title: Moderately elevated plant sterol levels are associated with reduced cardiovascular risk--the LASA study.
abstract: Functional foods with supplementation of plant sterols are already used by millions of people. However, at the same time it is current scientific thinking that elevation of plant sterols in the circulation causes coronary heart disease. Therefore, this study aimed to define the risk for coronary heart disease associated with moderately high plant sterol plasma levels in a cohort of elderly. In this study, we evaluated the association between plant sterols and coronary heart disease in a cohort of 1242 subjects older than 65 years, participating at the Longitudinal Aging Study Amsterdam (LASA). Concentrations of sitosterol, campesterol, brassicasterol and stigmasterol were assessed using highly sensitive and specific gas chromatography-mass spectrometry-selected ion-monitoring. Plant sterol concentrations (and their ratios to cholesterol) were slightly, however, significantly lower in patients with coronary heart disease. Moreover, high plasma concentrations of a marker plant sterol, sitosterol, were associated with a markedly reduced risk for coronary heart disease (OR 0.78, CI 0.62-0.98, p<0.05). In contrast neither plant stanols (sitostanol or campestanol) nor the cholesterol synthesis markers (lathosterol, lanosterol and desmosterol) nor their ratios to cholesterol were significantly different in the study groups. These data suggest that plant sterols could have neutral or even protective effects on development of coronary heart disease, which have to be confirmed in interventional trials.
authors.affiliation: Department of Neurology, University Clinic of the Saarland, Kirrberger Str., D-68421 Homburg, Germany. Electronic address: Klaus.fassbender@uniklinikum-saarland.de.
authors.forename: Klaus
authors.initials: K
authors.lastname: Fassbender
authors.affiliation: Department of Clinical Pharmacology, University of Bonn, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany. Electronic address: dieter.luetjohann@ukb.uni-bonn.de.
authors.forename: Dieter
authors.initials: D
authors.lastname: Lütjohann
authors.affiliation: EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Miranda G
authors.initials: MG
authors.lastname: Dik
authors.affiliation: EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Marijke
authors.initials: M
authors.lastname: Bremmer
authors.affiliation: Department of Statistics, University Clinic of the Saarland, Germany.
authors.forename: Jochem
authors.initials: J
authors.lastname: König
authors.affiliation: Department of Neurology, University Clinic of the Saarland, Kirrberger Str., D-68421 Homburg, Germany.
authors.forename: Silke
authors.initials: S
authors.lastname: Walter
authors.affiliation: Department of Neurology, University Clinic of the Saarland, Kirrberger Str., D-68421 Homburg, Germany.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Neurology, University Clinic of the Saarland, Kirrberger Str., D-68421 Homburg, Germany.
authors.forename: Maryse
authors.initials: M
authors.lastname: Letièmbre
authors.affiliation: Department of Clinical Pharmacology, University of Bonn, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: von Bergmann
authors.affiliation: EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Cees
authors.initials: C
authors.lastname: Jonker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D016491:Peripheral Vascular Diseases / Q000097:blood / Q000453:epidemiology; D010840:Phytosterols / Q000097:blood*; D012307:Risk Factors; D012855:Sitosterols / Q000097:blood*
chemical_list: D010840:Phytosterols; D012855:Sitosterols; C003535:campestanol; C025473:gamma-sitosterol; D002784:Cholesterol; C021255:stigmastanol