Soluble fibre (Plantago ovata husk) reduces plasma low-density lipoprotein (LDL) cholesterol, triglycerides, insulin, oxidised LDL and systolic blood pressure in hypercholesterolaemic patients: A randomised trial.
The objective was to evaluate whether the soluble fibre Plantago ovata (Po)-husk improves cardiovascular disease (CVD) risk biomarkers including low-density lipoprotein cholesterol (LDL-C).


METHODS
In a multi-centred, double-blind, placebo-controlled, parallel, randomised trial conducted in primary care-clinics in Spain, France and Holland, mild-moderate hypercholesterolaemic patients (age range: 43-67 years) received 14 g/d of Po-husk (n=126) or placebo (microcrystalline-cellulose 14 g/d; n=128) in a low saturated fat diet for 8 weeks. Subsequently, if LDL-C remained > or = 3.35 mmol/L [130 mg/dL], participants proceeded with the fibre plus simvastatin (20mg/d) for further 8 weeks. Lipid profile, blood pressure (BP), insulin, oxidised LDL and some gene polymorphisms involved in CVD risk were measured.


RESULTS
Relative to placebo, Po-husk reduced plasma LDL-C by -6% (P<0.0002), total cholesterol (TC) by -6%, triglycerides (TG) by -21.6%, apolipoprotein (Apo) B-100 by -6.7%, oxidised LDL by a mean of -6.82 U/L (95%CI: 3.15-10.48), insulin by -4.68 pmol/L (95%CI: 0.68-8.67) and systolic BP by -4.0mm Hg (95%CI; 1.2-6.7) (P<0.05). The TG-lowering effect in the Po-husk group was magnified by variants in plasminogen-activator-inhibitor (PAI-1; rs1799768) and fatty acid-binding protein (FABP-2; rs1799883) genes. At 16 weeks, the intra-group action of simvastatin (20mg/d) added to Po-husk or placebo was a similar LDL-C reduction.


CONCLUSIONS
Po-husk, apart from lowering LDL-C, also reduced TG, TG related to certain gene variants, TC, Apo B-100, oxLDL, insulin-resistance and systolic BP in mild-moderate hypercholesterolaemic individuals. Thus, the target patients to receive Po-husk would be those who present a cluster of various CVD risk factors, such as metabolic syndrome.
Solà
Rosa
R
Unitat de Recerca en Lípids i Arteriosclerosi, CIBERDEM, Hospital Universitari Sant Joan, IISPV, Universitat ROVIRA i VIRGILI, Reus, Spain. rosa.sola@urv.cat
Bruckert
Eric
E
Valls
Rosa-Maria
RM
Narejos
Silvia
S
Luque
Xavier
X
Castro-Cabezas
Manuel
M
Doménech
Gema
G
Torres
Ferran
F
Heras
Mercedes
M
Farrés
Xavier
X
Vaquer
José-Vicente
JV
Martínez
José-Miguel
JM
Almaraz
Maria-Cruz
MC
Anguera
Anna
A
D000328:Adult; D000368:Aged; D008078:Cholesterol, LDL / Q000378:metabolism*; D004043:Dietary Fiber / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood*; D007328:Insulin / Q000378:metabolism*; D008077:Lipoproteins, LDL / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010919:Placebos; D010943:Plantago / Q000378:metabolism*; D019821:Simvastatin / Q000008:administration & dosage; D013599:Systole; D014280:Triglycerides / Q000378:metabolism*
D008078:Cholesterol, LDL; D004043:Dietary Fiber; D007328:Insulin; D008077:Lipoproteins, LDL; D010919:Placebos; D014280:Triglycerides; C099252:oxidized low density lipoprotein; D019821:Simvastatin