Turini Elisa, Sarsale Miriana, Petri Davide, Totaro Michele, Lucenteforte Ersilia, Tavoschi Lara, Baggiani Angelo
Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno 37, 56123 Pisa, Italy.
Department of Pharmacy, University of Pisa, 56123 Pisa, Italy.
Foods. 2022 Mar 15;11(6):839. doi: 10.3390/foods11060839.
Plant sterols/phytosterols (PSs) are molecules with a similar structure to cholesterol that have a recognized effect on elevated LDL concentrations (LDL-c). PSs are used as a natural therapy against elevated LDL-c in combination with a healthy diet and exercise. A systematic review was performed to evaluate the efficacy of PS-enriched foods in the treatment of hypercholesterolemia. Randomized controlled clinical studies reporting the use of PS-enriched foods to reduce LDL-c among adult individuals were retrieved and assessed for risk of bias. Meta-analyses were performed to assess changes in LDL-c by treatment, food matrix, LDL-c range, sterols dosage and risk of bias (RoB). In the 13 studies analyzed, LDL-c in PS-treated participants decreased by an average of 12.14 (8.98; 15.29) mg/dL. PS administration was statistically more effective in patients with LDL-c ≥ 140 mg/dL and for PS dosages > 2 g/day. It can be concluded that PSs can be used as an important primary prevention measure for hypercholesterolemia and as tertiary prevention for cardiovascular events in patients who already have mild to moderate LDL-c. However, in severe hypercholesterolemia and in cases of familial hypercholesterolemia, it is necessary to combine dietary treatment with the use of statins.
植物甾醇/植物固醇（PSs）是一类结构与胆固醇相似的分子，已证实其对升高的低密度脂蛋白浓度（LDL-c）有作用。PSs被用作一种天然疗法，与健康饮食和运动相结合，用于降低升高的LDL-c。本研究进行了一项系统评价，以评估富含PS的食物在治疗高胆固醇血症中的疗效。检索了报告使用富含PS的食物降低成年个体LDL-c的随机对照临床研究，并评估其偏倚风险。进行荟萃分析，以评估治疗、食物基质、LDL-c范围、甾醇剂量和偏倚风险（RoB）对LDL-c变化的影响。在分析的13项研究中，接受PS治疗的参与者的LDL-c平均降低了12.14（8.98；15.29）mg/dL。PS给药在LDL-c≥140mg/dL的患者以及PS剂量>2g/天的情况下，在统计学上更有效。可以得出结论，PSs可作为高胆固醇血症的重要一级预防措施，以及对已经患有轻度至中度LDL-c的患者心血管事件的三级预防措施。然而，在严重高胆固醇血症和家族性高胆固醇血症病例中，有必要将饮食治疗与他汀类药物的使用相结合。
