出版社：American Society for Biochemistry and Molecular Biology
摘要：Consumption of plant sterols and treatment with ezetimibe bothreduce cholesterol absorption in the intestine. However, themechanism of action differs between the two treatments, andthe consequences of combination treatment are unknown. Therefore,we performed a double-blind, placebo-controlled, crossover studyfor the plant sterol component with open-label ezetimibe treatment.Forty mildly hypercholesterolemic subjects were randomized tothe following treatments for 4 weeks each: 10 mg/day ezetimibecombined with 25 g/day control spread; 10 mg/day ezetimibe combinedwith 25 g/day spread containing 2.0 g of plant sterols; 25 g/dayspread containing 2.0 g of plant sterols; and placebo treatmentconsisting of 25 g/day control spread. Combination treatmentof plant sterols and ezetimibe reduced low density lipoproteincholesterol (LDL-C) by 1.06 mmol/l (25.2%; P < 0.001) comparedwith 0.23 mmol/l (4.7%; P = 0.006) with plant sterols and 0.94mmol/l (22.2%; P < 0.001) with ezetimibe monotherapy. LDL-Creduction conferred by the combination treatment did not differsignificantly from ezetimibe monotherapy (–0.12 mmol/lor –3.5%; P = 0.13). Additionally, the plasma lathosterol-to-cholesterolratio increased with all treatments. Sitosterol and campesterolratios increased after plant sterol treatment and decreasedupon ezetimibe and combination therapy.
Our results indicate that the combination of plant sterols andezetimibe has no therapeutic benefit over ezetimibe monotherapyin subjects with mild hypercholesterolemia.Supplementary key words low density lipoprotein • humans • sitosterol • hypercholesterolemia
