Abstract 11348: Probiotics for Heart Health: Next Generation of Adjunct Therapies for Lipid Management

Abstract

Background/Objectives: The proportion of cholesteryl ester saturated fatty acids have been reported to be higher in individuals with established Coronary Artery Disease (CAD). Select probiotic bacterial strains have been shown to improve the cholesterol profile in humans; however their effect on cholesteryl esters has not yet been reported, which is the main objective of this study.

Hypothesis: The research hypothesis is that bile salt hydrolase (BSH) - active Lactobacillus reuteri NCIMB 30242 capsules would significantly reduce cholesteryl esters, in the context of its LDL-cholesterol lowering efficacy and mechanism of action, in a randomized controlled trial.

Methods: A total of 127 subjects were randomized to consume L. reuteri NCIMB 30242 capsules or placebo capsules over a 9-week intervention period.

Results: Over the intervention period, L. reuteri NCIMB 30242 capsules were shown to reduce total cholesteryl esters by 6.3% (P=0.015) and in particular, cholesteryl ester saturated fatty acids by 8.8% (P=0.002. Of the saturated fatty acids, palmitic acid and stearic acid were reduced by 8.8% (P=0.001) and 16.8% (P=0.003) respectively as compared to placebo. Furthermore, cholesteryl ester saturated fatty acids + oleic acid were reduced by 5.2% (P=0.039) as compared to placebo. The purported mechanism of action of L. reuteri NCIMB 30242 is in agreement with a reduction in cholesteryl ester fatty acids. Subjects consuming BSH-active L. reuteri NCIMB 30242 capsules showed a significant increase in plasma deconjugated bile acids (P<0.05), indicating increased intraluminal bile salt deconjugation, and a significant decrease in plasma plant sterols (P<0.05), indicating a reduced total inward transport of non-cholesterol sterols. Over the intervention period, the reduction in cholesteryl esters and cholesteryl ester saturated fatty acids were significantly correlated with reductions in both apoB-100 and LDL-cholesterol (P<0.001).

Conclusion: L. reuteri NCIMB 30242 capsules were shown to lower cholesteryl ester saturated fatty acids over a 9-week intervention period. These effects were correlated with reductions in apoB-100 and LDL-cholesterol and are consistent with the purported mechanism of action of BSH-active L. reuteri NCIMB 30242.