Copyright® Raisio A plant stanol yogurt drink alone or combined with a low-dose statin lowers serum triacylglycerol and non-HDL cholesterol in metabolic syndrome patients Plat et al. J Nutr 2009

Plat et al Background I Patients with metabolic syndrome are at an increased risk of cardiovascular disease. Several factors contribute to the risk apart from the ”traditional” high LDL-cholesterol, including high TG, low HDL and proinflammatory profile, all present in metabolic syndrome. Meta-analysis by Naumann et al suggested that plant stanol ester may also lower elevated serum TG concentration.

Plat et al Background II The aim of the study was to evaluate if plant stanol ester can improve the lipid-profile in metabolic syndrome patients. Effects of plant stanol ester were studied alone and in combination with low-dose Simvastatin.

Plat et al Methods I 36 metabolic syndrome patients  3-week run-in with placebo yogurt drink and placebo tablet  randomized into 4 treatment groups for 8 weeks placebo group (n=9); placebo yogurt drink + placebo tablet plant stanol ester group (n=9); yogurt drink with 2 g/d plant stanols + placebo tablet statin group (n=10); placebo yogurt drink + 10 mg simvastatin combination group (n=8); yogurt drink with 2 g/d plant stanols + 10 mg simvastatin

Plat et al Methods II Fasting blood samples week 2 & 3 (run-in) week 10 & 11 (experimental period) Analyses for lipids and lipoproteins markers of inflammation and endothelial function clinical safety variables

Plat et al Results I Participants had a clear atherogenetic phenotype that did not differ among the groups Compliance to the study protocol was excellent No changes in dietary parameters, weight or inflammation markers

Plat et al Results II In metabolic syndrome patients, plant stanol ester, Simvastatin or the combination lowered non-HDL- cholesterol concentration by 12.8 %, 30.7 % and 35.4 % respectively, compared to placebo TGs were lowered by 27.5 %, 21.7 % and 32.7 %, respectively, compared to placebo

Plat et al CHANGES IN CHOLESTEROL AND TG CONCENTRATIONS Control Plant stanol ester % Total cholesterol Simvastatin Plant stanol ester + simvastatin Non-HDL Cholesterol TG a a a a b b b b b c cc c Effects of plant stanol ester, Simvastatin, or the combination on serum cholesterol and triglyceride concentrations Values between each group carrying a different letter are significantly different (p<0.05)

Plat et al Conclusions In addition to lowering serum non-HDL-cholesterol concentration, consumption of plant stanol ester lowered serum TG concentrations by 27 % in metabolic syndrome patients.

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