Cholesterol balance and fecal neutral steroid and bile acid excretion in normal men fed dietary fats of different fatty acid composition

Connor, William E.; Witiak, Donald T.; Stone, Daniel B.; Armstrong, Marc P.

doi:10.1172/jci106102

Cited by 275 publications

(84 citation statements)

References 29 publications

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“…24 Cholesterol synthesis measured by the sterol balance technique (Table 4) was also found to be 30% of normal production. 25 These results are in agreement with those reported by Salen et al, 26 Miettinen, 4 and Lin and coworkers. 10 According to Nguyen and colleagues, 15 the low cholesterol synthesis in sitosterolemic patients is associated with a markedly reduced microsomal hydroxymethyl glutaryl-coenzyme A (HMG-CoA) reductase activity, the rate-controlling enzyme for cholesterol biosynthesis.…”

Section: Discussionsupporting

confidence: 92%

Sluggish sitosterol turnover and hepatic failure to excrete sitosterol into bile cause expansion of body pool of sitosterol in patients with sitosterolemia and xanthomatosis.

Bhattacharyya

Connor

Lin

et al. 1991

Arterioscler Thromb

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Sitosterolemia and xanthomatosis are characterized by the development of tendon and tuberous xanthomas at an early age and premature atherosclerosis despite normal plasma cholesterol concentrations. The reason(s) for the xanthoma formation and premature atherosclerosis are not clearly understood. The accumulation of sitosterol in the tissues of these patients could be due to increased uptake of low density lipoprotein (LDL) via LDL receptors because of an expanded sitosterol pool caused by sluggish turnover and decreased excretion of sitosterol into bile and feces coupled with the hyperabsorption of sitosterol. We have studied sitosterol and cholesterol turnovers, the biliary and fecal excretion of neutral and acidic steroids, and the response of plasma sterol (sitosterol and cholesterol) levels to either a sterol-free formula or low plant sterol diet in three patients. The average half-life of the first exponential (t A l/2) for sitosterol was 9.2 ±3.3 (mean±SD) days, which was more than twice that in normal humans. The second exponential (t B l/2) was 156±108 days, which was nearly 10 times longer than that for normal humans. The average cholesterol production rate in pool A was 0.87 g/day, which is about 40% of that in normal humans. Cholesterol synthesis measured by the sterol balance technique was also found to be about 70% lower than that for normal humans. In two patients fed a sterol-free formula diet, by 25 days their plasma sitosterol and cholesterol levels had decreased by 42% and 36%, respectively. However, in one patient plasma sitosterol and cholesterol concentrations remained unchanged while on the low plant sterolmixed food diet. The sitosterol to cholesterol ratio in bile (0.05) was extremely low compared with that found in plasma (0.14), indicating low excretion of sitosterol into the bile. Thus, patients with sitosterolemia have a slow turnover of sitosterol, low excretion of sitosterol into the duodenal bile and feces, and low cholesterol synthesis. These metabolic defects have implications in the formation of xanthomas and the development of premature atherosclerosis in these patients. (Arteriosclerosis and Thrombosis 1991;11:1287-1294)

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Section: Discussionsupporting

confidence: 92%

Sluggish sitosterol turnover and hepatic failure to excrete sitosterol into bile cause expansion of body pool of sitosterol in patients with sitosterolemia and xanthomatosis.

Bhattacharyya

Connor

Lin

et al. 1991

Arterioscler Thromb

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“…For example, in eight of these studies, 44 " 51 the P/S ratio of the polyunsaturated diet averaged about 7-fold higher than that of the saturated diet (1.5 vs 0.2), and these studies reported an average decrease in plasma cholesterol levels of only 8%. In six other studies, 31 ' 39 " 13 the P/S ratio of the polyunsaturated diet averaged 27-fold higher than that of the saturated diet (4.6 vs 0.17), and this difference was associated with an average cholesterol decrease of 20%.…”

Section: Plasma Cholesterolmentioning

confidence: 89%

Polyunsaturated fatty acids, hyperlipidemia, and thrombosis.

Goodnight¹,

Harris

Connor³

et al. 1982

Arteriosclerosis

654

150

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“…Sterol balance studies have been performed to evaluate the effects of the composition of the diet on sterol excretion (Connor et al, 1969;Grundy and Ahrens, 1969;Nestel et al, 1975). These metabolic ward investigations were elaborate, but owing to variations in bacterial degradation of the sterol ring structure in the large intestine, and variations in colonic transit time, precision was insufficient to settle the question of the effects of different diets on sterol excretion (Andersson and Bosaeus, 1993).…”

Section: Introductionmentioning

confidence: 99%

Oat bran rapidly increases bile acid excretion and bile acid synthesis: an ileostomy study

2007

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Objective: To study whether oat bran with native b-glucans increases bile acid excretion and bile acid synthesis as measured by serum concentrations of 7a-hydroxy-4-cholesten-3-one (7a-HC). Design: Short-term interventional crossover study evaluating cholesterol absorption, ileal excretion of cholesterol and bile acids, and serum levels of cholesterol and bile acid metabolites. Differences between diets evaluated with Wilcoxon's signed rank-sum test.Setting: Outpatients at a metabolic-ward kitchen. Subjects: Nine volunteers with conventional ileostomies. Methods: Two 3-day-diet periods, with controlled, blinded basal diet including 75 g extruded oat bran breakfast cereal daily, with either 11.6 g native or hydrolysed b-glucans. Results: Native oat bran increased median excretion of bile acids by 144% (P ¼ 0.008). Cholesterol excretion remained unchanged, cholesterol absorption decreased by 19% (P ¼ 0.013), whereas the sum of bile acid and cholesterol excretion increased by 40% (P ¼ 0.008) compared with hydrolysed oat bran. 7a-HC reflecting bile acid synthesis increased by 57% (P ¼ 0.008) within 24 h of consumption, whereas serum lathosterol concentration reflecting cholesterol synthesis increased by 12% (P ¼ 0.015). Conclusions: Oat bran with native b-glucans increases bile acid excretion within 24 h of consumption and this increase can also be detected by rising serum concentrations of 7a-HC. Thus, 7a-HC could be used for rapid detection of dietary effects on bile acid metabolism. These effects could possibly be explained by entrapment of whole micelles in the gut owing to higher viscosity.

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Cholesterol balance and fecal neutral steroid and bile acid excretion in normal men fed dietary fats of different fatty acid composition

Cited by 275 publications

References 29 publications

Sluggish sitosterol turnover and hepatic failure to excrete sitosterol into bile cause expansion of body pool of sitosterol in patients with sitosterolemia and xanthomatosis.

Sluggish sitosterol turnover and hepatic failure to excrete sitosterol into bile cause expansion of body pool of sitosterol in patients with sitosterolemia and xanthomatosis.

Polyunsaturated fatty acids, hyperlipidemia, and thrombosis.

Oat bran rapidly increases bile acid excretion and bile acid synthesis: an ileostomy study

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