Copyright® Raisio Effects of long-term plant sterol or stanol ester consumption on lipid and lipoprotein metabolism in subjects on statin treatment de Jong et al. Br J Nutr 2008; 100:

de Jong et al Background Subjects on statins may not reach the cholesterol target Plant stanol ester consumption has been shown to be effective in statin using subjects: Statin drug and plant stanol ester have different cholesterol lowering mechanisms: Statins inhibit cholesterol synthesis Plant stanols reduce the absorption of cholesterol in intestine The aim of the study was to confirm that the serum LDL- cholesterol-lowering effect of plant stanol ester is sustained also in statin using subjects.

de Jong et al Methods I 54 subjects on stable statin treatment 1.5 week run-in with placebo margarine 2.randomization to 3 different treatment groups for 85 weeks placebo margarine (n=17) plant stanol ester margarine (2,5 g/d plant stanols) (n=19) plant sterol ester margarine (2,5 g/d plant sterols) (n=18)

de Jong et al Methods II Blood samples were collected in the beginning and in the end on run-in period duplicate samples in 5, 25, 45, 65 and 85 weeks into the study analyses for lipids and apolipoproteins; plant stanols and plant sterols and markers of cholesterol metabolism

de Jong et al Results I Calculated daily plant stanol/sterol intake was 2.5 g  Study subjects adhered well to the guidance given regarding the use of the test products No differences in the energy intake or the nutrient composition of the diet at base-line or during the study, no weight-change

de Jong et al Results II Plant stanol consumption lowered total cholesterol by 9.4 % and LDL-C by 13.1 % compared to placebo (p=0.003 & 0.006) Plant sterol consumption lowered total cholesterol by 5.1 % and LDL-cholesterol by 8.7 % compared to placebo (p=0.092 & 0.080)

de Jong et al Plant stanol ester effectively reduces LDL cholesterol in combination with stable statin treatment * * * p<0.05 THE CHOLESTEROL-LOWERING EFFECT IS LASTING ALSO IN STATIN USING SUBJECTS Plant sterol ester (2.5 g/day plant sterol) Change (%) in LDL cholesterol Run-in period Week 45Week 85 Plant stanol ester (2.5 g/day plant stanol)

de Jong et al Conclusions Consumption of plant stanol ester significantly reduces serum total and LDL-cholesterol levels in subjects on stable statin drug use The cholesterol-lowering effect is lasting also in statin using subjects.

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