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Journal of Lipid Research, Vol 36, 1807-1812, Copyright © 1995 by Lipid Research, Inc.
H Gylling, MA Siimes and TA Miettinen
In familial hypercholesterolemia (FH) the lowering of serum cholesterol
levels should be started in childhood in order to prevent coronary artery
disease later in life. However, treatment of children is problematic. We
studied the effects of sitostanol (3 g/day) ester dissolved in rapeseed oil
margarine as a hypocholesterolemic agent in one homozygous and 14
heterozygous children with FH maintained on a low cholesterol diet for 6
weeks, using a double-blind crossover design. Absorption and synthesis of
cholesterol were evaluated by measuring serum plant sterol and cholesterol
precursor proportions to cholesterol by gas-liquid chromatography. The
compliance was good, and the children could not distinguish by taste the
two margarines without and with sitostanol ester. Sitostanol margarine
significantly reduced serum total, intermediate density (IDL), and low
density lipoprotein (LDL) cholesterol by 11, 26, and 15%, respectively, and
increased HDL/LDL cholesterol ratio by 27%. The proportions of serum delta
8-cholestenol, lathosterol, and desmosterol were significantly increased by
36, 19, and 18%, and those of serum cholestanol, campesterol, and
sitosterol were significantly decreased by 9, 42 and 29%, respectively,
suggesting that cholesterol absorption was decreased and synthesis was
compensatorily increased. High basal precursor sterol proportions predicted
a high decrease in LDL cholesterol levels. In conclusion, partial
replacement of normal dietary fat consumption by sitostanol ester margarine
appears to be an effective and safe hypocholesterolemic treatment in
children with FH.
ARTICLES
Sitostanol ester margarine in dietary treatment of children with familial hypercholesterolemia
Department of Internal Medicine, University of Helsinki, Finland.
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