Effects of plant sterols and stanols on lipid metabolism and cardiovascular risk

Nutrition, Metabolism and Cardiovascular Diseases

Volumn 11, Issue 1, 2001, Pages 31-40

  Plat, J ^a   Mensink, R P ^a  

^a MAASTRICHT UNIVERSITY   (Netherlands)

Author keywords

Atherosclerosis; Cholesterol; Phytosterolemia; Sitostanol; Sitosterol

Indexed keywords

CAMPESTANOL; CHOLESTEROL; HYPOCHOLESTEROLEMIC AGENT; PHYTOSTEROL; SITOSTANOL; SITOSTEROL DERIVATIVE;

CARDIOVASCULAR DISEASE; DIET; HEALTH FOOD; HUMAN; INTESTINE ABSORPTION; LIPID METABOLISM; METABOLISM; REVIEW; RISK FACTOR; SAFETY;

ANTICHOLESTEREMIC AGENTS; CARDIOVASCULAR DISEASES; CHOLESTEROL; DIET; HEALTH FOOD; HUMANS; INTESTINAL ABSORPTION; LIPID METABOLISM; PHYTOSTEROLS; RISK FACTORS; SAFETY; SITOSTEROLS;

EID: 0035259260     PISSN: 09394753     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (79)

1. Westergaard H, Dietschy JM (1976) The mechanism whereby bile acid micelles increase the rate of fatty acid and cholesterol uptake into the intestinal mucosal cell. J Clin Invest 58: 97-108
2. Anderson RA, Joyce C, Davis M, Reagen JW, Clark M, Shelness G, Rudel LL (1998) Identification of a form of acyl-CoA: cholesterol acyltransferase specific to liver and intestine in nonhuman primates. J Biol Chem 272: 26747-26754
3. Grundy SM (1983) Absorption and metabolism of dietary cholesterol. Ann Rev Nutr 3: 71-96
4. Ikeda I, Sugano M, Scallen TJ, Vahouny GV, Gallo LL (1990) Transfer of cholesterol and sitostanol from rat intestinal brush border membranes to phospholipid liposomes: effects of SCP-2, Agric Biol Chem 10: 2649a-2653a
5. Hauser H, Dyer JH, Nandy A, Vega MA, Werder M, Bieliausaite E, Weber FE, Compassi S, Gemperli A, Boffeli D, Wehrli E, Schulthess G, Phillips MC (1998) Identification of a receptor mediating absorption of cholesterol in the intestine. Biochem 37: 17843-17850
6. Repa JJ, Turley SD, Labaccaro JMA, Medina J, Li L, Lustig K, Shan B, Heyman RA, Dietchy JM, Mangelsdorf DJ (2000) Regulation of absorption and ABC1-mediated efflux of cholesterol by RXR heterodimers. Science 289: 1524-1529
7. Hernandez M, Montenegro J, Steiner M, Kim D, Sparrow C, Detmers PA, Wright SD, Chao Y (2000) Intestinal absorption of cholesterol is mediated by a saturable, inhibitable transporter. Biochim Biophys Acta 1486: 232-242
8. Detmers PA, Patel S, Hernandez M, Montenegro J, Lisnock J, Pikounis B, Steiner M, Kim D, Sparrow C, Chao Y, Wright SD (2000) A target for cholesterol absorption inhibitors in the enterocyte brush border membrane. Biochim Biophys Acta 1486: 243-252
9. Grundy SM, Mok HYI (1977) Determination of cholesterol absorption in man by intestinal perfusion J Lipid Res 18: 263-271
10. Kesaniemi YA, Miettinen TA (1987) Cholesterol absorption efficiency regulates plasma cholesterol level in the Finnish population. Eur J Clin Invest 17: 391-395
11. Ling WH, Jones PJH (1995) Minireview dietary phytosterols: a review of metabolism, benefits and side effects. Life Sci 57: 195-206
12. Weststrate JA, Meijer GW (1998) Plant sterol-enriched margarines and reduction of plasma total- and LDL-cholesterol concentrations in normocholesterolaemic and mildly hypercholesterolemic subjects. Eur J Clin Nutr 52: 334-343
13. Sierksma A, Weststrate JA, Meijer GW (1999) Spreads enriched with plant sterols, either esterified 4,4-dimethylsterols or free 4-desmethylsterols, and plasma total- and LDL-cholesterol concentrations. Br J Nutr 82: 273-282
14. Miettinen TA, Tilvis RS, Kesäniemi YA (1990) Serum plant sterols and cholesterol precursors reflect cholesterol absorption and synthesis in volunteers of a randomly selected male population. Am J Epidemiol 131: 20-31
15. Nair PP, Turjman N, Kessie G, Calkins B, Goodman GT, Davidovitz H, Nimmagadda G (1984) Diet, nutrition intake and metabolism in populations at high and low risk for colon cancer. Am J Clin Nutr 40 (Suppl. 4): 927-930
16. Field FJ., Mathur SN (1983) β-sitosterol: esterification by intestinal acylcoenzyme A: cholesterol acyltransferase (ACAT) and its effect on cholesterol esterification. J Lipid Res 24: 409-417
17. Child P, Kuksis A (1983) Uptake of 7-dehydro derivatives of cholesterol, campesterol, and β-sitosterol by rat erythrocytes, jejunal villus cells, and brush border membranes. J Lipid Res 24: 552-565
18. Miettinen TA, Vuoristo M, Nissinen M, Jarvinen H, Gylling H (2000) Serum, biliary and fecal cholesterol and plant sterols in colectomized patients before and during consumption of stanol ester margarine. Am J Clin Nutr 71: 1095-1102
19. Heinemann T, Axtmann G, von Bergmann K (1993) Comparison of intestinal absorption of cholesterol with different plant sterols in man. Eur J Clin Invest 23: 827-831
20. Boberg KM, Einarsson K, Bjorkhem I (1990) Apparent lack of conversion of sitosterol into C24-bile acids in humans. J Lipid Res 31: 1083-1088
21. Boberg KM, Lund E, Olund J, Bjorkhem I (1990) Formation of C21 bile acids from plant sterols in rats. J Biol Chem 265: 7967-7975
22. Tavani DM, Nes WR, Billheimer JT (1982) The sterol substrate specificity of acyl CoA: cholesterol acyltransferase from rat liver. J Lipid Res 23: 774-781
23. Robins SJ, Brunengraber H (1982) Origin of biliary cholesterol and lecithin in the rat: contribution of new synthesis and preformed hepatic stores. J Lipid Res 23: 604-608
24. Tilvis RS, Miettinen TA (1986) Serum plant sterols and their relation to cholesterol absorption. Am J Clin Nutr 43: 92-97
25. Robins SJ, Fasulo JM (1997) High density lipoproteins but not other lipoproteins provide a vehicle for sterol transport to bile. J Clin Invest 3:380-384
26. Botham KM, Bravo E (1995) The role of lipoprotein cholesterol in biliary steroid secretion. Studies with in vivo experimental models. Prog Lipid Res 34: 71-97
27. Gylling H, Radhakrishnan R, Miettinen TA (1997) Reduction of cholesterol in postmenopausal women with previous myocardial infarction and cholesterol malabsorption induced by dietary sitostanol ester margarine. Circulation 96: 4226-4231
28. Hallikainen MA, Uusitupa MI (1999) Effects of 2 low-fat stanol ester-containing margarines on serum cholesterol concentrations as part of a low fat diet in hypercholesterolemic subjects. Am J Clin Nutr 69: 403-410
29. Jones PJH, Ntanios FY, Raeini-Sarjaz M, Vanstone CA (1999) Cholesterol-lowering efficacy of a sitostanol-containing phytosterol mixture with a prudent diet in hyperlipidemic men. Am J Clin Nutr 69: 1144-1150
30. Ikeda, I, Tanabe Y, Sugano M (1989) Effects of sitosterol and sitostanol on micellar solubility of cholesterol. J Nutr Sci Vitaminol 35: 361-369
31. Heinemann T, Kullak-Ublick GA, Pietruck B, von Bergmann K (1991) Mechanisms of action of plant sterols on inhibition of cholesterol absorption; Comparison of sitosterol and sitostanol. Eur J Clin Pharmacol 40 [Suppl. 1]: s59-s63
32. Becker M, Staab D, von Bergmann K (1993) Treatment of severe familial hypercholesterolemia in childhood with sitosterol and sitostanol. J Pediatr 122: 292-296
33. Normén L, Dutta P, Lia A, Andersson H (2000) Soy sterol esters and b-sitostanol ester as inhibitors of cholesterol absorption in human small bowel. Am J Clin Nutr 71: 908-913
34. Hallikainen MA, Sarkkinen ES, Gylling H, Erkkila AT, Uusitupa MIJ (2000) Comparison of the effects of plant sterol ester and plant stanol ester-enriched margarines in lowering serum cholesterol concentrations in hypercholesterolaemic subjects on a low-fat diet. Eur J Clin Nutr 54: 671-677
35. Hendriks HFJ, Weststrate JA, van Vliet T, Meijer GW (1999) Spreads enriched with three different levels of vegetable oil sterols and the degree of cholesterol lowering in normocholesterolemic and mildly hypercholesterolemic subjects. Eur J Clin Nutr 53:319-327
36. Begemann F, Bandomer G, Herget HJ (1978) The influence of β-sitosterol on biliary cholesterol saturation and bile acid kinetics in man. Scand J Gastroent 13: 57-63
37. Tangedahl TN, Thistle JL, Hofmann AF, Matseshe JW (1979) Effect of β-sitosterol alone or in combination with chenic acid on cholesterol saturation of bile and cholesterol absorption in gallstone patients. Gastroenterology 76: 1341-1346
38. Thompson GR, Naoumova RP, Watts GF (1996) Role of cholesterol in regulating apolipoprotein B secretion by the liver. J Lipid Res 37: 439-447
39. Gylling H, Miettinen TA (1994) Serum cholesterol and lipoprotein metabolism in hypercholesterolemic NIDDM patients before and during sitostanol ester-margarine treatment. Diabetologia 37: 773-780
40. Plat J, Mensink RP (2000) Effects of plant stanol esters on LDL receptor expression on mononuclear cells from non-hypercholesterolemic subjects. Atherosclerosis 151: 86
41. Plat J, van Onselen ENM, van Heugten MMA, Mensink RP (2000) Effects on serum lipids, lipoproteins and fat soluble antioxidant concentrations of consumption frequency of margarines and shortenings enriched with plant stanol esters. Eur J Clin Nutr 54: 671-677
42. Bjorkhem I, Boberg KM (1994) Inborn errors in bile acid biosynthesis and storage of sterols other than cholesterol. In: Sciver CR, Beaudet AL, Sly WS, Valee D (Eds),The metabolic basis of inherited diseases. McGraw Hill, New York, 2073-2100
43. Lütjohann D, von Bergmann K (1997) Phytosterolemia: diagnosis, characterization, and therapeutical approaches. Ann Med 29: 181-184
44. Mietinen TA (1980) Phytosterolemia, xanthomatosis and premature atherosclerotic arterial disease: a case with high plant sterol absorption, impaired sterol elimination and low cholesterol synthesis. Eur J Clin Invest 10: 27-35
45. Salen G, Horak I, Rothkopf M, Cohen JL, Speck J, Tint GS, Shore V, Dayal B, Chen T, Shefer S (1985) Lethal atherosclerosis associated with abnormal plasma and tissue sterol composition in sitosterolemia with xanthomatosis. J Lipid Res 26: 1126-1133
46. Patel SB, Salen G, Hidaka H, Kwiterovich PO, Stalenhoef AFH, Miettinen TA, Grundy SM, Lee M, Rubenstein JS, Polymeroloulos MH, Brownstein MJ (1998) Mapping a gene involved in regulating dietary cholesterol absorption; The sitosterolemia locus is found at chromosome 2p21, J Clin Invest 102: 1041-1044
47. Bhattacharyya AK, Connor WE, Lin DS, McMurry MM, Shulman RS (1991) Sluggish sitosterol turnover and hepatic failure to excrete sitosterol into bile cause expansion of body pool of sitosterol in patients with sitosterolemia and xanthomatosis. Arterioscler Thromb 11: 1287-1294
48. Shefer S, Salen G, Nguyen L, batta AK, Packin V, Tint GS, Hauser S (1988) Competative inhibition of bile acid synthesis by endogenous cholestanol and sitosterol in sitosterolemia with xanthomatosis; Effect on cholesterol 7α-hydroxylase. J Clin Invest 82: 1833-1839
49. Nguyen LB, Shefer S, Salen G, Tint SG, Batta AK (1998) Competitive inhibition of hepatic sterol 27-hydroxylase by sitosterol: decreased activity in sitosterolemia. Proc Assoc Am Physicians 110: 32-39
50. Denke MA (1995) Lack of efficacy of low-dose sitostanol therapy as an adjunct to a cholesterol-lowering diet in men with moderate hypercholesterolemia. Am J Clin Nutr 61:392-396
51. Knopp RM (1999) Drug treatment of lipid disorders. N Engl J Med 341: 498-511
52. Blair S, Capuzzi DM, Gottlieb SO, Nguyen T, Morgan JM, Cater NB (2000) Incremental reduction of serum total cholesterol and low-density lipoprotein cholesterol with the addition of plant stanol ester containing spread to statin treatment. Am J Cardiol 86: 46-52
53. Gylling H, Miettinen TA (1996) Effects of inhibiting cholesterol absorption and synthesis on cholesterol and lipoprotein metabolism in hypercholesterolemic non-insulin-dependent diabetic men. J Lipid Res 37: 1776-1785
54. Gylling H, Miettinen TA (1995) The effect of cholesterol absorption inhibition on low density lipoprotein cholesterol level. Atherosclerosis 117: 305-308
55. Law M (2000) Plant sterol and stanol margarines and health. BMJ 320: 861-864
56. Thompson GR, Barrowman J, Gutierrez L, Dowling RH (1971) Action of neomycin on the intraluminal phase of lipid absorption. J Clin Invest 50: 319-323
57. Uusitupa MIJ, Miettinen TA, Happonen P, Ebeling T, Turtola H, Voutilainen E, Pyorala K (1992) Lathosterol and other noncholesterol sterols during treatment of hypercholesterolemia with lovastatin alone and with cholestyramine or guar gom. Arterioscler Thromb 12: 807-813
58. Miettinen TA, Gylling H, Strandberg T, Sarna S (1998) Baseline serum cholestanol as predictor of recurrent coronary events in subgroup of Scandinavian simvastatin survival study. BMJ 316: 1127-1130
59. Glueck JG, Speirs J, Tracy T, Streicher P, Illig E, Vandegrift J (1991) Relationships of serum plant sterols (phytosterols) and cholesterol in 595 hypercholesterolemic subjects, and familial aggregation of phytosterols, cholesterol, and premature coronary heart disease in hypercholesterolemic probands and their first-degree relatives. Metabolism 40: 842-848
60. Tang JL, Armitage JM, Lancaster T, Silagy CA, Fowler GH, Neil HAW (1998) Systemic review of dietary intervention trials to lower blood total cholesterol in free living subjects. BMJ 316: 1213-1220
61. Moghadasian MH, McManus BM, Godin DV, Rodrigues B, Frohlich JJ (1999) Proatherogenic and antiatherogenic effects of probucol and phytosterols in apolipoprotein E-deficient mice. Circulation 99: 1733-1739
62. Moghadasian MH, McManus BM, Pritchard PH, Frohlich JJ (1997) Tall oil-derived phytosterols reduce atherosclerosis in apoE deficient mice. Arterioscler Thromb Vasc Biol 17: 119-126
63. Volger OL, van der Boom J, de Wit ECM, Duyvenvoorde van W, Hornstra G, Plat J, Havekes LM, Princen HMG, Mensink RP (2000) Dietary vegetable- wood- or vegetable/wood derived stanol esters reduce atherosclerotic lesion size and severity in apoE*3-Leiden transgenic mice. Atherosclerosis 151: 77
64. Moghadasian MH, Godin DV, McManus BM, Frohlich JJ (1999) Lack of regression of atherosclerotic lesions in phytosterol treated apoE deficient mice. Life Sci 64: 1029-1036
65. Baker VA, Hepburn PA, Kennedy SJ, Jones PA, Lea LJ, Sumpter JP, Ashby J (1999) Safety evaluation of phytosterol esters. Part 1. Assesement of oestrogenicity using a combination of in vivo and in vitro assays. Food Chem Toxicol 37: 13-22
66. Thurnbull D, Frankos VH, Leeman WR, Jonker D (1999) Short-term tests of estrogenic potential of plant stanols and plant stanol esters. Reg Toxicol Pharmocol 29: 211-215
67. Slesinsky RS, Turnbull D, Frankos VH, Woterbeek APM, Waalkens-Berendsen DH (1999) Developmental toxicity study of vegetable oil-derived stanol fatty acid esters. Reg Toxicol Pharmocol 29: 227-233
68. Waalkens-Berendsen DH, Wolterbeek APM, Wijnands MVW, Richold M, Hepburn PA (1999) Safety evaluation of phytosterol esters, part 3. Two generation reproduction study in rats with phytosterol esters- a novel functional food. Food Chem Tox 37: 683-696
69. Whittaker MH, Frankos VH, Woterbeek APM, Waalkens-Berendsen DH (1999) Two-generation reproductive toxicity study of plant stanol esters in rats. Reg Toxicol Pharmocol 29: 196-204
70. Thurnbull D, Frankos VH, van Delft JHM, DeVogel N (1999) Genotoxicity evaluation of wood-derived and vegetable oil-derived stanol esters. Reg Toxicol Pharmocol 29: 205-210
71. Thurnbull D, Whittaker MH, Frankos VH, Jonker D (1999) 13 week oral toxicity study with stanol esters in rats. Reg Toxicol Pharmocol 29: 216-226
72. Plat J, Kerckhoffs DAJM, Mensink RP (2000) Therapeutic potential of plant sterols and stanols. Curr Opin Lipidol 11: 571-576
73. Plat J, Mensink RP (2000) Vegetable oil based versus wood based stanol ester mixtures: effects on serum lipids and hemostatic factors in non-hypercholesterolemic subjects. Atherosclererosis 148: 101-112
74. Hallikainen MA, Sarkkinen ES, Uusitupa MI (2000) Plant stanol esters affect serum cholesterol concentrations of hypercholesterolemic men and women in a dose-dependent manner. J Nutr 130: 767-776
75. Gylling H, Miettinen TA (1999) Cholesterol reduction by different plant stanol mixtures and with variable fat intake. Metabolism 48: 575-580
76. Andersson A, Karlström B, Mohsen R, Vessby (1999) Cholesterol-lowering effects of a stanol ester-containing low-fat margarine used in conjunction with a strict lipid-lowering diet. Eur Heart J Supplements 1: S80-S90
77. Nguyen TT, Dale LC (1999) Plant stanol esters and vitamin K. Mayo Clinic Proc 4: 642-643
78. Ratnayake WMN, L'Abbe MR, Mueller R, Hayward S, Plouffe L, Hollywood R, Trick K (2000) Vegetable oils high in phytosterols make erythrocytes less deformable and shorten the life span of stroke-prone spontaneously hypertensive rats. J Nutr 130: 1166-1178
79. Miettinen TA, Strandberg TE, Gylling H, for the Finnish Investigators of the Scandinavian Simvastatin Survival Study Group (2000) Noncholesterol sterols and cholesterol lowering by long-term simvastatin treatment in coronary patients; relation to basal serum cholestanol. Arterioscler Thromb Vasc Biol 20: 1340-1346