Endothelial function in hypercholesterolemic subjects: Effects of plant stanol and sterol esters

• Published in: Atherosclerosis Vol. 188; no. 2; pp. 425 - 432
• Main Authors: Hallikainen, Maarit, Lyyra-Laitinen, Tiina, Laitinen, Tomi, Ågren, Jyrki J., Pihlajamäki, Jussi, Rauramaa, Rainer, Miettinen, Tatu A., Gylling, Helena
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01.10.2006; Elsevier
• Subjects: Adult; Aged; Anticholesteremic Agents - administration & dosage; Anticholesteremic Agents - pharmacology; Anticholesteremic Agents - therapeutic use; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Blood Chemical Analysis; Blood Pressure; Brachial Artery - diagnostic imaging; Cardiology. Vascular system; Cardiovascular system; Cholesterol; Cholesterol, HDL - blood; Cross-Over Studies; Dietary Fats - administration & dosage; Double-Blind Method; Endothelial function; Endothelium, Vascular - drug effects; Female; Finland; Humans; Hypercholesterolemia; Hypercholesterolemia - blood; Hypercholesterolemia - drug therapy; Hypercholesterolemia - physiopathology; Investigative techniques of hemodynamics; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Plant stanols; Plant sterols; Sitosterols - administration & dosage; Sitosterols - pharmacology; Sitosterols - therapeutic use; Ultrasonography; Vasodilator agents. Cerebral vasodilators; Plant stanols; Hypercholesterolemia; Endothelial function; Plant sterols; Cholesterol; Human; Brachial artery; Metabolic diseases; Cardiovascular disease; Cholesterol LDL; Lipids; Hyperlipoproteinemia; Glucose; Lipoprotein; Triglyceride; Vascular disease; Cholesterol HDL; Dilatation; Atherosclerosis; Double blind study; Dyslipemia; Sterol
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2005.11.012

We investigated the effects of stanol (STAEST) and sterol esters (STEEST) on endothelial function in hypercholesterolemic subjects. In addition, associations of variables of cholesterol metabolism with endothelial function were investigated. In a double-blind randomized cross-over study ( n = 39) with age-matched parallel control group ( n = 37) the subjects consumed STAEST or STEEST spread (total plant sterols and stanols 1.93–1.98 g/day) for 10 weeks each. Controls consumed the spread without sterols or stanols for 20 weeks. At baseline, brachial artery diameter was positively correlated with serum triglycerides ( r = 0.375, p = 0.001) and glucose ( r = 0.420, p < 0.001) and with cholesterol synthesis marker ratios to cholesterol (e.g. desmosterol r = 0.540, p < 0.001) and negatively with HDL cholesterol ( r = −0.309, p = 0.008) and absorption marker ratios (e.g. campesterol r = −0.332, p = 0.004). During the intervention, LDL cholesterol was reduced by 6–9% from baseline with STAEST and STEEST spreads ( p < 0.05), and by 9–12%, respectively, from controls ( p < 0.05). Flow-mediated dilatation did not change during the investigation. Brachial artery diameter was unchanged in controls and during STAEST periods, but it was reduced during STEEST by 2.2% ( p = 0.012) from STAEST. In conclusion, variables of cholesterol metabolism are associated with brachial artery diameter at baseline. STEEST diminishes brachial artery diameter, but its clinical relevance remains unclear.