coronary artery calcium (CAC) scores, carotid intima media thickness (cIMT), and carotid-femoral pulse wave velocity (cf-PWV), at baseline. Several logistic and linear regression models were used, and significance level was set at a P < 0.05. Mean values (SD) for PS consumption were 256 (198) mg/day, CAC 22.78 (110.54) Agatston Units, cf-PWV 9.07 (1.60) m/s and cIMT 0.57 (0.12) mm. PS consumption in Q4 was associated with lower total- and LDL-c levels, and with higher percentiles of cf-PWV (P < 0.001). Proportion of subjects in Q4 of PS consumption was 1.5 times higher among individuals in cf-PWV Q4, than in Q1 (P = 0.002, for comparisons among quartiles). There was a trend (P = 0.003) for higher cf-PWV with higher PS intake. In crude logistic and linear regressions, PS intake was associated with cf-PWV. In the adjusted models, these associations disappeared. No associations were found between PS and cIMT or CAC.
In this large and apparently healthy cross-sectional sample from ELSA-Brasil, usual PS consumption was associated with lower total- and LDL-cholesterol, but not with markers of subclinical atherosclerosis.
植物固醇（PS）的摄入与总胆固醇和 LDL-胆固醇（LDL-c）浓度降低有关，但它对心血管风险的影响尚不清楚。本研究评估了在巴西成年人健康纵向研究（ELSA-Brasil）中，PS 的常规摄入量对亚临床动脉粥样硬化标志物的影响。
本横断面研究纳入了 ELSA-Brasil 的 2560 名年龄为 48（43-54）岁的参与者，他们有可用的食物频率问卷（FFQ）、冠状动脉钙（CAC）评分、颈动脉内膜中层厚度（cIMT）和颈动脉-股动脉脉搏波速度（cf-PWV），在基线时。使用了几种逻辑和线性回归模型，显著性水平设置为 P < 0.05。PS 摄入量的平均值（标准差）为 256（198）mg/天，CAC 为 22.78（110.54）Agatston 单位，cf-PWV 为 9.07（1.60）m/s，cIMT 为 0.57（0.12）mm。Q4 组的 PS 摄入量与总胆固醇和 LDL-c 水平降低相关，与 cf-PWV 的更高百分位数相关（P < 0.001）。PS 摄入量 Q4 组中，cf-PWV Q4 组的个体比 Q1 组的个体 PS 摄入量 Q4 组高 1.5 倍（P = 0.002，用于 Q1 组之间的比较）。PS 摄入量越高，cf-PWV 越高，呈趋势（P = 0.003）。在未经调整的逻辑和线性回归中，PS 摄入量与 cf-PWV 相关。在调整后的模型中，这些关联消失了。PS 与 cIMT 或 CAC 之间没有关联。
在这项来自 ELSA-Brasil 的大型且明显健康的横断面样本中，PS 的常规摄入量与总胆固醇和 LDL-c 降低有关，但与亚临床动脉粥样硬化标志物无关。
