cytellin and Hyperlipidemias

Plant sterols and stanols are plant steroids with a similar chemical structure and cellular function to human cholesterol, and are recommended as dietary modifiers of serum lipids. Plant sterols have a higher degree of absorption than plant stanols, suggesting differential efficacy between the two.. A meta-analysis of randomized controlled trials was performed to summarize direct comparisons between the effect of plant sterols vs plant stanols on serum lipid levels in healthy patients and patients with hypercholesterolemia.. A systematic literature search of MEDLINE, EMBASE, Cochrane CENTRAL, and the Natural Medicines Comprehensive Database was conducted from January 1950 through January 2009. Trials were included in the analysis if they were randomized controlled trials evaluating the effect of plant sterols vs plant stanols in healthy patients or patients with hypercholesterolemia who reported efficacy data on total, low-density lipoprotein, and high-density lipoprotein cholesterols or triglycerides. The weighted mean difference (WMD) of the change from baseline (in mg/dL) with 95% confidence interval was calculated as the difference between the means in the plant sterol and plant stanol groups using a random-effects model.. Fourteen studies (n=531 patients) met the inclusion criteria. Upon meta-analysis, the results showed that there is no statistically or clinically significant difference between plant sterols and plant stanols in their abilities to modify total cholesterol (WMD -1.11 mg/dL [-0.0286 mmol/L], 95% confidence interval [CI] -4.12 to 1.90, P=0.47), low-density lipoprotein cholesterol (WMD -0.35 mg/dL [-0.0091 mmol/L], 95% CI -2.98 to 2.28, P=0.79), high-density lipoprotein cholesterol (WMD -0.28 mg/dL [-0.00073 mmol/L], 95% CI -1.18 to 0.62, P=0.54), or triglycerides (WMD -1.80 mg/dL [-0.0203 mmol/L], 95% CI -6.80 to 3.21, P=0.48).. Plant sterols and plant stanols do not have statistically or clinically relevant differing effects on total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, or triglyceride levels. The selection of plant sterols vs plant stanols should then be based on potential differences in safety parameters and further study is required to elucidate such differences.

Topics: Anticholesteremic Agents; Cholesterol, HDL; Cholesterol, LDL; Humans; Hyperlipidemias; Lipid Metabolism; Phytosterols; Phytotherapy; Randomized Controlled Trials as Topic; Sitosterols; Treatment Outcome; Triglycerides

Plant sterols and stanols are similar in chemical structure to cholesterol, differing in their side chain configuration. The mechanism by which they lower cholesterol is thought to involve inhibition of cholesterol absorption. A number of products containing plant sterols are now available. A limitation on the development of such products is the poor water solubility of plant sterols. The most common solution is to esterify plant stanols or sterols with fatty acids to enhance availability in food fats such as margarines and salad dressings. A number of studies have shown the efficacy of plant stanol- and sterol-enriched margarines for lowering cholesterol. However, there have been no studies demonstrating that consumption of these stanol ester-containing margarines influences the incidence of coronary heart disease.

Topics: Administration, Oral; Clinical Trials as Topic; Coronary Artery Disease; Diet Therapy; Dietary Supplements; Evidence-Based Medicine; Food, Formulated; Humans; Hyperlipidemias; Hypolipidemic Agents; Phytosterols; Phytotherapy; Plant Extracts; Sitosterols

Topics: Humans; Hyperlipidemias; Sitosterols

To compare the efficacy and safety of plant sterols and stanols as well as policosanol in the treatment of coronary heart disease, as measured by a reduction in low-density lipoprotein cholesterol (LDL) levels.. Systematic review and meta-analysis of randomized controlled trials.. A total of 4596 patients from 52 eligible studies.. We searched MEDLINE, EMBASE, the Web of Science, and the Cochrane Library from January 1967-June 2003 to identify pertinent studies. Reduction of LDL levels was the primary end point; effects on other lipid parameters and withdrawal of study patients due to adverse effects were the secondary end points. Weighted estimates of percent change in LDL were -11.0% for plant sterol and stanol esters 3.4 g/day (range 2-9 g/day [893 patients]) versus -2.3% for placebo (769 patients) in 23 eligible studies, compared with -23.7% for policosanol 12 mg/day (range 5-40 mg/day [1528 patients]) versus -0.11% for placebo (1406 patients) in 29 eligible studies. Cumulative p values were significantly different from placebo for both (p<0.0001). The net LDL reduction in the treatment groups minus that in the placebo groups was greater with policosanol than plant sterols and stanols (-24% versus -10%, p<0.0001). Policosanol also affected total cholesterol, high-density lipoprotein cholesterol (HDL), and triglyceride levels more favorably than plant sterols and stanols. Policosanol caused a clinically significant decrease in the LDL:HDL ratio. Pooled withdrawal rate due to adverse effects and combined relative risk for patients who withdrew were 0% and 0.84, respectively (95% confidence interval [CI] 0.36-1.95, p=0.69), for plant sterols and stanols across 20 studies versus 0.86% and 0.31, respectively (95% CI 0.20-0.48, p<0.0001), for policosanol across 28 studies.. Plant sterols and stanols and policosanol are well tolerated and safe; however, policosanol is more effective than plant sterols and stanols for LDL level reduction and more favorably alters the lipid profile, approaching antilipemic drug efficacy.

Topics: Anticholesteremic Agents; Coronary Disease; Fatty Alcohols; Humans; Hyperlipidemias; Phytosterols; Randomized Controlled Trials as Topic; Sitosterols

The unraveling of genetic defects associated with disorders in lipid metabolism has contributed to the understanding of lipoprotein metabolism and the pathophysiological consequences of a particular mutation. The translation, however, of a single genetic defect into the individual's risk of cardiovascular disease and subsequent treatment strategies is an extremely complex issue that involves the identification of multiple additional determinants, including genetic, metabolic and environmental factors. The discovery of these factors, including genetic determinants of drug efficacy, provides insight into the interaction between regulatory systems traditionally thought to be unrelated and may, in the future, lead to a more complete diagnostic and therapeutic appreciation of the individual patient.

Topics: Animals; Humans; Hypercholesterolemia; Hyperlipidemias; Hyperlipoproteinemias; Hypertriglyceridemia; Hypolipidemic Agents; Lipoproteins; Sitosterols

Effective treatment of dyslipidemia improves prognosis. Statin therapy has been documented to decrease the cardiovascular event rate in the setting of elevated low-density lipoprotein (LDL) cholesterol levels and coronary heart disease, but most patients are not treated to the target (LDL

Topics: Anion Exchange Resins; Cholesterol, LDL; Drug Therapy, Combination; Fish Oils; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hyperlipidemias; Hypolipidemic Agents; Niacin; Sitosterols

The basis for treatment of lipid disorders in patients with non-insulin-dependent diabetes mellitus is weight reduction by diet and exercise, and additional control of glycaemic condition with oral antidiabetics, alone or in combination with insulin. Hypercholesterolaemic, mildly hypertriglyceridaemic non-insulin-dependent diabetes mellitus patients respond to cholesterol malabsorption caused by dietary sitostanol ester margarine, while long-term statin treatment of respective coronary patients significantly lowers the recurrence of coronary events, in addition to improving the lipid disorder. However, no information is available concerning the preventive effect of long-term improvement of lipid disorders in non-insulin-dependent diabetes mellitus patients without coronary heart disease, or in patients with the 'classical' type of diabetic lipid disorder, that is, hypertriglyceridaemia with low HDL and normal-low LDL-cholesterol levels. In this group of patients, beneficial lipid effects can be obtained (although perhaps not normalization) with fibrates alone or, especially, in combination with current statins.

Topics: Anticholesteremic Agents; Diabetes Mellitus, Type 2; Diet; Exercise; Humans; Hyperlipidemias; Hypoglycemic Agents; Hypolipidemic Agents; Sitosterols

Working from the foundation of the role of diet in the pathogenesis of hyperlipidemia, the authors present a rational, detailed therapy for treating the disorder. A three-phase approach is offered so that the patient can gradually incorporate new eating behavior into his or her lifestyle.

Topics: Body Weight; Cholesterol, Dietary; Chylomicrons; Diabetes Mellitus; Dietary Carbohydrates; Dietary Fats; Dietary Fiber; Dietary Proteins; Energy Intake; Ethanol; Humans; Hyperlipidemias; Hypertension; Lipid Metabolism; Phosphatidylcholines; Sitosterols

Topics: Cholesterol, Dietary; Cholestyramine Resin; Clofibrate; Colestipol; Dietary Fats; Drug Therapy, Combination; Humans; Hyperlipidemias; Hyperlipoproteinemia Type II; Hyperlipoproteinemia Type IV; Lipoproteins, LDL; Lipoproteins, VLDL; Niacin; Nicotinic Acids; Sitosterols

Topics: Arteriosclerosis; Child; Cholelithiasis; Cholestyramine Resin; Clofibrate; Colestipol; Dextrothyroxine; Humans; Hyperlipidemias; Hypolipidemic Agents; Lipoproteins, LDL; Lipoproteins, VLDL; Nicotinic Acids; Phenoxyacetates; Sitosterols

Topics: Cholestyramine Resin; Dextrothyroxine; Humans; Hypercholesterolemia; Hyperlipidemias; Hypolipidemic Agents; Lipoproteins; Neomycin; Nicotinic Acids; Oxandrolone; Probucol; Sitosterols; Triglycerides

Topics: Alcoholism; Arteriosclerosis; Blood Circulation; Carbon Monoxide; Cholestyramine Resin; Diabetes Mellitus; Humans; Hyperlipidemias; Hypertension; Nicotinic Acids; Physical Education and Training; Risk; Sitosterols; Smoking

Topics: Aminosalicylic Acid; Animals; Cholestyramine Resin; Clofibrate; Colestipol; Dextrothyroxine; Dogs; Drug Therapy, Combination; Humans; Hyperlipidemias; Hypolipidemic Agents; Lipoproteins; Neomycin; Nicotinic Acids; Rats; Sitosterols

Topics: Cholesterol; Cholesterol, Dietary; Dietary Fats; Energy Intake; Fatty Acids, Unsaturated; Humans; Hyperlipidemias; Lipoproteins; Nutritional Physiological Phenomena; Sitosterols

Topics: Blood Proteins; Cholesterol; Cholestyramine Resin; Chylomicrons; Clofibrate; Costs and Cost Analysis; Diet Therapy; Drug Therapy, Combination; Humans; Hyperlipidemias; Hypolipidemic Agents; Lipoproteins; Lipoproteins, HDL; Lipoproteins, LDL; Lipoproteins, VLDL; Neomycin; Nicotinic Acids; Phospholipids; Sitosterols; Thyroxine; Triglycerides

Topics: Aminosalicylic Acids; Androgens; Bile Acids and Salts; Butyrates; Cellulose; Cholestyramine Resin; Clofibrate; Contraceptives, Oral; Female; Gonadal Steroid Hormones; Halofenate; Humans; Hyperlipidemias; Hypolipidemic Agents; Intestinal Absorption; Lignin; Lipid Metabolism; Lipid Mobilization; Male; Nafenopin; Neomycin; Nicotinic Acids; Oxandrolone; Probucol; Progestins; Sitosterols; Sterols; Thyroxine; Triglycerides

Consumption of a cholesterol lowering dietary portfolio including plant sterols (PS), viscous fibre, soy proteins and nuts for 6 months improves blood lipid profile. Plant sterols reduce blood cholesterol by inhibiting intestinal cholesterol absorption and concerns have been raised whether PS consumption reduces fat soluble vitamin absorption.. The objective was to determine effects of consumption of a cholesterol lowering dietary portfolio on circulating concentrations of PS and fat soluble vitamins.. Using a parallel design study, 351 hyperlipidemic participants from 4 centres across Canada were randomized to 1 of 3 groups. Participants followed dietary advice with control or portfolio diet. Participants on routine and intensive portfolio involved 2 and 7 clinic visits, respectively, over 6 months.. No changes in plasma concentrations of α and γ tocopherol, lutein, lycopene and retinol, but decreased β-carotene concentrations were observed with intensive (week 12: p = 0.045; week 24: p = 0.039) and routine (week 12: p = 0.031; week 24: p = 0.078) portfolio groups compared to control. However, cholesterol adjusted β-carotene and fat soluble compound concentrations were not different compared to control. Plasma PS concentrations were increased with intensive (campesterol:p = 0.012; β-sitosterol:p = 0.035) and routine (campesterol: p = 0.034; β-sitosterol: p = 0.080) portfolio groups compared to control. Plasma cholesterol-adjusted campesterol and β-sitosterol concentrations were negatively correlated (p < 0.001) with total and LDL-C levels.. Results demonstrate that consuming a portfolio diet reduces serum total and LDL-C levels while increasing PS values, without altering fat soluble compounds concentrations. The extent of increments of PS with the current study are not deleterious and also maintaining optimum levels of fat soluble vitamins are of paramount necessity to maintain overall metabolism and health. Results indicate portfolio diet as one of the best options for CVD risk reduction.. clinicaltrials.gov Identifier: NCT00438425.

Topics: Adult; beta Carotene; Canada; Carotenoids; Cholesterol; Cholesterol, HDL; Cholesterol, LDL; Diet; Dietary Fiber; Feeding Behavior; Female; Follow-Up Studies; Humans; Hyperlipidemias; Lutein; Lycopene; Male; Middle Aged; Nuts; Phytosterols; Single-Blind Method; Sitosterols; Tocopherols; Triglycerides; Vitamin A; Vitamins

Non-cholesterol sterols reflect cholesterol metabolism. Statins reduce cholesterol synthesis usually with a rise in cholesterol absorption. Common hyperlipemias have shown different patterns of cholesterol metabolism. We evaluated whether cholesterol absorption and synthesis may differ after statin therapy in primary hyperlipemias.. We determined lipid profile, apoprotein B and serum sterols (lathosterol, sitosterol, campesterol by gas chromatography/mass spectrometry) before and after statins in 80 untreated hyperlipemic patients, 40 with polygenic hypercholesterolemia (PH) and 40 with familial combined hyperlipemia (FCH).. At baseline in FCH lathosterol was significantly higher while campesterol and sitosterol were significantly lower than in PH. After statins, the reduction in LDL-C did not significantly differ between the two groups; in PH there was a significant decrease of lathosterol from 96.1 to 52.6 102 μmol/mmol cholesterol (p=0.0001) with no significant modifications in campesterol and sitosterol; on the opposite, in FCH lathosterol decreased from 117 to 43 102 μmol/mmol cholesterol (p=0.0001) and campesterol and sitosterol significantly increased from 38 to 48 102 μmol/mmol cholesterol (p=0.0001), and from 75 to 86 102 μmol/mmol cholesterol, (p=0.022), respectively. After statin therapy only in FCH Δ-LDL-C showed a significant inverse correlation with Δ-sitosterol and with Δ-campesterol.. Primary hyperlipemias show different patterns of response to statins: in PH LDL reduction appears completely "synthesis inhibition" dependent, while in FCH LDL decrease appears to be synthesis dependent, partially limited by absorption increase. Studying cholesterol metabolism before and after hypolipemic therapy might be useful in identifying the best tailored treatment.

Topics: Adult; Aged; Atorvastatin; Cholesterol; Cholesterol, LDL; Female; Gas Chromatography-Mass Spectrometry; Heptanoic Acids; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypercholesterolemia; Hyperlipidemia, Familial Combined; Hyperlipidemias; Lipids; Male; Middle Aged; Phytosterols; Pyrroles; Simvastatin; Sitosterols

Plant stanols have been recommended in combination with individualized dietary interventions to reduce plasma cholesterol concentrations. It is unclear whether plant stanols in combination with dietary guidance in patients already using optimal doses of statins will further reduce fasting and postprandial lipids compared with standard care.. This single-blind, randomized study investigated the effect of plant stanols in margarines, combined with a lipid-lowering dietary intervention, in patients already on lipid-lowering medications at maximal doses not reaching their target lipid levels. Nutrition education was based on the stages of change theory. The control group (which served as the standard care control group) was also taking optimal doses of statins. This group received a margarine without plant stanols and a leaflet with Dutch nutrition guidelines. Fasting lipids were measured once in venous samples and postprandial lipemia was assessed by self-measured triglycerides in an outpatient setting. All subjects were given a capillary triglyceride measuring device (Accutrend GCT, Roche Diagnostics, Mannheim, Germany) and were instructed to measure their capillary triglycerides at six fixed time-points throughout the day on three different days. The mean area under the triglyceride curve represented total daylong triglyceridemia, which has been shown to reflect postprandial triglyceridemia. Twenty patients were included, 11 in the intervention group and 9 in the control group.. In the plant stanol group, low-density lipoprotein cholesterol decreased significantly by 15.6% compared with a reduction of only 7.7% in the control group. The daylong triglyceridemia was similar in both groups at the beginning and at the end of the study, and no change was observed by the intervention.. Intensive dietary intervention with addition of plant stanols results in clinically relevant reduction of low-density lipoprotein cholesterol in patients optimally treated with statins, compared with similar patients on statins receiving only standard care. The use of a plant stanol-enriched margarine did not decrease postprandial triglyceridemia in these patients.

Topics: Area Under Curve; Cholesterol; Cholesterol, LDL; Diet, Fat-Restricted; Fasting; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hyperlipidemias; Male; Margarine; Middle Aged; Netherlands; Patient Compliance; Postprandial Period; Quality of Life; Single-Blind Method; Sitosterols; Treatment Outcome; Triglycerides

The extent to which sterols and stanols modulate LDL particle size is unknown. We examined the effects of supplementation with unesterified plant sterols and stanols on several LDL electrophoretic characteristics. Healthy hypercholesterolemic subjects (n = 14) consumed each of four experimental diets contained plant sterols (S), plant stanols (SN), a 50:50 mixture of sterols and stanols (SSN), or cornstarch (control) in a randomized crossover design. The butter component of the diet was blended with unesterified sterols and stanols at a dose of 1.8 g/d. The LDL particles were characterized by polyacrylamide gradient gel electrophoresis of whole plasma. LDL cholesterol (LDL-C) concentrations decreased by 8.8, 13.6, and 13.1% in the S, SN, and SSN groups, respectively (P < 0.01) with a significant increase of 4.3% in the control group. None of the treatments with sterols and stanols induced significant changes in LDL peak particle diameter or in the cholesterol levels of the small LDL subfraction (<25.5 nm). The reduction in plasma LDL-C levels with SN consumption was due mainly to a decrease (P < 0.05) in the concentration of cholesterol in the large subfraction (>26.0 nm). The significant reduction in plasma LDL-C concentrations by sterol and stanol consumption in subjects was not paralleled by any beneficial changes in LDL electrophoretic characteristics.

Topics: Cholesterol, HDL; Cholesterol, LDL; Cross-Over Studies; Double-Blind Method; Female; Humans; Hyperlipidemias; Lipids; Lipoproteins, LDL; Male; Middle Aged; Phytotherapy; Sitosterols; Sterols; Triglycerides

Dietary plant sterols (phytosterols) have been shown to lower plasma lipid concentrations in animals and humans. However, the effect of phytosterol intake from tall oil on cholesterol and phytosterol metabolism has not been assessed in subjects fed precisely controlled diets.. Our objective was to examine the effects of sitostanol-containing phytosterols on plasma lipid and phytosterol concentrations and de novo cholesterol synthesis rate in the context of a controlled diet.. Thirty-two hypercholesterolemic men were fed either a diet of prepared foods alone or a diet containing 1.7 g phytosterols/d for 30 d in a parallel study design.. No overall effects of diet on total cholesterol concentrations were observed, although concentrations were lower with the phytosterol-enriched than with the control diet on day 30 (P < 0.05). LDL-cholesterol concentrations on day 30 had decreased by 8.9% (P < 0.01) and 24.4% (P < 0.001) with the control and phytosterol-enriched diets, respectively. HDL-cholesterol and triacylglycerol concentrations did not change significantly. Moreover, changes in circulating campesterol and beta-sitosterol concentrations were not significantly different between phytosterol-fed and control subjects. In addition, there were no significant differences in fractional (0.091 +/- 0.028 and 0.091 +/- 0.026 pool/d, respectively) or absolute (0.61 +/- 0.24 and 0.65 +/- 0.23 g/d, respectively) synthesis rates of cholesterol observed between control and phytosterol-fed subjects.. Addition of blended phytosterols to a prudent North American diet improved plasma LDL-cholesterol concentrations by mechanisms that did not result in significant changes in endogenous cholesterol synthesis in hypercholesterolemic men.

Topics: Adult; Anticholesteremic Agents; Cholesterol; Cholesterol, HDL; Cholesterol, LDL; Chromatography, Gas; Humans; Hyperlipidemias; Male; Middle Aged; Phytosterols; Sitosterols; Triglycerides

The effect of beta-sitosterol on plasma lipids and lipoproteins was evaluated in a randomized double-blind cross-over trial in 15 children and adolescents with familial hypercholesterolemia over a period of 6 months. Twelve patients completed the study, with good adherence to drug intake. Sitosterol lowered the plasma total choelsterol by 6%, LDL cholesterol by 7% and HDL cholesterol by 15% (P less than 0.05). This insufficient response of total and LDL cholesterol and the marked fall of HDL cholesterol appears to advise against the use of beta-sitosterol granulate in juvenile type II hyperlipoproteinemia.

Topics: Adolescent; Adult; Bromides; Child; Cholesterol; Clinical Trials as Topic; Double-Blind Method; Humans; Hyperlipidemias; Lipoproteins, HDL; Lipoproteins, LDL; Sitosterols; Triglycerides

The effect of beta-sitosterol on the lipid and lipoprotein level was evaluated in a randomised double-blind cross-over trial in 24 patients with primary familial type II hyperlipoproteinaemia over a period of 16 weeks. All patients completed the trial, however 10 of them had to be excluded from the evaluation due to fluctuations of their body weight or unreliable drug intake. Sitosterol lowered the total cholesterol level by 12.5% (P less than 0.01) from 9.96 mmol/l (3.69 g/l) to 8.37 mmol/l (3.23 g/l). The LDL-cholesterol level was lowered by 19.5% (P less than 0.05). The sitosterol concentration in plasma was consistently lower than 0.3% of total cholesterol. No side effects or tachyphylaxis was observed in the course of the trial. A return to normal of an increased serum cholesterol level by a combination of a lipid lowering diet and sitosterol monotherapy was only achieved in one patient.

Topics: Adolescent; Adult; Cholesterol; Clinical Trials as Topic; Female; Humans; Hyperlipidemias; Lipoproteins, LDL; Lipoproteins, VLDL; Male; Middle Aged; Placebos; Sitosterols

Topics: Cholesterol; Cholesterol, LDL; Desmosterol; Humans; Hypercholesterolemia; Hyperlipidemias; Hyperlipoproteinemia Type II; Lipids; Sitosterols; Squalene; Stigmasterol

The hypolipidemic effect of phytosterols has been wildely recognized, but its application is limited due to its insolubility in water and low solubility in oil. In this study, β-sitosterol ester with linoleic acids and β-sitosterol self-microemulsions were prepared and their hypolipidemic effects on hyperlipidemia mice were studied.. Firstly, the mice were randomly divided into normal group and model group,they were fed with basic diet and high-fat diet for 70 days respectively. After high-fat model mice was successfully established, the model group was further divided into eight groups: HFD (high-fat diet feeding), SELA-TSO(8 ml/kg, SELA:700 mg/kg), TSO (8 ml/kg), SSSM (8 ml/kg,SS:700 mg/kg), NLSM (8 ml/kg), SSHT-TSO (8 ml/kg, SS: 700 mg/kg) and SS-TSO (8 ml/kg, SS: 700 mg/kg) groups, and treated with β-sitosterol ester with linoleic acid, β-sitosterol self-microemulsion, commercial β-sitosterol health tablets and β-sitosterol powder for 35 days, respectively, and blank control groups were established. At the end of the treatment period, the blood lipid level, tissues, cholesterol and lipids in feces of mice in each group were investigated. Statistical and analytical data with SPSS 17.0 Software,statistical significance was set at p* < 0.05 and p** < 0.01 levels .. The order of lowering blood lipid effect is listed as: SSSM> SELA-TSO > SSHT-TSO > SS-TSO, which shows that β-sitosterolself-microemulsion have the highest treatment effect among the experimental groups.. In this study, a new formulation of β-sitosterol was developed, and its hypolipidemic effect was investigated. The results showed that β-sitosterol self-microemulsion has a good blood lipid lowering effect.

Topics: Administration, Oral; Animals; Body Weight; Eating; Emulsions; Feces; Hyperlipidemias; Hypolipidemic Agents; Linoleic Acid; Lipids; Male; Mice; Microscopy, Electron, Transmission; Organ Size; Sitosterols; Tablets

Hypolipidemic effect of Portulaca oleracea L. seed extract and its fractions have been studied on streptozotocin (STZ) at dose 75 mg/kg b.wt. After fractionation of the alcoholic extract; petroleum ether fraction was the most active fraction that decreased different hyperlipidemia biochemical parameters. After chromatographic analysis; oleamide, ethylpalmitate, β-amyrin, stigmasterol and β-sitosterol were identified. The GLC analysis of unsaponifiable matter revealed the presence of; lignoceric acid as a major constituent in the most bioactive fraction. In conclusion, petroleum ether fraction possessed a hypolipidemic effect in STZ-induced diabetic rats, which may be attributed to its phytosterols, fatty acid and amide compounds. The finding of the present investigation strongly demonstrates the potential of non-polar fraction of P. oleracea L. seed in combating hyperlipidemia in diabetic condition. So the petroleum ether fractions and its constituents can be used as hypolipdemic supplement in the developing countries towards the development of new therapeutic agents.

Topics: Animals; Diabetes Mellitus, Experimental; Hyperlipidemias; Hypolipidemic Agents; Male; Phytosterols; Phytotherapy; Plant Extracts; Portulaca; Rats; Seeds; Sitosterols; Stigmasterol; Streptozocin

Hyperlipidemia characterized of elevated serum lipid levels is a prevalent disease frequently resulting in cardiovascular disease (CVD). Berberine and evodiamine are herbal products of traditional Chinese herb Coptis chinensis and Evodia rutaecarpa, which are indicated to exert regulation of lipid metabolism. Therefore, the objective of this study was to investigate the lipid-lowering effect of berberine and evodiamine combination in hyperlipidemic rats.. The rat model of hyperlipidemia was established by providing high-fat-diet (HFD) for 4 weeks. Berberine (BB), evodiamine (EV), and their combination (BB + EV) were orally administered to HFD induced rats for 4 weeks. Body weight, food utilization, histopathology of liver tissues, lipid profiles of serum and liver were measured. Gas chromatography (GC) analysis was applied to examine the level of plasma total cholesterol and ß- Sitosterol (BS) to estimate cholesterol absorption activity. Furthermore, intestinal NPC1L1, ACAT2, and ApoB48 protein expressions were evaluated by immunohistochemical assay.. According to the results, decreased levels of serum cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDL-C), as well as hepatic TC were showed in hyperlipidemic rats treated by combination of berberine and evodiamine. GC analysis indicated that the elevated plasma BS was significantly ameliorated by BB, EV, and BB + EV. In addition, immunohistochemical analysis revealed that BB + EV treatment down-regulated the expressions of intestinal NPC1L1 and ACAT2, and ApoB48 in HFD induced rats.. Based on the above results, combination of berberine and evodiamine exerted a promising preventive effect on hyperlipidemia, partially through inhibiting intestinal absorption of cholesterol.

Topics: Administration, Oral; Animals; Apolipoprotein B-48; Berberine; Body Weight; Cholesterol, LDL; Coptis; Diet, High-Fat; Drug Combinations; Evodia; Gene Expression Regulation; Hyperlipidemias; Hypolipidemic Agents; Intestinal Absorption; Lipid Metabolism; Liver; Male; Membrane Transport Proteins; Quinazolines; Rats; Rats, Sprague-Dawley; Sitosterols; Sterol O-Acyltransferase; Sterol O-Acyltransferase 2; Triglycerides

Rapeseed oil (RSO) is a novel source of plant sterols, containing the unique brassicasterol in concentrations higher than allowed for plant sterol blends in food products in the European Union. Effects of RSO sterols and stanols on aortic atherosclerosis were studied in cholesterol-fed heterozygous Watanabe heritable hyperlipidaemic (Hh-WHHL) rabbits. Four groups (n 18 per group) received a cholesterol-added (2 g/kg) standard chow or this diet with added RSO stanol esters (17 g/kg), RSO stanol esters (34 g/kg) or RSO sterol esters (34 g/kg) for 18 weeks. Feeding RSO stanol esters increased plasma campestanol (P < 0.001) and sitostanol (P < 0.001) and aortic campestanol (P < 0.05) compared with controls. Feeding RSO sterol esters increased concentrations of plasma campesterol (P < 0.001), sitosterol (P < 0.001) and brassicasterol (P < 0.001) and aortic campesterol (P < 0.01). Significantly lower plasma cholesterol (P < 0.001) was recorded in the treated groups after 3 weeks and throughout the study. LDL-cholesterol was reduced 50 % in the high-dose RSO sterol ester (P < 0.01) and high-dose RSO stanol ester (P < 0.001) groups compared with controls. Atherosclerotic lesions were found in three rabbits in each of the RSO stanol ester groups and in one in the RSO sterol ester group. Aortic cholesterol was decreased in the treated groups (P < 0.001) in response to lowering of plasma cholesterol induced by RSO sterol and stanol esters. In conclusion, RSO stanol and sterol esters with a high concentration of brassicasterol were well tolerated. They were hypocholesterolaemic and inhibited experimental atherosclerosis in cholesterol-fed Hh-WHHL rabbits. A significant uptake of plant sterols into the blood and incorporation of campesterol and campestanol into aortic tissue was recorded.

Topics: Animals; Aorta; Atherosclerosis; Cholestadienols; Cholesterol; Cholesterol, Dietary; Fatty Acids, Monounsaturated; Female; Heterozygote; Hyperlipidemias; Lipids; Male; Phytosterols; Plant Oils; Rabbits; Rapeseed Oil; Sitosterols

Topics: ATP-Binding Cassette Transporters; Cholesterol; Humans; Hyperlipidemias; Mutation; Sitosterols

Used as a substitute for normal dietary intake of saturated fatty acids, margarines containing plant sterols can cause a modest reduction in serum total cholesterol and low-density lipoprotein cholesterol levels. They have been shown effective in patients with mild hypercholesterolemia, but they are also useful in the general population.

Topics: Anticholesteremic Agents; Cholesterol; Cholesterol, LDL; Coronary Disease; Costs and Cost Analysis; Female; Humans; Hypercholesterolemia; Hyperlipidemias; Hypolipidemic Agents; Margarine; Phytosterols; Randomized Controlled Trials as Topic; Simvastatin; Sitosterols; Time Factors

Topics: Anticholesteremic Agents; Cholesterol, Dietary; Dietary Fats; Humans; Hyperlipidemias; Intestinal Absorption; Sitosterols

Topics: Arteriosclerosis; Aspirin; Cholestyramine Resin; Clofibrate; Dextrothyroxine; Dipyridamole; Humans; Hyperlipidemias; Hypolipidemic Agents; Intracranial Arteriosclerosis; Nicotinic Acids; Sitosterols; Sulfinpyrazone

A report on the effects of primary bile acid ingestion alone or in combination with plant sterols on serum cholesterol levels, biliary lipid secretion, and bile acid metabolism. Biliary bile acid and cholesterol secretion were measured in four patients with type IIa hypercholesterolemia before and after randomized treatment periods. During these periods either a bile acid mixture (cholic-chenodeoxycholic 2:1, a proportion similar to that endogenously synthesized in health), at a level of 20 mg/kg, or the same mixture plus sitosterols, 200 mg/kg, was fed. Serum cholesterol and the cholesterol saturation of fasting-state bile was also measured. Pretreatment biliary lipid secretion was within normal limits. Bile acid kinetic measurements were also recorded before treatment and showed that cholic acid synthesis was disproportionately decreased relative to that of chenodeoxycholic acid, a finding previously reported by others. Administration of the bile acid mixture increased biliary bile acid secretion in 3 of 4 patients, but did not influence biliary cholesterol secretion. The combination of sitosterol-bile acid, however, caused a relative decrease in cholesterol secretion in bile, and fasting-state bile became unsaturated in all patients. No change in fecal neutral sterol excretion occurred during the beta-sitosterol-bile acid regimen, suggesting that simultaneous bile acid feeding blocks the compensatory increase in cholesterol synthesis known to be induced by beta-sitosterol feeding in hypercholesterolemic patients. Serum cholesterol levels also fell modestly during the sitosterol-bile acid regimen, the decrease averaging 15%. We conclude that the abnormally low rate of bile acid synthesis in patients with type IIa hyperlipoproteinemia does not influence biliary lipid secretion; that increasing the input of the two primary bile acids into the enterohepatic circulation does not increase biliary cholesterol secretion or lower serum cholesterol levels in such patients; and that the usual increase in cholesterol synthesis induced by beta-sitosterol feeding does not occur if bile acids are administered simultaneously.

Topics: Adult; Bile; Bile Acids and Salts; Cholesterol; Female; Humans; Hypercholesterolemia; Hyperlipidemias; Kinetics; Male; Middle Aged; Sitosterols; Sterols

Among the various available hypolipidemic agents only clofibrate-related substances, d-thyroxine and nicotinic acid are capable of lowering serum lipid values together with a relative or absolute rise of HDL. By that means one atherogenic risk factor is eliminated and compensated by an anti-risk factor. There are differences concerning the incidence and the seriousness of side-effects between the recommended hypolipidemic agents. Considering actual conditions attempts to find further factors that are associated with HDL level are the natural next step in efforts to develop effective lipid lowering drugs that decrease atherogenic lipoproteins, particularly LDL, and increase vasoprotective HDL.

Topics: Cholestyramine Resin; Clofibrate; Colestipol; Germany, West; Humans; Hyperlipidemias; Hypolipidemic Agents; Legislation, Drug; Nicotinic Acids; Sitosterols; Thyroxine

Cardiovascular disease has become the major cause of death in the Western countries. There is strong evidence that elevations of serum lipids contribute to the pathogenesis of premature atherosclerosis. The classification of the hyperlipoproteinemias has been most beneficial as a guide to development of dietary and pharmacological regimens for lowering serum lipid concentrations. The results of dietary and drug prevention trials are discussed. Insight into the mechanisms involved in lipoprotein metabolism as well as the mode of action and of side-effects of hypolipidemic drugs is reviewed. Using present knowledge of heart disease research, it is reasonable to suggest dietary and drug treatments for the high risk patient.

Topics: Anion Exchange Resins; Biguanides; Cholestyramine Resin; Clofibrate; Colestipol; DEAE-Dextran; Dextrothyroxine; Drug Therapy, Combination; Estrogens; Humans; Hyperlipidemias; Lipoproteins; Neomycin; Nicotinic Acids; Progestins; Sitosterols

The effect of Beta-Sitosterol (Sitosterin Delalande) on plasma lipids in 20 pretreated patients with type IIa and IIb familial hyperlipoproteinemia is reported. 6-18 g of the drug were given for a time of two to twelve months. In 11 patients the plasma cholesterol level decreased between 10 and 30%. Since Beta-Sitosterol has no effect on plasma triglycerides, an additional hypertriglyceridemia must be taken care of and treated if necessary. Beta-Sitosterol can be called an effective substance in the treatment of hypercholesterinemia. In addition the diet cure becomes easier.

Topics: Adult; Aged; Cholesterol, Dietary; Female; Humans; Hyperlipidemias; Male; Middle Aged; Sitosterols; Triglycerides

The effects of acute caloric restriction on cholesterol balance and kinetics of plasma cholesterol specific activity were investigated in five hyperlipemic subjects with varying degrees of obesity. Caloric restriction decreased plasma triglycerides by 41 +/- 12%, plasma cholesterol by 11 +/- 9%, and the ratio of esterified to free cholesterol by 12 +/- 7+. Immediately on institution of caloric restriction there appeared to be an influx of tissue cholesterol into plasma and a reduction in endogenous synthesis of cholesterol. The cholesterol balance decreased from 1,469 +/- 441 to 1,212 +/- 349 mg/day and the rate of decay of plasma cholesterol specific activity decreased 62 +/- 3%. The effect of caloric restriction on hepatic synthesis of bile acids was also very prompt. The total fecal bile acids were reduced immediately by 36 +/- 7%. Because the effect on fecal excretion of deoxycholic acid was greater than that on fecal lithocholic acid, it was suggested that hepatic synthesis of cholic acid was reduced more than the synthesis of chenodeoxycholic acid. Caloric restriction did not cause any change in the percentage of absorption of dietary cholesterol (40 +/- 2% versus 42 +/- 3%). These observations are in accord with our model relating cholesterol metabolism with the metabolism of plasma lipoproteins in man.

Topics: Adult; Bile Acids and Salts; Cholesterol; Cholesterol Esters; Cholesterol, Dietary; Diet; Dietary Carbohydrates; Dietary Fats; Dietary Proteins; Energy Intake; Feces; Humans; Hypercholesterolemia; Hyperlipidemias; Kinetics; Male; Middle Aged; Obesity; Sitosterols; Steroids; Triglycerides

To 9 patients with hyperlipoproteinemia type II and treated with different hypolipidemic drugs without success, sitosterol was given for a period of 4 to 16 months. The effective dose was 10.56 to 21.12g beta-sitosterol corresponding to 12 to 24g granulate. One patient developed a serious diarrhoe and dropped out. 4 patients showed an impressive decrease of serum cholesterol levels.

Topics: Adult; Aged; Cholesterol; Dose-Response Relationship, Drug; Female; Humans; Hypercholesterolemia; Hyperlipidemias; Lipoproteins, LDL; Lipoproteins, VLDL; Male; Middle Aged; Sitosterols; Triglycerides

Hyperlipemia is one of several risk factors for premature ischemic vascular disease. It usually represents a primary, lifelong metabolic disorder and control requires changes in life-style. These include a modification of diet (commonly caloric, cholesterol and saturated fat restriction), elimination of smoking and hypertension and, frequently, drug therapy. Drugs can attack endogenous triglyceride overproduction, lipoprotein lipase deficiency or defective remnant uptake, and can decrease cholesterol production and accelerate cholesterol degradation.

Topics: Adult; Cholestyramine Resin; Clofibrate; Coronary Disease; Female; Humans; Hyperlipidemias; Lipid Metabolism; Lipoprotein Lipase; Liver; Male; Middle Aged; Nicotinic Acids; Sitosterols; Thyroxine; Triglycerides

Topics: Anticholesteremic Agents; Cholestyramine Resin; Clofibrate; Colestipol; Dextrothyroxine; Drug Therapy, Combination; Humans; Hyperlipidemias; Nicotinic Acids; Sitosterols

Direct gas liquid chromatography (GLC) of total plasma lipids showed small peaks (0.5-1.5% of total free sterol area) corresponding to free C28 and C29 sterols in ca. 50% of some 3,000 normal subjects and patients with hyperlipemia. Comparable proportions of similar peaks were present in the sterol fraction isolated from the red blood cells of many of these subjects. The maximum levels of these components in the plasma and red blood cells of domestic and laboratory animals were up to 10 times higher than those seen in man. Detailed gas chromatography/mass spectrometry analyses of the plasma lipids from a much more limited number of subjects and animals showed that the GLC peaks corresponding to the free C28 and C29 sterols were largely due to the plant sterols campesterol, stigmasterol, and beta-sitosterol. In all instances, variable amounts (0.05-0.2% of the total free sterol area) of 7-dehydrocholesterol, desmosterol, lanosterol, and cholesterol alpha-oxide were also detected. While the total content and composition of the plasma plant sterols appeared to vary greatly among the subjects, it never exceeded 2% of total sterol in the normal subjects and patients examined. There was no evidence for a significant increase in the plant sterol content of the plasma of patients with hypercholesterolemia or hypertriglyceridemia.

Topics: Animals; Cholesterol; Chromatography, Gas; Desmosterol; Erythrocytes; Gas Chromatography-Mass Spectrometry; Humans; Hypercholesterolemia; Hyperlipidemias; Phytosterols; Sitosterols; Species Specificity

Topics: Adult; Child; Cholesterol; Drug Evaluation; Humans; Hyperlipidemias; Sitosterols

The most frequent indication for treatment of hyperlipidemia is for prevention of arteriosclerosis, a suspected but unproved benefit. The cornerstone of treatment of primary hyperlipidemia is diet; drugs may be added to, but do not replace, diet. When a drug is used with any patient, its potential benefits and hazards must be carefully weighed for the given subject. The subjects should be carefully followed and observed for side effects. Plasma lipids should be monitored during the course of treatment. Five drugs have been approved by the U.S. Food and Drug Administration for the treatment of hyperlipidemia: cholestyramine, clofibrate, nicotinic acid, sodium dextrothyroxine and beta-sitosterol. The use, the actions and the side effects of each and of several nonapproved agents are discussed.

Topics: Aminosalicylic Acids; Anabolic Agents; Cholestyramine Resin; Clofibrate; Colestipol; Dextrothyroxine; Estrogens; Halofenate; Humans; Hyperlipidemias; Neomycin; Nicotinic Acids; Progesterone; Sitosterols

Studies were carried out on the effects of polyunsaturated fats on lipid metabolism in 11 patients with hypertriglyceridemia. During cholesterol balance studies performed in eight patients, the feeding of polyunsaturated fats, as compared with saturated fats, caused an increased excretion of endogenous neutral steroids, acidic steroids, or both in most patients. Increases in steroid excretions were marked in some patients and generally exceeded the decrement of cholesterol in the plasma compartment. The finding of a greater excretion of fecal steroids on polyunsaturated fats in hypertriglyceridemic patients contrasts to the lack of change in sterol balance previously reported for patients with familial hypercholesterolemia; however, other workers have found that polyunsaturated fats also enhance steroid excretion in normal subjects. In most of the patients, simultaneous studies were carried out on biliary lipid composition, hourly outputs of biliary lipids, and pool sizes of bile acids. In several but not all patients, fasting gallbladder bile became more lithogenic after institution of polyunsaturated fats. This increased lithogenicity was not due to a decrease in bile acid pools; in no case was the pool decreased by polyunsaturated fats. On the other hand, two patients showed an increased output of biliary cholesterol, and frequently there was an increase in fecal neutral steroids that were derived from cholesterol; thus, polyunsaturated fats may increase bile lithogenicity in some patients through mobilization of cholesterol into bile. Reductions in plasma cholesterol during the feeding of polyunsaturated fats was seen in most patients, and these changes were usually associated with a decrease in concentration of plasma triglycerides. In fact, the degree of cholesterol lowering was closely correlated with the extent of triglyceride reduction. Therefore, in hypertriglyceridimec patients polyunsaturated fats may contribute to cholesterol reduction by changing the metabolism of triglycerides or very low density lipoproteins. The findings of changes in the metabolism of cholesterol, bile acids, and triglycerides in the patients of this study suggests that polyunsaturated fats may cause a lowering of cholesterol through multiple mechanisms, and it seems unlikely that a single action can explain all the effects of these fats on the plasma lipids.

Topics: Adult; Bile; Bile Acids and Salts; Cholesterol; Cholic Acids; Clofibrate; Deoxycholic Acid; Diet; Dietary Fats; Fats, Unsaturated; Feces; Gallbladder; Humans; Hyperlipidemias; Lipid Metabolism; Male; Middle Aged; Sitosterols; Triglycerides

Human intestinal specificity toward sterols was studied by a balance method in 10 hyperlipoproteinemic patients fed plant sterol mixture with chromium sesquioxide as fecal flow marker. The mean fecal recovery of campesterol (C28) was 20% less than that of beta-sitosterol (C29). This difference persisted when corrected for fecal flow (by marker recovery), indicating differences in their intestinal uptake (C28 greater than C29). The ratio of fecal cholesterol to its 5beta-reduction products was lower than that of beta-sitosterol in all patients; in vitro, 5beta-reduction of both sterols was similar. The recovery of sterols from patients was unrelated to their 5beta-reduction in the intestine.

Topics: Cholesterol; Cholesterol, Dietary; Chromium; Feces; Humans; Hyperlipidemias; Intestinal Mucosa; Phytosterols; Sitosterols

Topics: Animals; Cholesterol; Clofibrate; Diet, Atherogenic; Fatty Acids; Female; Hyperlipidemias; Lipoproteins; Lipoproteins, HDL; Lipoproteins, LDL; Lipoproteins, VLDL; Male; Neomycin; Pan troglodytes; Phospholipids; Sitosterols; Thyroxine; Triglycerides

This work was aimed at studying the quantity and composition of sterols and squalene secreted by the human skin. Lipids secreted by the entire skin were recovered by Soxhlet extraction of the clothing worn by a patient for 24 hr with a chloroform-methanol azeotrope and by extracting the water of a shower taken by the patient at the end of the 24-hr period. Squalene and sterols were quantified by gas-liquid chromatography. Plant sterols were separated from total sterols by thin-layer chromatography. Free and esterified cholesterol were separated by digitonin precipitation. In eight adults, seven of them with hyperlipoproteinemia, the total skin secretion of cholesterol ranged from 59 to 108 mg/day, with a mean of 88 +/- 17 (SD) mg/day. There was no difference in cholesterol secretion between the normocholesterolemic individual and the hypercholesterolemic ones, nor were there any differences according to type of hyperlipoproteinemia. Free cholesterol amounted to 54 +/- 5% of the total cholesterol. The secretion of squalene ranged from 125 to 475 mg/day in five patients. The secretion of both squalene and cholesterol was quite constant for any individual on a given diet. Cholesterol constituted 95.6 +/- 0.5% of the digitonin-precipitable total body surface sterols of eight patients, and lathosterol, the next largest fraction, 3.4 +/- 0.4%. Total plant sterols formed only 0.65 +/- 0.38% and beta-sitosterol 0.35 +/- 0.23% of the skin surface sterols in six patients whose dietary beta-sitosterol intake ranged from 230 to 3400 mg/day.

Topics: Adult; Aged; Calorimetry; Carbon Radioisotopes; Cholesterol; Chromatography, Gas; Chromatography, Thin Layer; Dietary Fats; Digitonin; Female; Humans; Hyperlipidemias; Lanosterol; Male; Middle Aged; Oils; Sitosterols; Skin; Squalene; Sterols; Time Factors

Topics: Adult; Carbon Isotopes; Cholesterol; Cholesterol, Dietary; Feces; Female; Humans; Hyperlipidemias; Intestinal Absorption; Male; Middle Aged; Sitosterols

Topics: Adult; Arteriosclerosis; Cholesterol; Cholestyramine Resin; Clofibrate; Coronary Disease; Electrophoresis, Polyacrylamide Gel; Humans; Hypercholesterolemia; Hyperlipidemias; Hypolipidemic Agents; Lipid Mobilization; Lipoproteins; Male; Middle Aged; Myocardial Infarction; Phospholipids; Sitosterols; Triglycerides

Topics: Adolescent; Adult; Alcohol Drinking; Body Weight; Child; Cholesterol, Dietary; Cholestyramine Resin; Clofibrate; Diet Therapy; Dietary Carbohydrates; Dietary Fats; Drug Therapy, Combination; Fats, Unsaturated; Female; Humans; Hyperlipidemias; Hypolipidemic Agents; Male; Middle Aged; Neomycin; Nicotinic Acids; Sitosterols; Thyroxine

Topics: Cholestyramine Resin; Clofibrate; Dextrothyroxine; Diet Therapy; Estrogens; Humans; Hyperlipidemias; Nicotinic Acids; Progestins; Sitosterols

Topics: Animals; Blood Coagulation; Chickens; Humans; Hyperlipidemias; Lipids; Sitosterols; Sterols