title: Serum plant sterols as surrogate markers of dietary compliance in familial dyslipidemias.
abstract: OBJECTIVE
  A well-balanced diet is the first-line treatment in hyperlipidemia. The objective was to study the association between serum phytosterols and dietary patterns to use them as surrogate markers of dietary compliance in primary dyslipidemias.
  
  
  METHODS
  288 patients with primary hyperlipidemias (192 autosomal dominant hypercholesterolemia (ADH) and 96 familial combined hyperlipidemia (FCHL)) were included. Principal factor analysis identified 2 major dietary patterns using a 137-item food frequency questionnaire. "Vegetable & Fruits pattern" was characterized by higher intake of fruits, green beans, nuts, tomatoes, roasted or boiled potatoes, lettuce and chard and lower of processed baked goods, pizza and beer. "Western pattern" was positively characterized by hamburgers, pasta, sunflower oil, rice, chickpeas, whole milk, veal, red beans and negatively with white fish. Serum non-cholesterol sterols were determined by HPLC-MS/MS.
  
  
  RESULTS
  Plant sterols to-total cholesterol (TC) levels were lower with a higher adherence to a "Vegetable & Fruits pattern" (P = 0.009), mainly in ADH subjects (R(2) = 0.019). Their concentration was greater with higher compliance to "Western pattern" especially in FCHL (P = 0.014). Higher levels of synthesis markers-to-TC with a greater adherence to "Vegetable & Fruits pattern" were found (P = 0.001) (R(2) = 0.033 and R(2) = 0.109 in ADH and FCHL respectively).
  
  
  CONCLUSIONS
  In subjects with primary dislipidemia, dietary patterns associate with serum absorption and synthesis markers, but no with lipid concentrations. The influence of diet on non-cholesterol sterols levels is not powerful enough to use them as subrogate markers.
authors.affiliation: Unidad de Lípidos and Laboratorio de Investigación Molecular, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de la Salud (I+CS), C/ Padre Arrupe s/n, 50009 Zaragoza, Spain. Electronic address: rmateo.iacs@aragon.es.
authors.forename: Rocío
authors.initials: R
authors.lastname: Mateo-Gallego
authors.affiliation: Unidad de Lípidos and Laboratorio de Investigación Molecular, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de la Salud (I+CS), C/ Padre Arrupe s/n, 50009 Zaragoza, Spain.
authors.forename: Lucía
authors.initials: L
authors.lastname: Baila-Rueda
authors.affiliation: GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, C/ Domingo Miral s/n, 50009 Zaragoza, Spain.
authors.forename: Theodora
authors.initials: T
authors.lastname: Mouratidou
authors.affiliation: Unidad de Lípidos and Laboratorio de Investigación Molecular, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de la Salud (I+CS), C/ Padre Arrupe s/n, 50009 Zaragoza, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: De Castro-Orós
authors.affiliation: Unidad de Lípidos and Laboratorio de Investigación Molecular, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de la Salud (I+CS), C/ Padre Arrupe s/n, 50009 Zaragoza, Spain.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Bea
authors.affiliation: Unidad de Lípidos and Laboratorio de Investigación Molecular, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de la Salud (I+CS), C/ Padre Arrupe s/n, 50009 Zaragoza, Spain.
authors.forename: Sofía
authors.initials: S
authors.lastname: Perez-Calahorra
authors.affiliation: Unidad de Lípidos and Laboratorio de Investigación Molecular, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de la Salud (I+CS), C/ Padre Arrupe s/n, 50009 Zaragoza, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Cenarro
authors.affiliation: GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, C/ Domingo Miral s/n, 50009 Zaragoza, Spain.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Moreno
authors.affiliation: Unidad de Lípidos and Laboratorio de Investigación Molecular, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de la Salud (I+CS), C/ Padre Arrupe s/n, 50009 Zaragoza, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Civeira
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D002851:Chromatography, High Pressure Liquid; D004032:Diet; D066273:Diet, Western; D005260:Female; D005638:Fruit; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood* / Q000178:diet therapy; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009754:Nuts; D010349:Patient Compliance; D010840:Phytosterols / Q000008:administration & dosage / Q000097:blood*; D010938:Plant Oils; D025341:Principal Component Analysis; D013030:Spain; D000074242:Sunflower Oil; D011795:Surveys and Questionnaires; D053719:Tandem Mass Spectrometry; D014675:Vegetables
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D010840:Phytosterols; D010938:Plant Oils; D000074242:Sunflower Oil
keywords: Dietary compliance; Dietary patterns; Familial hyperlipidemias; Phytosterols; Plant sterols