title: Long-term compliance and changes in plasma lipids, plant sterols and carotenoids in children and parents with FH consuming plant sterol ester-enriched spread.
abstract: OBJECTIVE
  To study the compliance and changes in plasma lipids, plant sterols, fat-soluble vitamins and carotenoids in children and parents with familial hypercholesterolemia (FH) consuming a plant sterol ester-enriched (PSE) spread.
  
  
  METHODS
  A 26-week open-label follow-up of children who had previously been studied in a controlled cross-over design. The parents were also included in the open-label arm of the study.
  
  
  METHODS
  Outpatient clinic for treatment of hyperlipidemia.
  
  
  METHODS
  A total of 37 children (7-13 y) and 20 parents (32-51 y) diagnosed with 'definite' or 'possible' heterozygous FH. In all, 19 of the parents, but no children, used statins. All were patients at the Lipid Clinic, National Hospital in Oslo.
  
  
  METHODS
  Subjects were recommended to eat 20 g/day of PSE spread as part of their lipid-lowering diet.
  
  
  RESULTS
  The mean intake of PSE spread was 13.7 and 16.5 g/days in the children and parents, respectively, corresponding to 1.2 and 1.5 g of plant sterols. Plasma total cholesterol decreased by 9.1% in both children (P<0.001) and parents (P=0.002). The corresponding decreases in LDL cholesterol were 11.4% (P<0.001) and 11.0% (P=0.012). Increases in serum lathosterol, campesterol and sitosterol, adjusted for total cholesterol, were observed in the children (31, 96, 48%, respectively, P<0.001) at the end of the controlled cross-over period. In the parents, serum campesterol and sitosterol, adjusted for total cholesterol, increased by 92 and 39%, respectively (P< 0.001). Lipid-adjusted serum alpha- and beta-carotene decreased by 17.4% (P=0.008) and 10.9% (P=0.018), respectively, in the children at the end of the controlled PSE period, but increased again during the follow-up. In the parents, serum alpha- and beta-carotene concentrations were unchanged, while serum lutein and lycopene decreased by 7.3% (P=0.037) and 14.6% (P=0.044), respectively.
  
  
  CONCLUSIONS
  Sustained efficacy of cholesterol reduction and long-term compliance of PSE intake were demonstrated in this study.
authors.affiliation: Lipid Clinic, National Hospital, Oslo, Norway. agotlia@hotmail.com
authors.forename: A L
authors.initials: AL
authors.lastname: Amundsen
authors.forename: F
authors.initials: F
authors.lastname: Ntanios
authors.forename: N van der
authors.initials: Nv
authors.lastname: Put
authors.forename: L
authors.initials: L
authors.lastname: Ose
mesh_terms: D000293:Adolescent; D000328:Adult; D002338:Carotenoids / Q000097:blood*; D002648:Child; D002784:Cholesterol / Q000031:analogs & derivatives* / Q000097:blood*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000097:blood / Q000178:diet therapy*; D008055:Lipids / Q000097:blood*; D008297:Male; D008383:Margarine; D008875:Middle Aged; D010349:Patient Compliance; D010840:Phytosterols / Q000008:administration & dosage*; D012855:Sitosterols; D016896:Treatment Outcome
chemical_list: D008055:Lipids; D010840:Phytosterols; D012855:Sitosterols; D002338:Carotenoids; C021273:campesterol; C025473:gamma-sitosterol; D008383:Margarine; D002784:Cholesterol