The effect of dietary fat content on plasma noncholesterol sterol concentrations in patients with familial hypercholesterolemia treated with simvastatin

Abstract

The effects of a low-fat, low-cholesterol diet (LFD) or a higher-fat, higher-cholesterol diet (HFD) on plasma concentrations of lipids, lipoproteins, lathosterol (an index of cholesterol synthesis rate), and plant sterols were determined in 19 patients with familial hypercholesterolemia (FH) treated with simvastatin. The study followed a randomized crossover design including two 8-week diet periods. The LFD significantly decreased plasma lathosterol (-22%), cholesterol (-6%), low-density lipoprotein (LDL) cholesterol (-6%), and high-density lipoprotein (HDL) cholesterol (-7%) levels compared with the HFD. Decreases in plasma lathosterol and LDL cholesterol concentrations in patients during the LFD were significantly correlated (r = .522, n = 19, P < .05). These results suggest that a LFD may enhance the decrease in cholesterol synthesis induced by simvastatin treatment, and in this way might contribute to the decrease in plasma cholesterol levels when the fat content of the diet is reduced in simvastatin-treated FH patients.