Non-cholesterol sterols in serum and endarterectomized carotid arteries after a short-term plant stanol and sterol ester challenge

Miettinen, T.A.; Nissinen, M.; Lepäntalo, M.; Albäck, A.; Railo, M.; Vikatmaa, P.; Kaste, M.; Mustanoja, S.; Gylling, H.

doi:10.1016/j.numecd.2009.09.006

« Previous Next »Nutrition, Metabolism & Cardiovascular Diseases
Volume 21, Issue 3 , Pages 182-188, March 2011

Non-cholesterol sterols in serum and endarterectomized carotid arteries after a short-term plant stanol and sterol ester challenge

T.A. Miettinen
- Department of Medicine, Division of Internal Medicine, University of Helsinki, Helsinki, Finland
- Corresponding author at: Biomedicum Helsinki C 4 22, P.O. BOX 700, FIN-00029 HUS, Finland. Fax: +358 9 47171851.
M. Nissinen
- Department of Medicine, Division of Gastroenterology, University of Helsinki, Helsinki, Finland
M. Lepäntalo
- Department of Surgery, Division of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland
A. Albäck
- Department of Surgery, Division of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland
M. Railo
- Department of Surgery, Division of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland
P. Vikatmaa
- Department of Surgery, Division of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland
M. Kaste
- Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
S. Mustanoja
- Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
H. Gylling
- Department of Clinical Nutrition, University of Kuopio, Kuopio, Finland
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland

Received 3 June 2009; received in revised form 9 September 2009; accepted 10 September 2009. published online 22 January 2010.

Abstract

Background and Aims

It is not known whether dietary intake of plant stanols or sterols changes the composition of arterial sterols. Therefore, we compared serum and carotid artery cholesterol and non-cholesterol sterols after plant stanol (staest) or sterol (steest) ester feeding in endarterectomized patients.

Methods and Results

Elderly statin-treated asymptomatic patients undergoing carotid endarterectomy were randomized double-blind to consume staest (n=11) or steest (n=11) spread (2g of stanol or sterol/day) for four weeks preoperatively. Non-cholesterol sterols from serum and carotid artery tissue were analysed with gas-liquid chromatography. Staest spread lowered serum total (17.2%), VLDL, and LDL cholesterol and serum triglycerides, while steest spread lowered serum total (13.8%) and LDL cholesterol levels from baseline (p<0.05 for all). Serum cholestanol and avenasterol were decreased in both groups, but campesterol and sitosterol were decreased by staest and increased by steest from baseline (p<0.05 from baseline and between the groups). Serum sitostanol to cholesterol ratio was increased by staest, but in arterial tissue this ratio was similar in both groups. On staest, lathosterol, campesterol, and sitosterol, and on steest sitosterol and avenasterol correlated significantly between serum and arterial tissue. Cholesterol metabolism, eg. lathosterol/campesterol, suggested that plant sterols were reduced in serum and in arterial tissue during staest.

Conclusion

The novel observations were that plant stanol ester consumption, in contrast to plant sterols, tended to reduce carotid artery plant sterols in statin-treated patients. Furthermore, despite increased serum sitostanol contents during plant stanol ester consumption, their arterial levels were unchanged suggesting that sitostanol is not taken up into the arterial wall.

Keywords: Plant stanol esters, Plant sterol esters, Cholesterol metabolism, Statins, Plaque, Atherosclerosis, Sitosterol, Sitostanol