Effect of a diet based on low-fat foods enriched with nonesterified plant sterols and mineral nutrients on serum cholesterol.

Plant sterols have been incorporated into nutritional fats to achieve cholesterol lowering, but studies using enrichment of low-fat foods with plant sterols have not been reported. Our study was aimed at determining the effect of dietary intake of low-fat foods containing natural nonesterified plant sterols together with recommended doses of calcium, magnesium, and potassium on serum cholesterol and low-density lipoprotein (LDL) cholesterol-lowering in persons with mild to moderate hypercholesterolemia. This was a randomized, double-blind, placebo-controlled feeding trial lasting 15 weeks and performed in 2 university hospital centers. Seventy-eight subjects aged 25 to 75 years with serum cholesterol concentrations varying between 6 mmol/L (232 mg/dl) and 8 mmol/L (310 mg/dl) were randomly allocated to active treatment consisting of intake of bread, meat products, and jam enriched with 1.25 to 5.0 g/day of plant sterols and the slightly elevated concentrations of mineral nutrients, or the corresponding placebo food items. Serum lipid, high-density lipoprotein cholesterol and calculated LDL cholesterol concentrations were determined. Seventy-one persons completed the trial. Reduction in serum total cholesterol was 8% in the active treatment group and 3% in the placebo group (p = 0.0071) and that of LDL cholesterol was 13% in the active treatment group and 5% in the placebo group (p = 0.0070). In conclusion, natural nonesterified plant sterols contained in low-fat food items and ingested in moderate doses reduced serum total and LDL cholesterol concentrations to the same extent as reported previously for esterified plant sterol derivatives added to nutritional fats. The presence of mineral nutrients in doses recommended for blood pressure-lowering did not interfere with the cholesterol-lowering efficacy of the sterols, providing a promising approach to dietary prevention of cardiovascular diseases.     

血清载脂蛋白人群分布特征及与血脂的关系

目的 :分析自然人群中载脂蛋白 (apo)AⅠ、AⅡ、B、CⅡ、CⅢ和E的性别、年龄分布特征 ,及与血脂的关系。方法 :1999年 9月至 10月在北京市自然人群中采用分层随机抽样进行横断面研究。1174名 35～ 6 4岁的男女两性测定了apoAⅠ、AⅡ、B、CⅡ、CⅢ、E和血脂。结果 :1 人群apoAⅠ、AⅡ、B呈正态分布 ,CⅡ、CⅢ和E呈对数正态分布。 2 35～ 6 4岁女性各载脂蛋白均随年龄的增加而升高 ,男性仅apoAⅠ随年龄的增加而升高。 3 男性apoAⅠ低于女性 ,apoAⅡ、B、CⅡ、CⅢ高于女性。女性绝经后各载脂蛋白水平较绝经前高 (P <0 0 5 )。 4 高胆固醇血症 (或混合型高脂血症 )者各种载脂蛋白均升高 (P<0 0 1) ,单纯低高密度脂蛋白血症者AⅠ、AⅡ和CⅢ显著降低 (P <0 0 5 )。 5 多因素分析表明 :apoB与非高密度脂蛋白胆固醇 (nHDL C)相关最强 ,男女两性的偏相关平方 (PartialR2 )分别为 0 6 5 8和 0 76 9,但它与低密度脂蛋白胆固醇 (LDL C)的相关则较弱 ,男女两性的PartialR2 分别为 0 2 43和 0 183;apoAⅠ与HDL C的相关最强 ,男女两性的PartialR2 分别为 0 2 82和 0 2 38;apoCⅢ与男性TG和绝经前女性TG的相关最强PartialR2 分别为 0 6 2 9和 0 6 37。结论 :人群载脂蛋白水平与性别、年龄和绝经状况有关 :3     

Impact of margarine enriched with plant sterols on blood lipids, platelet function, and fibrinogen level in young men

The effects of margarines enriched with omega-6 polyunsaturated fatty acids (PUFA), as well as those containing plant sterols or stanols, on reduction of plasma low-density lipoprotein-cholesterol (LDL-C) have been extensively studied. However, their impact on fibrinogen (Fb) concentration and blood platelet function is much less known. Our research involved 42 healthy male students (average age, 23.7 +/- 1.6) who during the research period were subjected to a controlled regime of nutrition and physical activity. After a period of diet stabilization involving 30 g butter daily in 2 servings, the subjects were randomly divided into 2 groups. In the first group, the butter was replaced by the same quantity of PUFA margarine, while the second group received margarine with added plant sterols instead of butter. The subjects consuming margarine with sterols showed a significant (11%) decrease in LDL-C (P<.001). Margarine rich in PUFA caused a 6% reduction in LDL-C (P<.01), with a simultaneous 3% reduction in high-density lipoprotein-cholesterol (HDL-C) (P<.001). Both types of margarine increased the concentration of Fb (P<.001), without exceeding the normal medium value of 2.8 g/L. After the consumption of margarine with sterols, the adhesion and aggregation time of blood platelets was significantly prolonged after collagen-epinephrine activation. Margarine with sterols, through its antiplatelet activity and the significant reduction of LDL-C, can play a vital role in the nonpharmacologic prevention of circulatory diseases.     

载脂蛋白E基因多态性与健康人群血脂谱改变的关系

目的 :研究载脂蛋白E(apoE)基因多态性与健康人群血脂谱改变的关系。方法 :随机选择 16 8例江苏地区无血缘关系健康汉族人群 ,用聚合酶链反应 限制性片段长度多态性技术检测其apoE基因型。分析各基因型及等位基因对血脂、载脂蛋白及脂蛋白 (a)的影响。结果 :apoE各等位基因血清总胆固醇 (TC)、低密度脂蛋白胆固醇 (LDL C)及apoB水平由高到低依次为ε4 >ε3>ε2 。ε2 等位基因具有明显的降低TC、LDL C和apoB的作用 ;而ε4 等位基因的作用正相反。结论 :apoE基因多态性是个体间血脂谱差异的独立遗传因素。     

腹膜透析对尿毒症血清载脂蛋白和脂质的影响

本文前瞻性观察腹膜透析治疗１５例尿运症患者对血清载脂蛋白和脂质的影响，发现腹膜透析治疗前、后血ＨＤＬ－Ｃ和ＨＤＬ２－Ｃ亚型、ａｐｏＡｉ均显著低于正常人；透析后ａｐｏＢ１００显著高于正常人；自身前后比较透析后血ａｐｏＣⅡ，ＣⅢ显著降低，血ａｐｏＡⅠ轻度降低，ａｐｏＢ１００轻度增高。提示腹膜透析可加剧尿毒症原有的载脂蛋白和脂质异常，增加了并发心血管疾病的危险性。     

The association of fasting plasma sulfur-containing compounds with BMI, serum lipids and apolipoproteins

Background and aimSulfur amino acids are recognized as potent modulators of lipid metabolism. Plasma total cysteine (tCys) is associated with fat mass, obesity and serum LDL-cholesterol and apolipoprotein (Apo)-B in large population studies. It is not known how fasting plasma concentrations of cysteine precursors and products relate to these associations in humans, given that sulfur-containing compounds (SCC) influence rodent weight gain and serum lipids.Methods and resultsWe investigated the cross-sectional associations of fasting plasma SCC (methionine, total homocysteine, cystathionine, tCys, taurine and total glutathione) with BMI and fasting serum lipids and apolipoproteins in 854 men and women with and without cardiovascular disease (CVD).In multiple linear regression analysis adjusted for age, gender, CVD and other SCC, neither methionine, taurine, nor total glutathione was associated with BMI. Plasma taurine was, however, inversely related to HDL-cholesterol (partial r = ?0.12, p = 0.004) and its associated apoA1 (partial r = ?0.18, p < 0.001). Plasma cystathionine correlated positively with triglycerides and BMI, while tCys positively correlated with total cholesterol, LDL-cholesterol (partial r = 0.20, p < 0.001) and its associated apoB. The associations of SCC with serum lipids were independent of BMI. tCys was also independently associated with BMI (partial r = 0.20, p < 0.001) after adjustment for other SCC, glucose, lipids and apolipoproteins.ConclusionsFasting tCys is associated with BMI independently of metabolically related SCC. Elevation of plasma SCC is generally associated with an unfavorable lipid profile. The negative relations of plasma taurine with HDL-C and apoA1 deserve further investigation.     

The beneficial effects of plant sterols on serum cholesterol.

Phytosterol-enriched margarines are a recent addition to the list of so-called 'functional foods'. The ingestion of phyto-sterols lowers the serum cholesterol by inhibiting intestinal uptake of the sterol. The phytosterols available in consumer products are comprised predominantly of beta-sitosterol and sitostanol. The esterified form of these phytosterols increases their solubility and enhances their residence time in the small intestine. Their ability to displace cholesterol from micelles in the small intestine underlies the mechanism that inhibits cholesterol absorption, leading to a 10% reduction in total serum cholesterol. Numerous well designed studies have documented the beneficial actions of these phytosterols on serum cholesterol.     

The effect of age, sex, alcohol consumption and cigarette smoking on serum concentrations of lipids and apolipoproteins in Zimbabwean blacks

Serum concentrations of total cholesterol, HDL cholesterol, triglycerides and apolipoproteins A-I and B were studied in black subjects with no known risk factor for coronary heart disease and in subjects with a single risk factor. The concentrations of lipids and apolipoproteins were sex-dependent. HDL cholesterol and apolipoprotein A-I were age-dependent in females (P less than 0.05 and P less than 0.01, respectively). There was a dose-related association between alcohol consumption and serum concentrations of triglycerides, HDL cholesterol, apolipoproteins A-I and B in males (P less than 0.001 and P less than 0.002, respectively in the heavy drinkers). The effects of cigarette smoking on the concentrations of serum lipids and apolipoproteins appear to be prominent in the heavy smoking subjects (P less than 0.001 and P less than 0.001, respectively). This work suggests that HDL cholesterol and apolipoprotein A-I may discriminate black subjects at risk of developing atherosclerosis.     

Effect of mild aerobic exercise on serum lipids and apolipoproteins in patients with coronary artery disease

The effects of mild aerobic exercise on serum lipids, apolipoproteins and lecithin-cholesterol acyltransferase (LCAT) activity were examined in 11 male patients with coronary artery disease and 4 healthy male controls. The mild aerobic exercise program involved exercise intensity at 50% of maximal oxygen uptake, as determined from the blood lactate threshold, for 60 min periods 3 times per week for 10 weeks. Following mild aerobic exercise, serum levels of high density lipoprotein cholesterol (HDL-C) were increased significantly from 50 +/- 7 mg/dl to 59 +/- 11 mg/dl (p less than 0.05) with a simultaneous increase in apolipoprotein A-I (apo A-I) in normal controls. The LCAT activity was significantly increased from 65 +/- 22 nmol/ml/hr to 99 +/- 30 nmol/ml/hr in normal controls (p less than 0.05). Furthermore, maximal oxygen uptake (VO2max) was significantly increased in normal controls. In contrast, no significant changes were found in HDL-C, apo A-I, apo B, VO2max and body weight in patients with coronary artery disease. There was significant correlation between the initial HDL-C level and the change in HDL-C level following the exercise program in the combined group of normal controls and patients with coronary artery disease.     

原发性高血压病患者血清抵抗素与血脂及载脂蛋白的相关性

在71例原发性高血压病患者测量体重指数、体内脂肪百分比、腰臀比和测定空腹血抵抗素、血糖、胰岛素、脂类及载脂蛋白浓度。结果显示原发性高血压病患者血清抵抗素水平与血糖、血脂和载脂蛋白代谢有关，提示抵抗素对能量代谢有重要的影响。     

The effect of growth hormone replacement on serum lipids, lipoproteins, apolipoproteins and cholesterol precursors in adult growth hormone deficient patients

OBJECTIVE Adult patients with growth hormone deflciency are thought to be at higher risk of mortallty from cardiovascular disease. We therefore investlgated the effect of recombinant human growth hormone (rhGH) replacement therapy on fasting serum concentrations of IIplds, lipoproteins and cholesterol precursors in adult growth hormone deficient patients. DESIGN Double-blind placebo controlled trial. Patients were randomly allocated to placebo or rhGH replacement therapy (0·018 Ulkglday for 1 month followed by 0·036 Ufkglday for 1 month). PATIENTS Eighteen patients with severe growth hormone deficiency. MEASUREMENTS Fasting lipid, lipoprotein and cholesterol precursors (lathosterol and mevalonic acid) were measured at baseline and after 2 months. RESULTS In the rhGH treated group there was a significant fall in serum cholesterol (P < 0·01) (6·44 ±0·49 to 5·71 ± 0·48 mmol/l), LDL cholesterol (P < 0·02) (4·29 ± 0·49 to 3·62 ± 0·44 mmol/l), LDL cholesterollHDL cholesterol ratio (P < 0·02) (3·99 · 0·62 to 3·26 ± 0·39), apollpo-protein B (P>0·01 (1·30 ± 0·11 to 1·15 ± 0·11 g/l) and mevalonic acid (P<0·05) (13·4 ±10·96 to 6·21 ± 1·91 μg/l). There were no significant changes In triglycerides, HDL cholesterol, apolipoprotein A1, lipoprotein (a) or lathosterol concentrations. In the GH treated group the rise in serum insulln was inversely correlated wlth the fall in cholesterol (P < 0·05), LDL cholesterol (P < 0·01) and apolipoproteln B (P < 0·01). There were no significant changes in any of the measured variables in the placebo group. CONCLUSION We conclude that GH may be involved in the regulation of lipid and lipoprotein metabolism and that rhGH replacement therapy of adult GHD patients is associated with beneficial changes in lipid and lipoprotein profiles. The reduction in mevalonic acid is consistent with up-regulation of hepatic LDL receptors caused by GH and this may explain the fall in LDL cholesterol and apolipoprotein B concentrations.     

Effect of oxytetracycline on bacterial intestinal metabolism of neutral sterols and on serum lipids

The effect of oral oxytetracycline administration to five healthy male volunteers on intestinal bacterial metabolism of faecal neutral sterols was studied. A reduction in bacterial transformation of cholesterol to coprostanol and coprostanone was observed which lasted 1-2 weeks after 5 days' intake of oxytetracycline (1000 mg/day). In addition, a reduction in the amount of esterified neutral sterols in faeces was observed. The significant changes in the intestinal metabolism of cholesterol had no effect on the levels of serum cholesterol, HDL-cholesterol, LDL-cholesterol, or triglycerides.     

Effect of plant sterol-enriched margarine on plasma lipids and sterols in subjects heterozygous for phytosterolaemia

OBJECTIVE: Margarine with added plant sterols lowers plasma cholesterol levels. It is of importance to know whether these margarines can be used safely in carriers of a hereditary disorder with increased absorption of plant sterols. DESIGN: In an open feeding study of 8 weeks with a 2-week run-in period and 2 final weeks as a washout period on control margarine (0.3% plant sterols), two obligate heterozygous parents of a patient with classical sitosterolaemia were subjected for 4 weeks to a diet containing margarine enriched with plant sterols (8%). Fasting blood samples were taken weekly. Primary outcomes were plasma lipid and lipoprotein levels and plant sterol levels. RESULTS: Both parents were hyperlipidaemic. Total plasma cholesterol levels were decreased by 11 and 12%, respectively, after 4 weeks of the consumption of 40 g day(-1) of plant sterol-enriched margarine. This was mainly due to changes in LDL-cholesterol, whereas the other lipoproteins, including lipoprotein(a), were unaffected. Total plant sterol levels increased maximally 139% from 0.31 to 0.82% of total sterols in the father, and maximally 83% from 0.32 to 0.66% of total sterols in the mother. CONCLUSION: An intake of around 3 g day(-1) of plant sterols by subjects heterozygous for phytosterolaemia increased campesterol or sitosterol levels in blood to similar levels as found in normal subjects. In addition, plasma cholesterol levels were reduced to the same extent as in normal or hypercholesterolaemic individuals.     

Differentiation of beta-blocker effects on serum lipids and apolipoproteins in hypertensive patients with normolipidaemic or dyslipidaemic profiles.

To evaluate the differential effects of beta-blockers on serum lipids and apolipoproteins in normolipidaemic and dyslipidaemic hypertensives, 330 patients with mild to moderate essential hypertension were studied 1 month after placebo therapy and 6 months after monotherapy with propranolol (n = 53), atenolol (n = 66), metoprolol (n = 58), pindolol (n = 53), or celiprolol (n = 100). Serum total cholesterol, triglycerides, high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), and apolipoproteins (Apo) A1 and B were measured at baseline and study end. A total of 136 (41.2%) patients were considered normolipidaemic (pretreatment LDL-C < 160 mg.dl-1) and 194 (58.8%) were considered dyslipidaemic (LDL-C > 160 mg.dl-1). Changes in total cholesterol differed between normolipidaemics and dyslipidaemics with propranolol (+13% in normolipidaemics vs -0.5% in dyslipidaemics, P < 0.001), atenolol (+7% vs -2%, P = 0.01), metoprolol (+9% vs -4%, P0.0006), pindolol (+8% vs -9%, P < 0.001), and celiprolol (-1% vs -13%, P = 0.002). HDL-C differed less, with propranolol (-18% vs -13%), atenolol (-6% vs -2%), metoprolol (-2% vs -6%), pindolol (+4% vs +1%), and celiprolol (+9% vs +4%); none of these changes between normolipidaemic and dyslipidaemic patients were statistically significant. LDL-C changes differed the most, with propranolol (+35% vs -1%, P < 0.0001), atenolol (+15% vs -4%, P = 0.001), metoprolol (+12% vs -6%, P = 0.004), pindolol (+12% vs -13%, P < 0.0001), and celiprolol (+3% vs -16%, P = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)     

Effect of soybean crude fiber on the concentrations of serum lipids and apolipoproteins in hyperlipemic subjects

Effect of soybean crude fiber on the concentrations of serum lipids and apolipoproteins in hyperlipemic subjects was examined. The concentrations of serum triglycerides, VLDL triglycerides and VLDL cholesterol were decreased significantly following the administration of soybean crude fiber for 2 months. Neither were significant changes found in total cholesterol, LDL cholesterol, HDL cholesterol, apo A-I, apo A-II, apo C-II and apo B levels, nor in body weight before and after the administration of soybean crude fiber.     

Effects of plant stanol esters supplied in low-fat yoghurt on serum lipids and lipoproteins, non-cholesterol sterols and fat soluble antioxidant concentrations.

Oil-based products enriched with plant stanol esters can lower low-density lipoprotein (LDL) cholesterol concentrations by 10-14%. Effectiveness of low-fat products, however, has never been evaluated, although such products fit into a healthy diet. We therefore examined the effects of plant stanol esters emulsified into low-fat yoghurt (0.7% fat) on fasting concentrations of plasma lipids and lipid-soluble antioxidants, which may also change by plant stanol consumption. Sixty non-hypercholesterolemic subjects first consumed daily three cups (3 x 150 ml) of placebo yoghurt for 3 weeks. For the next 4 weeks, 30 subjects continued with the placebo yoghurt, while the other 30 subjects received three cups of experimental yoghurt. Each cup provided 1 g of plant stanols (0.71 g sitostanol plus 0.29 g campestanol) as its fatty acid ester. LDL cholesterol (mean+/-S.D.) increased by 0.06+/-0.21 mmol/l in the placebo group, but decreased by -0.34+/-0.30 mmol/l in the experimental group. The difference in changes between the two groups of 0.40 mmol or 13.7% was highly significant (P<0.001; 95% confidence interval for the difference, (-)0.26 -(-)0.53 mmol/l). Effects were already maximal after 1 week. HDL cholesterol and triacylglycerol concentrations did not change. Total tocopherol levels increased by 1.43 micromol/mmol LDL cholesterol (14.0%, P=0.015). beta-carotene levels, however, decreased by -0.02 micromol/mmol LDL cholesterol (-14.4%, P=0.038). Decreases in absolute beta-carotene concentrations were found in all apoB-containing lipoproteins. LDL-cholesterol standardised phytofluene levels decreased by 21.4+/-25.7% (P<0.001), while other plasma carotenoid (lutein/zeaxanthin, beta-cryptoxanthin, lycopene and alpha-carotene) levels did not change significantly. We conclude that low-fat yoghurt enriched with plant stanol esters lowers within 1 week LDL cholesterol to the same extent as oil-based products. LDL-cholesterol standardised concentrations of tocopherol increased. The observed decrease in beta-carotene levels, as found in many other studies, appears not to be limited to the LDL fraction.