title: "Add-on" effect of phytosterols-enriched fermented milk on lipids and markers of cholesterol metabolism in statin-treated elderly patients.
abstract: The effect of plant sterol (PS) enriched matrices on lipid profile has been evaluated in statin-treated individuals, with LDL-C concentrations between 3.35mmol/L and 4.90mmol/L, but studies in the elderly are scarce. In this study the additional effect of a low-fat PS-enriched fermented milk (PS-FM) on cholesterol metabolism markers and serum lipids was evaluated in the elderly on stable statin therapy with baseline LDL-C<3.35mmol/L. Thirty-five individuals (88.6% women; 81±8years old; BMI 29.9±6.0kg/m(2)), living in elderly nursing care facilities were placed on a daily intake of 2g PS-FM for 6weeks, in addition to their statin monotherapy. A fasting blood sample was collected at baseline (t0), after 2 consecutive periods of 3weeks intake (t1 and t2), and after 6weeks of washout (t3), for the analysis of serum lipid profile and cholesterol synthesis (lathosterol, desmosterol) and absorption (sitosterol, campesterol and cholestanol) markers. PS-FM consumption led to a LDL-C reduction of 0.15mmol/L (t1) and 0.27mmol/L (t2) from baseline (P<0.05). Serum campesterol and sitosterol (P<0.001) increased (t0-t1; t0-t2), reflecting PS intake and contributing to the inhibition of cholesterol intestinal absorption, leading to a decrease in cholestanol-to-cholesterol ratio. There was a reciprocal homeostatic rise of serum cholesterol precursors, desmosterol and lathosterol (P<0.001) from baseline, based on the up-regulation of the opposing pathway. Statin-treated elderly individuals, with baseline LDL-C<3.35mmol/L, may still have therapeutic benefit from strategies that reduce cholesterol absorption, such as 2g/day PS-FM.
authors: Instituto Politécnico de Coimbra, ESTESC-Coimbra Health School, Ciências Complementares, Rua 5 Outubro, S. Martinho do Bispo, Apartado 7006, 3046-854 Coimbra, Portugal; CEF - Center for Pharmaceutical Studies, Health Sciences Campus, Pharmacy Faculty, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal. Electronic address: imandrade@estescoimbra.pt.
authors: Isabel
authors: I
authors: Andrade
authors: Department of Internal Medicine, Coimbra University Hospitals, Medicine Faculty, University of Coimbra, 3000-075 Coimbra, Portugal.
authors: Lèlita
authors: L
authors: Santos
authors: CEF - Center for Pharmaceutical Studies, Health Sciences Campus, Pharmacy Faculty, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; CNC - Center for Neuroscience and Cell Biology, Pharmacy Faculty, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal.
authors: Fernando
authors: F
authors: Ramos
mesh_terms: D000368:Aged; D000818:Animals; D015415:Biomarkers / Q000097:blood / Q000378:metabolism; D002784:Cholesterol / Q000097:blood / Q000378:metabolism*; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D005285:Fermentation; D006706:Homeostasis / Q000187:drug effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D050356:Lipid Metabolism / Q000187:drug effects*; D008297:Male; D008892:Milk / Q000737:chemistry*; D010840:Phytosterols / Q000494:pharmacology*
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010840:Phytosterols; D002784:Cholesterol
keywords: Cholesterol absorption markers; Cholesterol synthesis markers; Elderly; Plant sterols; Statin