Anagnostis Panagiotis, Kotsis Vasileios, Banach Maciej, Mikhailidis Dimitri P
3rd Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital Thessaloniki, 56429 Thessaloniki, Greece.
Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), 90-419 Lodz, Poland.
Metabolites. 2023 Jan 18;13(2):145. doi: 10.3390/metabo13020145.
Plant sterols are molecules that are structurally similar to cholesterol and provided only as dietary sources (e.g., vegetables, fruits, nuts, cereals) since they cannot be synthesized by humans. Sterol-enriched diets (≥2 g/day) may decrease total and low-density lipoprotein cholesterol concentrations by 5-10%, either alone or when added to statins, since they antagonize dietary cholesterol absorption in the intestine. On the other hand, increased serum phytosterol concentrations, (including when associated with sitosterolemia, a rare genetic defect) may contribute to atherosclerotic risk, although a threshold for such a role has not been established. Medications such as ezetimibe may effectively reduce cholesterol and phytosterol absorption. Whether the therapeutic approach associated with the reduction of phytosterol absorption is also translated into a reduction in a patient's residual cardiovascular risk needs to be established.
植物甾醇是结构与胆固醇相似的分子，由于人体无法合成，仅作为膳食来源（如蔬菜、水果、坚果、谷物）提供。富含甾醇的饮食（≥2克/天）单独使用或与他汀类药物合用时，可使总胆固醇和低密度脂蛋白胆固醇浓度降低5-10%，因为它们可拮抗肠道对膳食胆固醇的吸收。另一方面，血清植物甾醇浓度升高（包括与罕见的遗传缺陷——谷甾醇血症相关时）可能会增加动脉粥样硬化风险，尽管尚未确定这种作用的阈值。依折麦布等药物可有效降低胆固醇和植物甾醇的吸收。与降低植物甾醇吸收相关的治疗方法是否也能转化为降低患者残余心血管风险，还有待确定。
