Changes in serum level and metabolism of cholesterol with plant stanol esters in postmenopausal women with and without coronary artery disease

Abstract

Objective: Especially in women, serum cholesterol lowering with cholesterol malabsorption using plant sterol ester margarine has revealed controversial results. Accordingly, in this retrospective study, we evaluated whether plant stanol (3 g/d) ester margarine consumption for 6 and 12 weeks lowers serum cholesterol levels in mildly hypercholesterolemic women without (n = 38) and with (n = 22) coronary heart disease.

Design: The study population was selected from two of our earlier studies correspondingly matched for age, body mass index, and serum cholesterol and triglyceride levels. In addition, the long-term effect (12 months) of plant stanol ester with a dose reduction after 6 months (from 3-2 g stanol/d) was studied in the noncoronary group.

Results: At baseline, the coronary and noncoronary groups had similar serum lathosterol (synthesis marker) and campesterol and sitosterol (absorption markers) ratios to cholesterol, but high-density lipoprotein cholesterol was lower and serum squalene and desmosterol ratios to cholesterol were significantly higher in the coronary versus noncoronary groups. Short-term plant stanol ester consumption reduced serum cholesterol by 8.7% (P < 0.001) in the coronary group from the control margarine period, and in the noncoronary group by 11% from the control group (P < 0.001). The cholesterol-lowering effect sustained unchanged in the noncoronary subjects during one year consumption despite reduction of the plant stanol intake from 3 g/d to 2 g/d.

Conclusion: Plant stanol ester margarine consumption effectively reduced serum cholesterol in postmenopausal women with and without coronary artery disease in short-term and for at least 1 year in the noncoronary group, suggesting that stanol ester margarine might be used in the long-term for cholesterol lowering in women.