Serum lipids, plant sterols, and cholesterol kinetic responses to plant sterol supplementation in phytosterolemia heterozygotes and control individuals.

Background: Plant sterol (PS) supplementation is increasingly ac-cepted as a dietary strategy to lower plasma cholesterol concentra-tions. However, information is scarce about the effect of increased PS intake in potentially vulnerable groups, such as phytosterolemia heterozygotes (HET). Objective: This study assessed the responsiveness of circulating PS and lipid concentrations and cholesterol kinetics (absorption and synthesis) to daily PS supplementation in HET (ABCG8 S107X mutation) compared with a healthy control cohort. Design: A double-blind, randomized, crossover, placebo-controlled study was conducted in 10 HET and 15 control subjects. The par-ticipants had a mean (±SEM) age of 34 ± 2 y and a BM1 (in kg/m²) of 29.9 ±1.1 and consumed ∼ 1.6 g PS or placebo capsules daily with supper for 4 wk. Cholesterol absorption and synthesis were assessed by using [¹³C]cholesterol and deuterium oxide, respec-tively. Results: Plasma LDL-cholesterol concentrations decreased (P = 0.006) in both groups after PS supplementation (HET: 2.73 ± 0.19 mmol/L; control: 3.11 ± 0.19 mmol/L) compared with placebo (HET: 3.12 ± 0.20 mmol/L; control: 3.50 ± 0.21 mmol/L), whereas PS concentrations (campesterol+ß-sitosterol) increased (P = 0.03) in both groups after PS supplementation (HET: 39.72 ± 6.05 /¡mol/L; control: 24.03 ± 1.65 /¡mol/L) compared with placebo (HET: 27.32 ± 3.80 /&um;mol/L; control: 21.12 ± 2.05 /(mol/L). Cho-lesterol absorption efficiency decreased (P = 0.010) by ∼22% and ∼17% and synthesis rates increased (P = 0.040) by ∼20% and ∼24% in the HET and control groups, respectively, in response to PS consumption compared with placebo. Conclusion: These data suggest that heterozygosity for the ABCG8 S107X mutation does not influence the action of dietary PS on circu-lating cholesterol concentrations but may affect sterol absorption. This trial was registered at clinicaltrials.gov as NCT01102647. [ABSTRACT FROM AUTHOR]