膳食植物甾醇或固醇既不堆积于狭窄的主动脉瓣也不影响其结构或炎症状态

Clin Nutr. 2015 Dec;34(6):1251-7.

Dietary plant stanols or sterols neither accumulate in stenotic aortic valves nor influence their structure or inflammatory status.

Simonen P, Lommi J, Hallikainen M, Helske-Suihko S, Werkkala K, Kupari M, Kovanen PT, Gylling H.

Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland.

Wihuri Research Institute, Helsinki, Finland.

Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.

Department of Medicine, Division of Internal Medicine, University of Helsinki, Helsinki, Finland.

BACKGROUND & AIMS: Consumption of plant stanols and plant sterols decreases LDL cholesterol level and increases serum concentrations of plant stanols/sterols, but it is practically unexplored whether also their tissue concentrations increase. Thus, the aim of this study was to assess whether consuming plant stanols/sterols increases their concentrations in stenotic aortic valves and affect the valvular structure (collagen and elastin) or inflammation (macrophages and mast cells).

METHODS: In a randomized, double-blind controlled intervention patients with severe aortic stenosis consumed margarine without (n = 11) or with 2 g of plant stanols (n = 12) or sterols (n = 13) until valve replacement surgery (2.6 months, on average). The effects of sitostanol and sitosterol on the expression and secretion of proinflammatory cytokines by cultured aortic valve myofibroblasts were also assessed.

RESULTS: Control-related LDL-cholesterol was diminished by 16% (p < 0.05) by plant stanol and by 11% (NS) by plant sterol consumption, respectively. In the resected valves, cholesterol, plant stanol and sterol levels were similar in all groups. Consumed plant stanols or sterols had no effect on valvular structure or mast cell or macrophage numbers in valves. Incubation of cultured myofibroblasts derived from stenotic valves with sitostanol or sitosterol decreased mRNA expression of the monocyte chemotactic protein-1 (p < 0.05) and interleukin-1 beta (p < 0.05).

CONCLUSIONS: In this study, plant stanol/sterol consumption did not affect cholesterol, plant stanol or sterol levels in stenotic aortic valves; neither did they influence the structure or the inflammatory status of the valves. However, these findings need to be confirmed in a larger-scale intervention. ClinicalTrials.govRegister #NCT00738933.

KEYWORDS: Cholesterol; Clinical trial; Cytokines; Macrophages; Sitostanol; Sitosterol

PMID: 25614126

DOI: 10.1016/j.clnu.2015.01.001