title: Plant stanol esters lower LDL cholesterol level in statin-treated subjects with type 1 diabetes by interfering the absorption and synthesis of cholesterol.
abstract: OBJECTIVE
  We investigated the effects of plant stanol esters (STAEST) on serum cholesterol and lipoprotein lipid concentrations and serum non-cholesterol sterols in patients with type 1 diabetes who were on statin treatment.
  
  
  METHODS
  In a randomized, double-blind, parallel study the intervention group (n=12) consumed vegetable oil-based spread enriched with STAEST (3.0 g/d of plant stanols), and the control group (n=12) consumed the same spread containing no added plant stanols for 4 weeks.
  
  
  RESULTS
  Serum total, LDL and non-HDL cholesterol concentrations were decreased by 9.6, 16.4 and 15.3% compared with the baseline concentrations in the STAEST group (P<0.05 for all). The respective reductions were 7.8, 14.8 and 12.2% compared with the controls (P<0.05 for all). No effects on HDL cholesterol or serum triglyceride concentrations were found. The STAEST consumption significantly decreased serum plant sterol concentrations and the ratios to cholesterol by 30-32 and 25-27% (P<0.05 for all) compared with the baseline levels, respectively. Cholesterol synthesis markers were not increased in the STAEST group, but serum lathosterol to campesterol ratio was significantly increased by 57% compared with the baseline levels indicating increased cholesterol synthesis at least to some extent in compensation for decreased cholesterol absorption. However, cholesterol homeostasis, intact at baseline and in the control group also during the intervention was lost in the STAEST group.
  
  
  CONCLUSIONS
  STAEST significantly decreased serum total, LDL and non-HDL cholesterol concentrations and thus offers an additional benefit to cholesterol lowering in patients with type 1 diabetes who are on statin treatment.
authors.affiliation: Institute of Public Health and Clinical Nutrition, Department of Clinical Nutrition, University of Eastern Finland, Kuopio, Finland. Maarit.Hallikainen@uef.fi
authors.forename: Maarit
authors.initials: M
authors.lastname: Hallikainen
authors.forename: Sudhir
authors.initials: S
authors.lastname: Kurl
authors.forename: Markku
authors.initials: M
authors.lastname: Laakso
authors.forename: Tatu A
authors.initials: TA
authors.lastname: Miettinen
authors.forename: Helena
authors.initials: H
authors.lastname: Gylling
mesh_terms: D015415:Biomarkers / Q000097:blood; D002784:Cholesterol / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D003131:Combined Modality Therapy; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications*; D004041:Dietary Fats / Q000008:administration & dosage* / Q000097:blood; D004311:Double-Blind Method; D015536:Down-Regulation; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000628:therapy*; D005260:Female; D005387:Finland; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012855:Sitosterols / Q000008:administration & dosage* / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL; D004041:Dietary Fats; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D012855:Sitosterols; C407042:plant stanol ester; D002784:Cholesterol