Abstract
Moderately elevated levels of plasma plant sterols have been suspected to be causally involved in atherosclerosis. The aim of this study was to investigate whether plant sterols and other markers of sterol metabolism predicted all-cause and cardiovascular mortality in participants of the Ludwigshafen Risk and Cardiovascular health (LURIC) study. A total of 1,257 individuals who did not use statins and at baseline had a mean (+/- SD) age of 62.8 (+/- 11.0) years were included in the present analysis. Lathosterol, cholestanol, campesterol, and sitosterol were measured to estimate cholesterol synthesis and absorption. The mean (+/- SD) time of the follow-up for all-cause and cardiovascular mortality was 7.32 (+/- 2.3) years. All-cause (P = 0.001) and cardiovascular (P = 0.006) mortality were decreased in the highest versus the lowest lathosterol to cholesterol tertile. In contrast, subjects in the third cholestanol to cholesterol tertile had increased all-cause (P < 0.001) and cardiovascular mortality (P = 0.010) compared with individuals in the first tertile. The third campesterol to cholesterol tertile was associated with increased all-cause mortality (P = 0.025). Sitosterol to cholesterol tertiles were not significantly related to all-cause or cardiovascular mortality. The data suggest that high absorption and low synthesis of cholesterol predict increased all-cause and cardiovascular mortality in LURIC participants.
Highlights
Elevated levels of plasma plant sterols have been suspected to be causally involved in atherosclerosis
All noncholesterol sterols were positively correlated with total cholesterol (r = 0.348, P < 0.001; r = 0.494, P < 0.001; r = 0.412, P < 0.001; and r = 0.393, P < 0.001 for lathosterol, cholestanol, campesterol, and sitosterol, respectively)
Baseline characteristics according to lathosterol to cholesterol tertiles The cholestanol, campesterol, and sitosterol to cholesterol ratios and all absorption marker to lathosterol ratios were inversely related to the lathosterol to cholesterol tertiles (Table 1)
Summary
Elevated levels of plasma plant sterols have been suspected to be causally involved in atherosclerosis. The data suggest that high absorption and low synthesis of cholesterol predict increased all-cause and cardiovascular mortality in LURIC participants.—Silbernagel, G., G. The associations of cholesterol metabolism and plasma plant sterols with all-cause and cardiovascular mortality. It has been speculated that moderately increased plasma plant sterols might be atherogenic in the general population as well Epidemiological studies concerning this issue have been controversial [3, 5,6,7,8,9,10,11,12,13,14,15,16,17,18]. We examined the associations of plasma plant sterols and cholesterol metabolism with the severity of CAD in participants of the Ludwigshafen Risk and Cardiovascular Health (LURIC) study [23]. LURIC is a large prospective clinical study of individuals who have undergone
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