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Cited by 209Lipoproteins and Cardiovascular HealthCholesterol and Lipid MetabolismNutritional Studies and Diet

Plant sterols and cardiovascular disease: a systematic review and meta-analysis†

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Genser, Bernd, Silbernagel, Günther, De Backer, Guy, Bruckert, Eric, Carmena, Rafael, Chapman, M. John, Deanfield, John, Descamps, Olivier S. +3 more·2012·European Heart Journal
DOI 10.1093/eurheartj/ehr441PMC PMC3279314
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Abstract

The impact of increased serum concentrations of plant sterols on cardiovascular risk is unclear. We conducted a systematic review and meta-analysis aimed to investigate whether there is an association between serum concentrations of two common plant sterols (sitosterol, campesterol) and cardiovascular disease (CVD). We systematically searched the databases MEDLINE, EMBASE, and COCHRANE for studies published between January 1950 and April 2010 that reported either risk ratios (RR) of CVD in relation to serum sterol concentrations (either absolute or expressed as ratios relative to total cholesterol) or serum sterol concentrations in CVD cases and controls separately. We conducted two meta-analyses, one based on RR of CVD contrasting the upper vs. the lower third of the sterol distribution, and another based on standardized mean differences between CVD cases and controls. Summary estimates were derived by fixed and random effects meta-analysis techniques. We identified 17 studies using different designs (four case-control, five nested case-control, three cohort, five cross-sectional) involving 11 182 participants. Eight studies reported RR of CVD and 15 studies reported serum concentrations in CVD cases and controls. Funnel plots showed evidence for publication bias indicating small unpublished studies with non-significant findings. Neither of our meta-analyses suggested any relationship between serum concentrations of sitosterol and campesterol (both absolute concentrations and ratios to cholesterol) and risk of CVD. Our systematic review and meta-analysis did not reveal any evidence of an association between serum concentrations of plant sterols and risk of CVD.

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  • A systematic review and meta-analysis of prospective cohort studies failed to show evidence of a protective association between serum concentrations of sitosterol and campesterol and CVD risk.

    “a systematic review and meta-analysis of prospective cohort studies of the relationship between serum concentrations of two common plant sterols (sitosterol, campesterol) and CVD risk failed to show evidence of a protective association.64”

    From Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-analysis of Controlled Trials (2018) · cites this paper as [64]

    The Discussion reports no evidence of an association between serum sitosterol or campesterol and CVD risk, supporting the claim that the review found no protective association. However, the Methods say the review included studies with different research designs, not only prospective cohort studies; the supplied passages do not give page numbers. (LLM, conf=0.90)

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Authors
Genser, B., Silbernagel, G., De Backer, G., Bruckert, E., Carmena, R., Chapman, M. J., Deanfield, J., Descamps, O. S., Rietzschel, E. R., Dias, K. C., & März, W.
Affiliations
  • Universidade Federal da Bahia (BR)
  • University of Tübingen (DE)
  • Inserm (FR)
  • University College London (GB)
  • Ghent University (BE)
  • Medical University of Graz (AT)
Corresponding author
Genser, Bernd
ORCID
Venue
European Heart Journal
Publisher
Oxford University Press (OUP)
Published
2012-02
Volume
33
Issue
4
Pages
444-451
ISSN
  • 0195-668X (ISSN-L)
  • 1522-9645
DOI
10.1093/eurheartj/ehr441
PMC
PMC3279314
OpenAlex
W2062160470
Cited by
209
References
71
Citations by year
2026: 2 · 2025: 7 · 2024: 9 · 2023: 17 · 2022: 13 · 2021: 15 · 2020: 11 · 2019: 10 · 2018: 15 · 2017: 17 · 2016: 10 · 2015: 25 · 2014: 25 · 2013: 23 · 2012: 9
FWCI
5.06
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • European Heart Journal (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion)
Funders
Danone
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Keywords
phytosterols, sitosterol, campesterol, cardiovascular disease, cardiovascular risk, cholesterol, publication bias
MeSH terms
Cardiovascular Diseases, Cholesterol, Diet, Epidemiologic Methods, Humans, Phytosterols, Risk Factors, Sitosterols, Publication Bias

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