Journal Article

The effect of plant sterols on serum triglyceride concentrations is dependent on baseline concentrations: a pooled analysis of 12 randomised controlled trials

Meijer, Linsie, Geleijnse, Johanna M., Ras, Rouyanne T., van der Knaap, Henk C. M., Trautwein, Elke A., Demonty, Isabelle, Zock, Peter L.

2013

Overview

Purpose Plant sterols (PS) are well known for their low-density lipoprotein cholesterol-lowering effect. Until recently, they were believed to have little or no impact on blood triglycerides (TG). However, studies taken individually were possibly lacking statistical power to detect modest TG decreases. This study was performed to quantify the TG-lowering effect of PS by pooling individual subject data from 12 randomised controlled trials that investigated the effects of PS on blood lipids. Methods The main outcome variable was the control-adjusted PS effect on relative (%) and absolute (mmol/L) changes in TG. The relative and absolute changes in high-density lipoprotein cholesterol (HDL-C) were also assessed. Differences in changes of serum lipid concentrations between PS and control treatments were estimated by an ANCOVA using a random effect model which included PS intake (active or control), study and predefined subject characteristics. Results The twelve randomised controlled trials included in total 935 hypercholesterolaemic subjects not preselected based on their baseline TG concentrations. In most studies, the PS dose ranged between 1.6 and 2.5 g/day. PS intake significantly lowered serum TG by 6.0% (95% CI: −10.7, −1.2) or 0.12 mmol/L (95% CI: −0.20, −0.04). No significant interaction was observed between PS intake and baseline TG concentrations on relative changes, but, on absolute changes, interaction was significant with larger TG decreases observed with higher TG concentrations at baseline. No effects were observed on HDL-C concentrations. Conclusions These results show that PS exert a modest TG-lowering effect which is dependent on baseline concentrations.

• Publisher: Springer-Verlag,Springer Nature B.V
• Subject: administration & dosage / analysis of covariance / Anticholesteremic Agents / Anticholesteremic Agents - administration & dosage / blood / blood lipids / blood serum / cardiovascular-disease / Chemistry / Chemistry and Materials Science / cholesteremic effect / Cholesterol, HDL / Cholesterol, HDL - blood / Cholesterol, LDL / Cholesterol, LDL - blood / clinical-trials / density-lipoprotein cholesterol / diet / enriched spread / fat spreads / high density lipoprotein / high density lipoprotein cholesterol / Humans / hypercholesterolemia / ldl-cholesterol concentrations / lipid content / low density lipoprotein / mildly hypercholesterolemic subjects / Nutrition / Original Contribution / phytosterol intake / phytosterols / Phytosterols - administration & dosage / plasma-lipids / Randomized Controlled Trials as Topic / statistical models / triacylglycerols / Triglycerides / Triglycerides - blood