Additive effects of plant sterols supplementation in addition to different lipid-lowering regimens
Abstract
Objective Plant sterol (PS) supplementation has been widely used alone or combined with lipid-lowering therapies (LLTs) to reduce low-density lipoprotein (LDL) cholesterol. The effects of PS added to high-intensity LLT are less reported, especially regarding the effects on cholesterol synthesis and absorption.Methods A prospective, randomized, open-label study, with parallel arms and blinded end points was designed to evaluate the effects of addition of PS to LLT on LDL cholesterol, markers of cholesterol synthesis, and absorption. Eighty-six patients of both genders were submitted to a 4-wk run-in period with atorvastatin 10 mg (baseline). Following, subjects received atorvastatin 40 mg, ezetimibe 10 mg, or combination of both drugs for another 4-wk period (phase I). In phase II, capsules containing 2.0 g of PSs were added to previous assigned treatments for 4 wk. Lipids, apolipoproteins, plasma campesterol, β-sitosterol, and desmosterol levels were assayed at all time points. Within and between-group analyses were performed.Results Compared with baseline, atorvastatin 40 mg reduced total and LDL cholesterol (3% and 22%, respectively, P < .05), increased β-sitosterol, campesterol/cholesterol, and β-sitosterol/cholesterol ratios (39%, 47%, and 32%, respectively, P < .05); ezetimibe 10 mg reduced campesterol and campesterol/cholesterol ratio (67% and 70%, respectively, P < .05), and the combined therapy decreased total and LDL cholesterol (22% and 38%, respectively, P < .05), campesterol, β-sitosterol, and campesterol/cholesterol ratio (54%, 40%, and 27%, P < .05). Addition of PS further reduced total and LDL cholesterol by ∼ 7.7 and 6.5%, respectively, in the atorvastatin therapy group and 5.0 and 4.0% in the combined therapy group (P < .05, for all), with no further effects in absorption or synthesis markers.Conclusions PS added to LLT can further improve lipid profile, without additional effects on intestinal sterol absorption or synthesis.
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Nutraceuticals, either alone or in combination, when administered with statins seem to confer additional benefit on plasma lipid profiles, allowing statin doses to be reduced without diminishing total cholesterol and LDL-C reduction, and significantly limiting adverse effects.
“Nutraceuticals, either alone or in combination, when administered with statins seem to confer additional benefit on plasma lipid profiles (Table 5), allowing the statin doses to be reduced (in case of statin intolerance) without diminishing the results in terms of total cholesterol (TC) and LDL-C reduction (109-121) and significantly limiting adverse effects (122).”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [116]
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- Authors
- Malina, D. M. T., Fonseca, F. A., Barbosa, S. A., Kasmas, S. H., Machado, V. A., França, C. N., Borges, N. C., Moreno, R. A., & Izar, M. C.
- Affiliations
- Universidade Federal de São Paulo (BR)
- Universidade de Santo Amaro (BR)
- Corresponding author
- Izar, Maria C.
- Venue
- Journal of clinical lipidology
- Publisher
- Elsevier BV
- Published
- 2015-07
- Volume
- 9
- Issue
- 4
- Pages
- 542-552
- ISSN
- 1876-4789 (ISSN-L)
- 1933-2874
- OpenAlex
- W2131855630
- Cited by
- 25
- References
- 45
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 5 · 2019: 2 · 2018: 2 · 2017: 5 · 2016: 1 · 2015: 1
- FWCI
- 3.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of clinical lipidology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Health Sciences › Medicine › Surgery › Natural Products and Biological Research
- Keywords
- phytosterols, lipid-lowering therapy, LDL cholesterol, atorvastatin, ezetimibe, combination therapy, cholesterol absorption, cholesterol biosynthesis, campesterol, β-sitosterol, desmosterol, apolipoproteins, hypercholesterolemia
- MeSH terms
- Atorvastatin, Ezetimibe, Aged, Anticholesteremic Agents, Apolipoproteins, Cholesterol, Drug Synergism, Female, Humans, Hypercholesterolemia, Lipids, Cholesterol, LDL, Male, Middle Aged, Phytosterols, Sitosterols, Dietary Supplements, Lipid Metabolism
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