title: Evaluation of the use of beta-sitostanol as a nonabsorbable marker for quantifying cholesterol absorption.
abstract: For over a decade investigators have quantified cholesterol absorption by comparison of dietary intake and fecal excretion of isotopic cholesterol with that of beta-sitosterol as a "nonabsorbable" marker. However, beta-sitosterol might not be ideal due to its potential for absorption. We therefore carried out two studies to evaluate a new marker with less potential for absorption, [3H]beta-sitostanol. In the first study (Study I, n = 22), we compared absorption of [3H]beta-sitostanol and [14C]beta-sitosterol in a simultaneous dual-label continuous feeding ("phytosterol absorption") experiment. We observed a consistently higher ratio of [3H]beta-sitostanol/[14C]beta-sitosterol in the stool relative to diet on the first day of fecal collection (6.1% +/- 3.2% loss of [3H]beta-sitosterol, range 3-12%), but thereafter, the ratio in stool was similar to that in diet. In Study II (n = 23), we compared cholesterol absorption directly using [3H]beta-sitosterol and [14C]cholesterol, and, separately, [3H]beta-sitostanol and [14C]cholesterol. We found that mean absorption between the two methods was similar (45% +/- 11% versus 44% +/- 10%, respectively, P difference = 0.40), and the two methods correlated well with one another (r = 0.83) when samples from all available days were used. Variability between the two methods was greater in individuals who absorbed more than 40% of cholesterol. Cholesterol loss on day 2 estimated from use of beta-sitostanol as a nonabsorbable marker was predictive of absorption using ratios from days 4-6 (r = 0.80). These results suggest that, for the majority of subjects, beta-sitosterol is a valid nonabsorbable marker for cholesterol absorption.
authors.affiliation: Department of Internal Medicine, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27157, USA.
authors.forename: J G
authors.initials: JG
authors.lastname: Terry
authors.forename: B L
authors.initials: BL
authors.lastname: McGill
authors.forename: J R
authors.initials: JR
authors.lastname: Crouse
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000737:chemistry; D002784:Cholesterol / Q000493:pharmacokinetics*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007408:Intestinal Absorption / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012855:Sitosterols / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D012855:Sitosterols; C025473:gamma-sitosterol; D002784:Cholesterol; C021255:stigmastanol