Atherosclerosis
Volume 210, Issue 2 , Pages 362-365 , June 2010

Relationship between cholesterol synthesis and intestinal absorption is associated with cardiovascular risk

  • Oliver Weingärtner

      Affiliations

    • Klinik für Innere Medizin III, Kardiologie, Angiologie und internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Kirrberger Strasse, Gebäude 40, D-66421 Homburg/Saar, Germany
    • Corresponding Author InformationCorresponding author. Tel.: +49 06841 1621333; fax: +49 06841 1621331.
  • ,
  • Dieter Lütjohann

      Affiliations

    • Institut für klinische Chemie und Pharmakologie, Universitätsklinikum Bonn, D-53105 Bonn, Germany
  • ,
  • Michael Böhm

      Affiliations

    • Klinik für Innere Medizin III, Kardiologie, Angiologie und internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Kirrberger Strasse, Gebäude 40, D-66421 Homburg/Saar, Germany
  • ,
  • Ulrich Laufs

      Affiliations

    • Klinik für Innere Medizin III, Kardiologie, Angiologie und internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Kirrberger Strasse, Gebäude 40, D-66421 Homburg/Saar, Germany

Received 10 November 2009 ,Revised 14 December 2009 ,Accepted 4 January 2010.

References 

  1. National Cholesterol Education Program Expert Panel. Third report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). National Heart, Lung, and Blood Institute, National Institutes of Health, Publication No 02-5215, 2002; 3143–421.
  2. Baigent C, Keech A, Kearney PM, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005;366:1267–1278
  3. Miettinen TA, Gylling H, Strandberg T, Sarna S. Baseline serum cholestanol as predictor of recurrent coronary events in subgroup of Scandinavian simvastatin survival study. Finnish 4S Investigators. BMJ. 1998;316:1127–1130
  4. Castelli WP. Epidemiology of coronary heart disease: the Framingham study. Am J Med. 1984;76:4–12
  5. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet. 1994;344:1383–1389
  6. Shepherd J, Cobbe SM, Ford I, et al. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland Coronary Prevention Study Group. N Engl J Med. 1995;333:1301–1307
  7. Calpe-Berdiel L, Escola-Gil JC, Blanco-Vaca F. New insights into the molecular actions of plant sterols and stanols in cholesterol metabolism. Atherosclerosis. 2009;203:18–31
  8. Silbernagel G, Fauler G, Renner W, et al. The relationships of cholesterol metabolism and plasma plant sterols with the severity of coronary artery disease. J Lipid Res. 2009;50:334–341
  9. Matthan NR, Pencina M, Larocque JM, et al. Alterations in cholesterol absorption and synthesis characterize Framingham offspring study participants with coronary heart disease. J Lipid Res. 2009;50:1927–1935
  10. Miettinen TA. Detection of changes in human cholesterol metabolism. Ann Clin Res. 1970;2:300–320
  11. Miettinen TA, Tilvis RS, Kesaniemi YA. Serum plant sterols and cholesterol precursors reflect cholesterol absorption and synthesis in volunteers of a randomly selected male population. Am J Epidemiol. 1990;131:20–31
  12. Lütjohann D, Bjorkhem I, Beil UF, von Bergmann K. Sterol absorption and sterol balance in phytosterolemia evaluated by deuterium-labeled sterols: effect of sitostanol treatment. J Lipid Res. 1995;36:1763–1773
  13. Kidambi S, Patel SB. Sitosterolaemia: pathophysiology, clinical presentation and laboratory diagnosis. J Clin Pathol. 2008;61:588–594
  14. Weingärtner O, Lütjohann D, Ji S, et al. Vascular effects of diet supplementation with plant sterols. J Am Coll Cardiol. 2008;51:1553–1561
  15. Weingärtner O, Böhm M, Laufs U. Controversial role of plant sterol esters in the management of hypercholesterolaemia. Eur Heart J. 2009;30:404–409
  16. Patel MD, Thompson PD. Phytosterols and vascular disease. Atherosclerosis. 2006;186:12–19
  17. Miettinen TA, Gylling H. Effect of statins on noncholesterol sterol levels: implications for use of plant stanols and sterols. Am J Cardiol. 2005;96:40D–46D
  18. Miettinen TA, Strandberg TE, Gylling H. Noncholesterol sterols and cholesterol lowering by long-term simvastatin treatment in coronary patients: relation to basal serum cholestanol. Arterioscler Thromb Vasc Biol. 2000;20:1340–1346
  19. Buchwald H, Varco RL, Matts JP, et al. Effect of partial ileal bypass surgery on mortality and morbidity from coronary heart disease in patients with hypercholesterolemia. Report of the Program on the Surgical Control of the Hyperlipidemias (POSCH). N Engl J Med. 1990;323:946–955
  20. Dujovne CA, Ettinger MP, McNeer JF, et al. Efficacy and safety of a potent new selective cholesterol absorption inhibitor, ezetimibe, in patients with primary hypercholesterolemia. Am J Cardiol. 2002;90:1092–1097
  21. Salen G, Starc T, Sisk CM, Patel SB. Intestinal cholesterol absorption inhibitor ezetimibe added to cholestyramine for sitosterolemia and xanthomatosis. Gastroenterology. 2006;130:1853–1857
  22. Weststrate JA, Meijer GW. Plant sterol-enriched margarines and reduction of plasma total- and LDL-cholesterol concentrations in normocholesterolaemic and mildly hypercholesterolaemic subjects. Eur J Clin Nutr. 1998;52:334–343
  23. Miettinen TA, Puska P, Gylling H, Vanhanen H, Vartiainen E. Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic population. N Engl J Med. 1995;333:1308–1312
  24. Plat J, Mensink RP. Plant stanol and sterol esters in the control of blood cholesterol levels: mechanism and safety aspects. Am J Cardiol. 2005;96:15D–22D
  25. Sarwar R, Neuwirth C, Walji S, et al. Efficacy of ezetimibe and future role of management of refractory hyperlipidaemia in high-risk patients. Br J Cardiol. 2008;15:205–209
  26. Thuluva SC, Igel M, Giesa U, et al. Ratio of lathosterol to campesterol in serum predicts the cholesterol-lowering effect of sitostanol-supplemented margarine. Int J Clin Pharmacol Ther. 2005;43:305–310
  27. Fransen HP, de Jong N, Wolfs M, et al. Customary use of plant sterol and plant stanol enriched margarine is associated with changes in serum plant sterol and stanol concentrations in humans. J Nutr. 2007;137:1301–1306
  28. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) . Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285:2486–2497
  29. Lichtenstein AH, Appel LJ, Brands M, et al. Summary of American Heart Association diet and lifestyle recommendations revision 2006. Arterioscler Thromb Vasc Biol. 2006;26:2186–2191
  30. Arzneimittelkommission der deutschen Ärzteschaft (Drug Commission of the German Medical Profession) Newsletter 2004–2045; 15.01.04.
  31. National Institute for Health and Clinical Excellence. LIPID MODIFICATION. Cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular diseases, www.nice.org.uk/nicemedia/pdf/CG67NICEGuideline.pdf; [27.12.2009].
  32. Katan MB, Grundy SM, Jones P, et al. Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clin Proc. 2003;78:965–978
  33. de Jong N, Klungel OH, Verhagen H, et al. Functional foods: the case for closer evaluation. BMJ. 2007;334:1037–1039
  34. McNamara DJ, Davidson NO, Samuel P, Ahrens EH. Cholesterol absorption in man: effect of administration of clofibrate and/or cholestyramine. J Lipid Res. 1980;21:1058–1064
  35. Davidson MH, Dillon MA, Gordon B, et al. Colesevelam hydrochloride (cholestagel): a new, potent bile acid sequestrant associated with a low incidence of gastrointestinal side effects. Arch Intern Med. 1999;159:1893–1900
  36. Knopp RH. Drug treatments of lipid disorders. N Engl J Med. 1999;341:498–511
  37. Weingärtner O, Weingärtner N, Scheller B, et al. Alterations in cholesterol homeostasis are associated with coronary heart disease in patients with aortic stenosis. Coron Artery Dis. 2009;20:376–382
  38. Teoh H, Mendelsohn AA, Goodman SG, et al. Usefulness of statin-ezetimibe combination to reduce the care gap in dyslipidemia management in patients with a high risk of atherosclerotic disease. Am J Cardiol. 2009;104:798–804
  39. Farnier M, Averna M, Missault L, et al. Lipid-altering efficacy of ezetimibe/simvastatin 10/20mg compared with rosuvastatin 10mg in high-risk hypercholesterolaemic patients inadequately controlled with prior statin monotherapy—the IN-CROSS study. Int J Clin Pract. 2009;63:547–559
  40. Weingärtner O. Prospective studies testing relevant clinical endpoints are needed. BMJ. 2007;Available online: http://www.bmj.com/cgi/elettters/334/7602/1037#171841
  41. Weingärtner O, Böhm M, Laufs U. Plant sterols as dietary supplements for the prevention of cardiovascular diseases. Dtsch Med Wochenschr. 2008;133:1201–1204

PII: S0021-9150(10)00006-7

doi: 10.1016/j.atherosclerosis.2010.01.003

Atherosclerosis
Volume 210, Issue 2 , Pages 362-365 , June 2010