Changes in serum level and metabolism of cholesterol with plant stanol esters in postmenopausal women with and without coronary artery disease

OBJECTIVE

Especially in women, serum cholesterol lowering with cholesterol malabsorption using plant sterol ester margarine has revealed controversial results. Accordingly, in this retrospective study, we evaluated whether plant stanol (3 g/d) ester margarine consumption for 6 and 12 weeks lowers serum cholesterol levels in mildly hypercholesterolemic women without (n = 38) and with (n = 22) coronary heart disease.

DESIGN

The study population was selected from two of our earlier studies correspondingly matched for age, body mass index, and serum cholesterol and triglyceride levels. In addition, the long-term effect (12 months) of plant stanol ester with a dose reduction after 6 months (from 3-2 g stanol/d) was studied in the noncoronary group.

RESULTS

At baseline, the coronary and noncoronary groups had similar serum lathosterol (synthesis marker) and campesterol and sitosterol (absorption markers) ratios to cholesterol, but high-density lipoprotein cholesterol was lower and serum squalene and desmosterol ratios to cholesterol were significantly higher in the coronary versus noncoronary groups. Short-term plant stanol ester consumption reduced serum cholesterol by 8.7% (P < 0.001) in the coronary group from the control margarine period, and in the noncoronary group by 11% from the control group (P < 0.001). The cholesterol-lowering effect sustained unchanged in the noncoronary subjects during one year consumption despite reduction of the plant stanol intake from 3 g/d to 2 g/d.

CONCLUSION

Plant stanol ester margarine consumption effectively reduced serum cholesterol in postmenopausal women with and without coronary artery disease in short-term and for at least 1 year in the noncoronary group, suggesting that stanol ester margarine might be used in the long-term for cholesterol lowering in women.