Abstract 676: Relation of Serum Plant Sterol Levels to Tissue Concentrations - Effects of Diet and Family History
Introduction: Premature atherosclerosis in patients with sitosterolemia and epidemiological studies suggest that plant sterols may contribute to the pathogenesis of cardiovascular diseases. This study investigates the concentrations of plant sterols in serum and in aortic valve cusps in relation to dietary habits and family history.
Methods: 78 consecutive patients admitted for aortic valve replacement were studied. On admission dietary habits and family history for coronary heart disease were determined. Serum and tissue concentrations of lathosterol, campesterol and sitosterol were determined.
Results: We found a strong correlation for plant sterols in serum and in aortic valve cusps (r = 0.77; p < 0,0001; for the ratio campesterol/cholesterol). Furthermore, patients consuming margarine supplemented with plant sterol esters (n=6) had significantly higher concentrations of plant sterols in serum (p<0,001) and in aortic valve cusps (p < 0,0001). The effect of sterol ester supplemented margarine on serum and aortic valve cusps was dose-dependent. 40 patients had no statin treatment or consumption of sterol-ester supplemented margarine. In this subgroup, patients with a positive family history showed a significant increase of plant sterol concentrations in serum (p<0.003 for the ratio campesterol/cholesterol). In contrast, there was no increase in cholesterol and the cholesterol precursor lathosterol. Furthermore, there was an increased ratio of campesterol/cholesterol (p<0.012), but no difference in cholesterol and lathosterol/ cholesterol concentrations in aortic valve cusps.
Conclusion: Serum concentrations of plant sterols predict the concentration of plant sterols in cardiovascular tissue. Consumption of margarine supplemented with plant sterol-esters is associated with increased serum and tissue concentrations of plant sterols. Family history of cardiac diseases correlates to sterol concentrations in serum and tissue. Further studies are needed to evaluate a potential pro-atherogenic effect of plant sterols in cardiovascular diseases before a diet supplemented with plant sterol esters can be recommended.