title: A plant stanol yogurt drink alone or combined with a low-dose statin lowers serum triacylglycerol and non-HDL cholesterol in metabolic syndrome patients.
abstract: We evaluated the effects of 2 commonly available strategies (plant stanol ester drink and 10 mg simvastatin) on coronary heart disease (CHD) risk variables in participants with metabolic syndrome. Metabolic syndrome patients are at increased risk to develop CHD, partly due to high triacylglycerol (TAG) and low HDL cholesterol (HDL-C) concentrations and a low-grade inflammatory profile. Effects of plant stanol esters on TAG concentrations in these participants are unknown. After a 3-wk run-in period in which individuals consumed placebo yogurt drinks and placebo capsules, participants were randomly divided into 4 groups: placebo (n = 9), simvastatin + placebo drink (n = 10), placebo + stanol drink (n = 9), and simvastatin + stanol drink (n = 8). After 9 wk, we evaluated the effects on serum lipids, low-grade inflammation, and endothelial dysfunction markers. In metabolic syndrome patients, stanol esters (2.0 g/d), simvastatin, or the combination lowered non-HDL-C by 12.8% (P = 0.011), 30.7% (P < 0.001), and 35.4% (P < 0.001), respectively, compared with placebo. TAG were lowered by 27.5% (P = 0.044), 21.7% (P = 0.034), and 32.7% (P < 0.01), respectively. The total-:HDL-C ratio was significantly lowered in all 3 intervention groups. We found no treatment effects on the apolipoprotein CII:CIII ratio, cholesterol ester transfer protein mass, FFA concentrations, and markers for low-grade inflammation or endothelial dysfunction. This study shows that in metabolic syndrome patients, plant stanol esters lower not only non-HDL-C, but also TAG. Effects on TAG were also present in combination with statin treatment, illustrating an additional benefit of stanol esters in this CHD risk population.
authors.affiliation: Maastricht University, Department of Human Biology, 6200 MD, Maastricht, The Netherlands. j.plat@hb.unimaas.nl
authors.forename: Jogchum
authors.initials: J
authors.lastname: Plat
authors.forename: Gemma
authors.initials: G
authors.lastname: Brufau
authors.forename: Geesje M
authors.initials: GM
authors.lastname: Dallinga-Thie
authors.forename: Margreet
authors.initials: M
authors.lastname: Dasselaar
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Mensink
mesh_terms: D001053:Apolipoproteins / Q000097:blood; D001628:Beverages; D001835:Body Weight / Q000187:drug effects; D053480:Cholesterol Ester Transfer Proteins / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood*; D015243:Cholesterol, VLDL / Q000097:blood*; D004268:DNA-Binding Proteins / Q000235:genetics / Q000378:metabolism; D004359:Drug Therapy, Combination; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005786:Gene Expression Regulation / Q000502:physiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D000071518:Liver X Receptors; D024821:Metabolic Syndrome / Q000628:therapy*; D057093:Orphan Nuclear Receptors; D047493:PPAR alpha / Q000235:genetics / Q000378:metabolism; D018160:Receptors, Cytoplasmic and Nuclear / Q000235:genetics / Q000378:metabolism; D019821:Simvastatin / Q000494:pharmacology; D012855:Sitosterols / Q000008:administration & dosage / Q000494:pharmacology*; D014280:Triglycerides / Q000097:blood*; D015014:Yogurt
chemical_list: D001053:Apolipoproteins; C506642:CETP protein, human; D053480:Cholesterol Ester Transfer Proteins; D008078:Cholesterol, LDL; D015243:Cholesterol, VLDL; D004268:DNA-Binding Proteins; D005230:Fatty Acids, Nonesterified; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000071518:Liver X Receptors; D057093:Orphan Nuclear Receptors; D047493:PPAR alpha; D018160:Receptors, Cytoplasmic and Nuclear; D012855:Sitosterols; D014280:Triglycerides; C407042:plant stanol ester; D019821:Simvastatin