Phytosterol Supplementation Could Improve Atherogenic and Anti-Atherogenic Apolipoproteins: A Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials

(2019) Phytosterol Supplementation Could Improve Atherogenic and Anti-Atherogenic Apolipoproteins: A Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials. Journal of the American College of Nutrition. ISSN 0731-5724

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Abstract

Phytosterol and phytostanol (PS) supplementation is reported to improve atherogenic and anti-atherogenic apolipoproteins (Apo). The purpose of the present study is to critically investigate the effectiveness of PS supplementation on Apo in adults. A comprehensive search was conducted of all randomized controlled trials (RCTs) conducted up to September 2018 in the following databases: PubMed, Web of Science, Cochrane Library, and Scopus. Mean difference with 95 confidence intervals (CIs) were pooled using a random-effects model (DerSimonian-Laird method). Fifty-one arms from 37 RCTs were included in the present meta-analysis. Findings showed that PS supplementation and fortification increased Apo-AI (weighted mean difference WMD: 0.014 mg/dl, 95% CI: 0.001, 0.028, p = 0.042) and Apo-CII (WMD: 0.303 mg/dl, 95% CI: 0.084, 0.523, p = 0.007) and lowered Apo-B (WMD: -0.063 mg/dl, 95% CI: -0.075, -0.051, p < 0.001), Apo-B/Apo-A-I ratio (WMD: -0.044 mg/dl, 95% CI: -0.062, -0.025, p < 0.001), and Apo-E (WMD: -0.255 mg/dl, 95% CI: -0.474, -0.036, p = 0.023). However, PS supplementation did not have significant effects on Apo-AII and Apo-CIII. PS supplementation or fortification significantly changes Apo-E (r = -0.137, p nonlinearity = 0.006) and Apo-CIII (r = 1.26, p nonlinearity = 0.028) based on PS dosage (mg/d) and Apo-CIII (r = 3.34, p nonlinearity = 0.013) and Apo-CII (r = 1.09, p nonlinearity = 0.017) based on trial duration (weeks) in a nonlinear fashion. Based on our findings, supplements or fortified foods containing PS might have a considerable favorite effect in achieving Apo profile target; however, due to high heterogeneity among included studies, results must be interpreted with caution.KEY TEACHING POINTS Cardiovascular diseases (CVDs) recognized as main public health concern worldwide with considerable mortality of all global deaths. Apo-lipoproteins are amphipathic molecules involved in the lipoprotein metabolism which introduced as biomarkers in the evaluation of CVD risk. Phytosterols bioactive components of plants have important biological functions in cholesterol metabolism in humans. Here we showed that phytosterols and phytostanols improve apo-lipoproteins profile of humans; finding from meta-analysis of randomized controlled trials. Phytosterols supplementation lowered atherogenic apo-lipoproteins (Apo-B and Apo-E) and increased anti-atherogenic apo-lipoproteins (Apo-AI, Apo-CII).

Item Type: Article
Keywords: phytosterol phytostanol apolipoproteins meta-analysis serum-cholesterol concentrations stanol ester consumption sterol-enriched spread low-fat diet plant sterol cardiovascular-disease lipid profile a-i hypercholesterolemic patients lipoprotein metabolism
Subjects: QU Biochemistry. Cell Biology and Genetics > QU 145-220 Nutrition. Vitamins
Cardiovascular System > WG 500-700 Blood Vessels. Vascular Diseases
Divisions: School of Nutrition and Food Sciences > Department of Clinical Nutrition
School of Nutrition and Food Sciences > Student Research Committee
Journal or Publication Title: Journal of the American College of Nutrition
Journal Index: ISI
Identification Number: https://doi.org/10.1080/07315724.2019.1605313
ISSN: 0731-5724
Depositing User: Zahra Otroj
URI: http://eprints.mui.ac.ir/id/eprint/9989

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