Dose-dependent LDL-cholesterol lowering effect by plant stanol ester consumption: clinical evidence.
Dose-dependent LDL-cholesterol lowering effect by plant stanol ester consumption: clinical evidence.
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DOI：
10.1186/1476-511x-11-140
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发表时间：
2012-10-22
影响因子：
4.5
通讯作者：
Gylling H
中科院分区：
文献类型：
--
作者：
Laitinen K;Gylling H
血脂升高与心血管疾病有关，需要有效的治疗手段来降低低密度脂蛋白胆固醇 (LDL-C) 水平。植物甾烷醇通过部分阻止胆固醇吸收来降低 LDL-C 水平。因此，建议食用添加植物甾烷醇（通常在商业食品中用植物油脂肪酸酯化）的食品来降低血清胆固醇水平。经科学评估，每天摄入 1.5 至 2.4 克植物甾烷醇，可在不同人群、年龄和患有不同疾病的人群中降低 LDL-C 7 至 10%。根据早期研究，普遍的认识是摄入量超过约 2.5 克/天就无法进一步减少。然而，最近的研究表明，植物甾烷醇在降低血清 LDL-C 方面表现出持续的剂量反应效应。本综述讨论了每日植物甾烷醇摄入量为 4 克/天或更多时，植物甾烷醇酯消耗量与 LDL-C 浓度降低之间存在剂量效应关系的证据。我们确定了五项此类研究，总体数据表明，每日摄入 9 至 10 克植物甾烷醇与最相关的 LDL 胆固醇降低效果（18%）呈线性剂量效应关系。研究表明，随着低密度脂蛋白胆固醇的降低，胆固醇吸收标志物，即血清植物甾醇与胆固醇的比率，通过增加植物甾烷醇的摄入剂量而降低。每日摄入植物甾烷醇 10 克以下的研究均未报告植物甾烷醇对临床或生化产生不良影响。以类似的方式，血清抗氧化维生素减少的幅度与消耗的植物甾烷醇的剂量无关，并且植物甾烷醇酯消耗者和对照之间的差异很小并且不显着或不存在。高剂量食用植物甾烷醇是可行的，因为一系列食品可在商业上购买，包括涂抹酱和酸奶类饮料。总之，最近的临床研究和荟萃分析已经证明了高于目前推荐剂量的植物甾烷醇的剂量效应关系。需要进一步的研究为新的健康声明应用和饮食建议提供证实性证据。
Elevated serum lipids are linked to cardiovascular diseases calling for effective therapeutic means to reduce particularly LDL-cholesterol (LDL-C) levels. Plant stanols reduce levels of LDL-C by partly blocking cholesterol absorption. Accordingly the consumption of foods with added plant stanols, typically esterified with vegetable oil fatty acids in commercial food products, are recommended for lowering serum cholesterol levels. A daily intake of 1.5 to 2.4 g of plant stanols has been scientifically evaluated to lower LDL-C by 7 to 10% in different populations, ages and with different diseases. Based on earlier studies, a general understanding is that no further reduction may be achieved in intakes in excess of approximately 2.5 g/day. Recent studies however suggest that plant stanols show a continuous dose–response effect in serum LDL-C lowering. This review discusses the evidence for a dose-effect relationship between plant stanol ester consumption and reduction of LDL-C concentrations with daily intakes of plant stanols of 4 g/day or more. We identified five such studies and the overall data demonstrate a linear dose-effect relationship with the most pertinent LDL-Cholesterol lowering outcome, 18%, achieved by a daily intake of 9 to 10 g of plant stanols. Along with reduction in LDL-C, the studies demonstrated a decrease in cholesterol absorption markers, the serum plant sterol to cholesterol ratios, by increasing the dose of plant stanol intake. None of the studies with daily intakes up to 10 g of plant stanols reported adverse clinical or biochemical effects from plant stanols. In a like manner, the magnitude of decrease in serum antioxidant vitamins was not related to the dose of plant stanols consumed and the differences between plant stanol ester consumers and controls were minor and insignificant or nonexisting. Consumption of plant stanols in high doses is feasible as a range of food products are commercially available for consumption including spreads and yoghurt type drinks. In conclusion, a dose-effect relationship of plant stanols in higher doses than currently recommended has been demonstrated by recent clinical studies and a meta-analysis. Further studies are called for to provide confirmatory evidence amenable for new health claim applications and dietary recommendations.