J. Lipid Res.
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A more recent version of this article appeared on June 1, 2003

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J. Lipid Res., doi:10.1194/jlr.M200455-JLR200
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Submitted on December 6, 2002
Revised on March 6, 2003
Accepted on March 25, 2003

Response of obligate heterozygotes for phytosterolemia to a low-fat diet and to a plant sterol ester dietary challenge

Peter O. Kwiterovich Jr, Shirley C. Chen, Donna G. Virgil, Amy Schweitzer, Dagmar R. Arnold, and Lisa E. Kratz

Pediatrics, Johns Hopkins University, Baltimore, MD 21205

Corresponding Author: pkwitero{at}jhmi.edu

Twelve obligate heterozygotes from two kindreds were ascertained through phytosterolemic probands homozygous for molecular defects in the ATP- binding cassette (ABC) half-transporter, ABCG8. The response of these heterozygotes to a Step 1 diet low in fat, saturated fat and cholesterol, and to 2.2 grams daily of plant sterols (as esters), was determined in Protocol I (16 weeks) and Protocol II (28 weeks) during three consecutive feeding periods: Step 1/placebo-spread; Step 1/plant sterol-spread; and, Step 1/placebo-spread (washout). At baseline, half the heterozygotes had moderate dyslipidemia and one-third had mildly elevated campesterol and sitosterol levels. On the Step 1/placebo-spread, mean LDL cholesterol decreased significantly, 11.2 % in Protocol I (N = 12), and 16.0% in Protocol II (N = 7). Substitution with plant sterol-spread produced a significant treatment effect on LDL levels in Protocol I and II. Conversely, the mean levels of campesterol and sitosterol increased 119% and 54%, respectively, during the use of plant sterol-spread for 6 weeks in Protocol I, an effect mirrored for 12 weeks in Protocol II. During the placebo-spread washouts, LDL levels increased, while those of plant sterols decreased, to baseline levels in both protocols. In conclusion, phytosterolemic heterozygotes respond well to a Step 1 diet, and their response to a plant sterol-ester challenge appears similar to that observed in normals.


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[Abstract] [Full Text] [PDF]


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