title: The role of soluble fiber intake in patients under highly effective lipid-lowering therapy.
abstract: BACKGROUND
  It has been demonstrated that statins can increase intestinal sterol absorption. Augments in phytosterolemia seems related to cardiovascular disease.
  
  
  OBJECTIVE
  We examined the role of soluble fiber intake in endogenous cholesterol synthesis and in sterol absorption among subjects under highly effective lipid-lowering therapy.
  
  
  METHODS
  In an open label, randomized, parallel-design study with blinded endpoints, subjects with primary hypercholesterolemia (n = 116) were assigned to receive during 12 weeks, a daily dose of 25 g of fiber (corresponding to 6 g of soluble fibers) plus rosuvastatin 40 mg (n = 28), rosuvastatin 40 mg alone (n = 30), sinvastatin 40 mg plus ezetimibe 10 mg plus 25 g of fiber (n = 28), or sinvastatin 40 mg plus ezetimibe 10 mg (n = 30) alone.
  
  
  RESULTS
  The four assigned therapies produced similar changes in total cholesterol, LDL-cholesterol, and triglycerides (p < 0.001 vs. baseline) and did not change HDL-cholesterol. Fiber intake decreased plasma campesterol (p < 0.001 vs. baseline), particularly among those patients receiving ezetimibe (p < 0.05 vs. other groups), and β-sitosterol (p = 0.03 vs. baseline), with a trend for lower levels in the group receiving fiber plus ezetimibe (p = 0.07). Treatment with rosuvastatin alone or combined with soluble fiber was associated with decreased levels of desmosterol (p = 0.003 vs. other groups). Compared to non-fiber supplemented individuals, those treated with fibers had weight loss (p = 0.04), reduced body mass index (p = 0.002) and blood glucose (p = 0.047).
  
  
  CONCLUSIONS
  Among subjects treated with highly effective lipid-lowering therapy, the intake of 25 g of fibers added favorable effects, mainly by reducing phytosterolemia. Additional benefits include improvement in blood glucose and anthropometric parameters.
authors.affiliation: Department of Medicine, Cardiology Division, Federal University of Sao Paulo, São Paulo, SP, Brazil.
authors.forename: Silvia C
authors.initials: SC
authors.lastname: Ramos
authors.forename: Francisco A
authors.initials: FA
authors.lastname: Fonseca
authors.forename: Soraia H
authors.initials: SH
authors.lastname: Kasmas
authors.forename: Flávio T
authors.initials: FT
authors.lastname: Moreira
authors.forename: Tatiana
authors.initials: T
authors.lastname: Helfenstein
authors.forename: Ney C
authors.initials: NC
authors.lastname: Borges
authors.forename: Ronilson A
authors.initials: RA
authors.lastname: Moreno
authors.forename: Vinicius M
authors.initials: VM
authors.lastname: Rezende
authors.forename: Fernanda C
authors.initials: FC
authors.lastname: Silva
authors.forename: Maria C
authors.initials: MC
authors.lastname: Izar
mesh_terms: D001384:Azetidines / Q000008:administration & dosage; D001786:Blood Glucose / Q000032:analysis; D002784:Cholesterol / Q000031:analogs & derivatives / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood / Q000187:drug effects*; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects*; D004043:Dietary Fiber / Q000008:administration & dosage*; D000069438:Ezetimibe; D005260:Female; D005464:Fluorobenzenes / Q000494:pharmacology; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000178:diet therapy; D007410:Intestinal Diseases / Q000097:blood; D008052:Lipid Metabolism, Inborn Errors / Q000097:blood; D008297:Male; D008875:Middle Aged; D010840:Phytosterols / Q000009:adverse effects / Q000097:blood; D011743:Pyrimidines / Q000494:pharmacology; D000068718:Rosuvastatin Calcium; D012855:Sitosterols / Q000008:administration & dosage; D013449:Sulfonamides / Q000494:pharmacology; D014280:Triglycerides / Q000097:blood
chemical_list: D001384:Azetidines; D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004043:Dietary Fiber; D005464:Fluorobenzenes; D010840:Phytosterols; D011743:Pyrimidines; D012855:Sitosterols; D013449:Sulfonamides; D014280:Triglycerides; C021273:campesterol; C025473:gamma-sitosterol; D000068718:Rosuvastatin Calcium; D002784:Cholesterol; D000069438:Ezetimibe