Effect of sucrose polyester on plasma lipids and cholesterol absorption in African green monkeys with variable hypercholesterolemic response to dietary cholesterol

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The effect of sucrose polyester (SPE), a nonabsorbable fat, on plasma lipids and cholesterol absorption was studied in 29 adult male African green monkeys whose plasma cholesterol concentrations ranged from 133 to 358 mg/dl while consuming a diet containing 0.36 mg cholesterol/kcal. SPE was added to this diet at concentrations equivalent to doses for human beings of 15, 30, and 45 g/day. All 29 animals were fed either no SPE or one of the three concentrations of SPE for 2-mo intervals in a Latin square experimental design which ultimately allowed each animal to receive all dietary treatments. The lowest concentration of SPE reduced absorption of dietary cholesterol in all animals by an average of 16%. Increasing the concentration of SPE did not further decrease cholesterol absorption. Plasma cholesterol concentrations, however, were reduced by SPE only in the most hypercholesterolemic animals. The plasma cholesterol lowering effect was progressively less in animals that were less responsive to dietary cholesterol, such that in animals with plasma cholesterol concentrations less than 200 mg/dl there was no effect of SPE. The cholesterol lowering effect of SPE was due entirely to a lowering in LDL, with no effect on HDL cholesterol or triglycerides. Animals with the greatest plasma cholesterol response (hyperresponders) absorbed a significantly higher percentage of dietary cholesterol than did hyporesponders (56% vs. 37%). When cholesterol absorption was decreased in hyperresponders by SPE to levels equivalent to hyporesponders, the hyperresponders still maintained higher plasma cholesterol concentrations. Thus, the difference in cholesterol absorption appears to only partially explain the individuality in plasma cholesterol response to dietary cholesterol. These results also suggest that SPE may be a particularly useful drug in lowering plasma cholesterol concentrations in individuals that are hyperresponsive to dietary cholesterol.