| Nutrition Journal | |
| Effect of a plant sterol, fish oil and B vitamin combination on cardiovascular risk factors in hypercholesterolemic children and adolescents: a pilot study | |
| Zdeňka Ďuračková1  Sue F Plummer2  Duolao Wang3  Andrej Dukát4  Stanislav Oravec4  Csilla Mišľanová5  Zuzana Nagyová6  Jana Muchová1  Iveta Garaiova2  | |
| [1] Institute of Medical Chemistry, Biochemistry and Clinical Biochemistry, Faculty of Medicine, Comenius University, Bratislava, 813 72, Slovakia;Research Department, Obsidian Research Ltd, Port Talbot, UK;Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK;2nd Department of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia;Department of Bioactive Substances and Nutritional Screening, Slovak Medical University, Bratislava, Slovakia;Juvenalia Paediatric Centre, Dunajská Streda, Slovakia | |
| 关键词: Adolescents; Children; B vitamins; Fish oil; Plant sterols; Cholesterol; | |
| Others : 823704 DOI : 10.1186/1475-2891-12-7 |
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| received in 2012-05-22, accepted in 2012-12-20, 发布年份 2013 | |
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【 摘 要 】
Background
Assessment of cardiovascular disease (CVD) risk factors can predict clinical manifestations of atherosclerosis in adulthood. In this pilot study with hypercholesterolemic children and adolescents, we investigated the effects of a combination of plant sterols, fish oil and B vitamins on the levels of four independent risk factors for CVD; LDL-cholesterol, triacylglycerols, C-reactive protein and homocysteine.
Methods
Twenty five participants (mean age 16 y, BMI 23 kg/m2) received daily for a period of 16 weeks an emulsified preparation comprising plant sterols esters (1300 mg), fish oil (providing 1000 mg eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA)) and vitamins B12 (50 μg), B6 (2.5 mg), folic acid (800 μg) and coenzyme Q10 (3 mg). Atherogenic and inflammatory risk factors, plasma lipophilic vitamins, provitamins and fatty acids were measured at baseline, week 8 and 16.
Results
The serum total cholesterol, LDL- cholesterol, VLDL-cholesterol, subfractions LDL-2, IDL-1, IDL-2 and plasma homocysteine levels were significantly reduced at the end of the intervention period (p<0.05). The triacylglycerols levels decreased by 17.6%, but did not reach significance. No significant changes in high sensitivity C-reactive protein, HDL-cholesterol and apolipoprotein A-1 were observed during the study period. After standardisation for LDL cholesterol, there were no significant changes in the levels of plasma γ-tocopherol, β-carotene and retinol, except for reduction in α-tocopherol levels. The plasma levels of n-3 fatty acids increased significantly with the dietary supplementation (p<0.05).
Conclusions
Daily intake of a combination of plant sterols, fish oil and B vitamins may modulate the lipid profile of hypercholesterolemic children and adolescents.
Trial registration
Current Controlled Trials ISRCTN89549017
【 授权许可】
2013 Garaiova et al.; licensee BioMed Central Ltd.
【 预 览 】
| Files | Size | Format | View |
|---|---|---|---|
| 20140713012826826.pdf | 214KB |
【 参考文献 】
- [1]Allender S, Scarborough P, Peto V, Rayner M, Leal J, Luengo-Fernandez R, Gray A: EHN European cardiovascular disease statistics 2008 edition. British Heart Foundation Statistics Database; http://www.heartstats.org webcite
- [2]Daniels SR, Gidding SS, de Ferranti SD: Pediatric aspects of familial hypercholesterolemias: recommendations from the National Lipid Association Expert Panel on Familial Hypercholesterolemia. J Clin Lipidol 2011, 5:S30-S37.
- [3]McNeal CJ, Dajani T, Wilson D, Cassidy-Bushrow AE, Dickerson JB, Ory M: Hypercholesterolemia in Youth: Opportunities and obstacles to prevent premature atherosclerotic cardiovascular disease. Curr Atheroscler Rep 2010, 12:20-28.
- [4]O’Gorman CSM, O’Neill MB, Conwell LS: Considering statins for cholesterol-reduction in children if lifestyle and diet changes do not improve their health: a review of the risks and benefits. Vasc Health Risk Manag 2011, 7:1-14.
- [5]Gylling H, Siimes MA, Miettinen TA: Sitostanol ester margarine in dietary treatment of children with familial hypercholesterolemia. J Lipd Res 1995, 36:1807-1812.
- [6]Amundsen ǺL, Ose L, Nenseter MS, Ntanios FY: Plant sterol ester-enriched spread lowers plasma total and LDL cholesterol in children with familial hypercholesterolemia. Am J Clin Nutr 2002, 76:338-344.
- [7]De Jongh S, Vissers MN, Rol P, Bakker HD, Kastelein JJP, Stroes ESG: Plant sterols lower LDL cholesterol without improving endothelial function in prepubertal children with familial hypercholesterolaemia. J Inherit Metab Dis 2003, 26:343-351.
- [8]Bresson J-L, Flynn A, Heinonen M, Hulshof K, Korhonen H, Lagiou P, Løvik M, Marchelli R, Martin A, Moseley B, Przyrembel H, Salminen S, Strain SJJ, Strobel S, Tetens I, van den Berg H, van Loveren H, Verhagen H: Scientific opinion of the Panel on Dietetic Products Nutrition and Allergies on a request from the European Commission and a similar request from France in relation to the authorisation procedure for health claims on plant sterols/stanols and lowering/reducing blood LDL-cholesterol pursuant to Article 14 of Regulation (EC) No 1924/2006. The EFSA Journal 2009, 1175:1-9.
- [9]Adkins Y, Kelley DS: Mechanisms underlying the cardioprotective effects of omega-3 polyunsaturated fatty acids. J Nutr Biochem 2010, 21:781-792.
- [10]Engler MM, Engler MB, Malloy M, Chiu E, Besio D, Paul S, Stuehlinger M, Morrow J, Ridker P, Rifai N, Mietus-Snyder M: Docosahexaenoic acid restores endothelial function in children with hyperlipidemia: results from the EARLY Study. Int J Clin Pharmacol Ther 2004, 42(12):672-679.
- [11]Engler MM, Engler MB, Malloy MJ, Paul SM, Kulkarni KR, Mietus-Snyder ML: Effect of docosahexaenoic acid on lipoprotein subclasses in hyperlipidemic children (the EARLY Study). Am J Cardiol 2005, 95:869-871.
- [12]Debreceni B, Debreceni L: Why do homocysteine-lowering B vitamin and antioxidant E vitamin supplementations appear to be ineffective in the prevention of cardiovascular diseases? Cardiovasc Ther 2011. 10.1111/j.1755-5922.2011.00266.x
- [13]Jehlička P, Stožický F, Mayer JR O, Varvařovská J, Racek J, Trefil L, Siala K: Asymmetric dimethylarginine and the effect of folate substitution in children with familial hypercholesterolemia and diabetes mellitus Type 1. Physiol Res 2009, 58:179-184.
- [14]Šoltésová M, Hrebík M: Atherosclerosis in childhood and primary prevention (In Slovak). Pediatria (Bratisl) 2006, 1(4):227-231.
- [15]Oravec S, Dukát A, Gavorník P, Lovásová Z, Gruber K: Atherogenic normolipidemia-a new phenomenon in the lipoprotein profile of clinically healthy subjects. Neuroendocrinol Lett 2011, 32(3):317-321.
- [16]Houze P, Gamra S, Madelaine I, Bousquet B, Gourmel B: Simultaneous determination of total plasma glutathione, homocysteine, cysteinylglycine, and methionine by high-performance liquid chromatography with electrochemical detection. J Clin Lab Anal 2001, 15:144-153.
- [17]Melnyk S, Pogribna M, Pogribny I, Hine RJ, James SJ: A new HPLC method for the simultaneous determination of oxidized and reduced plasma aminothiols using coulometric electrochemical detection. J Nutr Biochem 1999, 10:490-497.
- [18]Hess D, Keller HE, Oberlin B, Bonfanti R, Schuep W: HPLC determination of carotenoids, tocopherols and retinol in plasma. Int J Vitam Nutr Res 1991, 61:232-238.
- [19]Garaiova I, Guschina IA, Plummer SF, Tang J, Wang D, Plummer NT: A randomised cross-over trial in healthy adults indicating improved absorption of omega-3 fatty acids by pre-emulsification. Nutr J 2007, 6:4. BioMed Central Full Text
- [20]Amundsen ǺL, Ntanios F, van der Put N, Ose L: Long-term compliance and changes in plasma lipids, plant sterols and carotenoids in children and parents with FH consuming plant sterol ester-enriched spread. Eur J Clin Nutr 2004, 58:1612-1620.
- [21]Ketomäki AM, Gylling H, Antikainen M, Siimes MA, Miettinen TA: Red cell and plasma plant sterols are related during consumption of plant stanol and sterol ester spreads in children with hypercholesterolemia. J Pediatr 2003, 142:524-531.
- [22]Calpe-Berdiel L, Escolà-Gil JC, Blanco-Vaca F: New insights into the molecular actions of plant sterols and stanols in cholesterol metabolism. Atherosclerosis 2009, 203:18-31.
- [23]Verhoye E, Langlois MR, Rietzchel E, De Buyzere M, Gillebert T, De Bacquer D, De Backer G, Bekaert S, van Oostveldt P, Segers P, Verdonck P, Langlois M: Circulating oxidized low-density lipoprotein: a biomarker of atherosclerosis and cardiovascular risk? Clin Chem Lab Med 2009, 47(2):128-137.
- [24]Matvienko OA, Lewis DS, Swanson M, Arndt B, Rainwater DL, Stewart J, Alekel DL: A single daily dose of soybean phytosterols in ground beef decreases serum total cholesterol and LDL cholesterol in young, mildly hypercholesterolemic men. Am J Clin Nutr 2002, 76:57-64.
- [25]Lamarche B, Desroches S, Jenkins DJA, Kendall CWC, Marchie A, Faulkner D, Vidgen E, Lapsley KG, Trautwein EA, Parker TL, Josse RG, Leiter LA, Connelly PW: Combined effects of a dietary portfolio of plant sterols, vegetable protein, viscous fibre and almonds on LDL particle size. Br J Nutr 2004, 92:657-663.
- [26]Sialvera TE, Pounis GD, Koutelidakis AE, Richter DJ, Yfanti G, Kapsokefalou M, Goumas G, Chiotinis N, Diamantopoulos E, Zampelas A: Phytosterols supplementation decreases plasma small and dense LDL levels in metabolic syndrome patients on a westernized type diet. Nutr Metab Cardiovasc Dis 2011. 10.1016/j.numecd.2010.12.004
- [27]Chapman MJ, Ginsberg HN, Amarenco P, Andreotti F, Boren J, Catapano AL, Descamps OS, Fisher E, Kovanen PT, Kuivenhoven JA, Lesnik P, Masana L, Nordestgaard BG, Ray KK, Reiner Z, Taskinen M-R, Tokgözoglu L, Tybjaerg-Hansen A, Watts GF, (the European Atherosclerosis Society Consensus Panel): Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management. Eur Heart J 2011, 32:1345-1361.
- [28]Demonty I, Ras RT, van der Knaap HCM, Meijer L, Zock PL, Geleijnse JM, Trautwein EA: The effect of plant sterols on serum triglyceride concentrations is dependent on baseline concentrations: a pooled analysis of 12 randomised controlled trials. Eur J Nutr 2012.
- [29]Micallef MA, Garg ML: Beyond blood lipids: phytosterols, statins and omega-3 polyunsaturated fatty acid therapy for hyperlipidemia. J Nutr Biochem 2009, 20:927-939.
- [30]Marangoni F, Poli A: Phytosterols and cardiovascular health. Pharmacol Res 2010, 61:193-199.
- [31]General view of the Scientific Committee on Food on the long-term effects of the intake of elevated levels of phytosterols from multiple dietary sources, with particular attention to the effects on β-carotene [http://Europa.eu.int/comm/food/fs/sc/scf/index_en.html webcite]
- [32]van Beynum IM, Smeitink JAM, den Heijer M, te Poele Pothoff MTWB, Blom HJ: Hyperhomocysteinemia: A risk factor for ischemic stroke in children. Circulation 1999, 99:2070-2072.
- [33]Kosch A, Koch HG, Heinecke A, Kurnik K, Heller C, Nowak-Göttl U, Childhood Thrombophilia Study Group: Increased fasting total homocysteine plasma levels as a risk factor for thromboembolism in children. Thromb Haemost 2004, 91:308-314.
- [34]Kerr MA, Livingstone B, Bates CJ, Bradbury I, Scott JM, Ward M, Pentieva K, Mansoor MA, McNulty H: Folate, related B vitamins, and homocysteine in childhood and adolescence: potential implications for disease risk in later life. Pediatrics 2009, 123:627-635.
- [35]Bates CJ, Mansoor MA, Gregory J, Pentieva K, Prentice A: Correlates of plasma homocysteine, cysteine and cysteinyl-glycerine in respondents in the British National Diet and Nutrition Survey of young people aged 4-18 years, and a comparison with the survey of people aged 65 years and over. Br J Nutr 2002, 87:71-79.
- [36]van Beynum IM, den Heijer M, Thomas CMG, Afman L, Oppenraay-van Emmerzaal D, Blom HJ: Total homocysteine and its predictors in Dutch children. Am J Clin Nutr 2005, 81:1110-1116.
- [37]The Homocysteine Studies Collaboration: Homocysteine and risk of ischemic heart disease and stroke. JAMA 2002, 288:2015-2022.
- [38]Engler MM, Engler MB, Arterburn LM, Bailey E, Chiu EY, Malloy MJ, Mietus-Snyder ML: Docosahexaenoic acid supplementation alters plasma phospholipid fatty acid composition in hyperlipidemic children: results from the Endothelial Assessment of Risk from Lipids in Youth (EARLY) study. Nutr Res 2004, 24:721-729.
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