Affiliation:
1. Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, 46 Rue du Bugnon, 1011 Lausanne, Switzerland
2. Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, 53127 Bonn, Germany
3. Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Lenggstrasse 31, P.O. Box 363, 8032 Zürich, Switzerland
Abstract
The association between phytosterols and lipid levels remains poorly assessed at a population level. We assessed the associations between serum levels of six phytosterols (campesterol, campestanol, stigmasterol, sitosterol, sitostanol and brassicasterol) and of lipids [total, low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol, triglycerides, apolipopoprotein A-IV and lipoprotein Lp(a)] in two cross-sectional surveys of a population-based, prospective study. Data from 910 participants (59.1% women, 70.4 ± 4.7 years) for the first survey (2009–2012) and from 721 participants (60.2% women, 75.1 ± 4.7 years) for the second survey (2014–2017) were used. After multivariable adjustment, all phytosterols were positively associated with total cholesterol: slope and (95% confidence interval) 1.594 (1.273–1.915); 0.073 (0.058–0.088); 0.060 (0.044–0.076); 2.333 (1.836–2.830); 0.049 (0.033–0.064) and 0.022 (0.017–0.028) for campesterol, campestanol, stigmasterol, sitosterol, sitostanol and brassicasterol, respectively, in the first survey, and 1.257 (0.965–1.548); 0.066 (0.052–0.079); 0.049 (0.034–0.063); 1.834 (1.382–2.285); 0.043 (0.029–0.057) and 0.018 (0.012–0.023) in the second survey, all p < 0.05. Similar positive associations were found between all phytosterols and LDL cholesterol. Positive associations were found between campesterol and sitosterol and HDL-cholesterol: slope and (95% CI) 0.269 (0.134–0.405) and 0.393 (0.184–0.602) for campesterol and sitosterol, respectively, in the first survey, and 1.301 (0.999–1.604) and 0.588 (0.327–0.849) in the second survey, all p < 0.05. No associations were found between phytosterols and triglyceride or lipoprotein Lp(a) levels, while a positive association between campesterol and apolipoprotein A-IV levels was found: 2.138 (0.454–3.822). Upon normal dietary intakes, serum phytosterol levels were positively associated with total and LDL cholesterol levels, while no consistent association with other lipid markers was found.
Funder
GlaxoSmithKline, the Faculty of Biology and Medicine of Lausanne, the Swiss National Science Foundation
Swiss Personalized Health Network
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