Introducing a new component of the metabolic syndrome: low cholesterol absorption

Simonen, Piia; Gylling, Helena; Howard, Alan; Miettinen, Tatu A.

doi:10.1093/ajcn/72.1.82

Cited by 160 publications

(145 citation statements)

References 33 publications

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“…The only research found was in subjects with type 2 diabetes mellitus (DM) using plant sterol and cholesterol precursors as indicators of absorption and synthesis. 39,40 Although, both studies indicated a decrease in synthesis and an increase in absorption after weight loss, the methods used only a crude estimation of cholesterol kinetics, as plant sterols and cholesterol precursors might be affected by diet and are not quantitative measures of metabolism. [39][40][41] The use of isotope ratio methodology in this trial offers a more precise quantifiable measure of cholesterol metabolism and, thus, may explain the differences in findings between this and other studies.…”

Section: Discussionmentioning

confidence: 99%

Cholesterol metabolism and body composition in women: the effects of moderate weight loss

et al. 2007

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Objective: To determine how moderate weight loss protocol through diet and exercise may affect changes in body composition, to determine the effects of weight loss on cholesterol metabolism and to examine the relationship between cholesterol metabolism and changes in body composition. Design: Thirty-five otherwise healthy, hypercholesterolemic women completed a 24-week weight loss study. A 20% decrease in energy intake through diet and a 10% increase in energy expenditure by exercise were combined with motivational strategies to encourage weight loss. The diet was self-selected and comprised of 50-60% carbohydrates, 20% protein and o30% fat. Results: Participants lost an average of 11.772.5 kg (Po0.001). Whole body and regional losses in tissue mass occurred after weight loss. After weight loss, cholesterol fractional synthesis rate (FSR) decreased (P ¼ 0.003) 3.8679.33%, whereas rates of cholesterol absorption and turnover did not change (3.31719.4%, P ¼ 0.32 and À0.0176.20%, P ¼ 0.75, respectively). Changes in cholesterol turnover were positively correlated (r ¼ 0.44, P ¼ 0.01) with changes in FSR. Reductions in visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were predictive (b ¼ À5.04, r ¼ 0.38; P ¼ 0.03, and b ¼ À147, r ¼ 0.40; P ¼ 0.03, respectively) of increases in cholesterol turnover. Losses in skeletal muscle (SM) and upper-body SM predicted (b ¼ 6.82, r ¼ 0.36; P ¼ 0.04 and b ¼ 14.7, r ¼ 0.41; P ¼ 0.01, respectively) decreases in cholesterol absorption. Conclusions: Decreases in cholesterol synthesis after moderate weight loss are not compensated for by changes in cholesterol absorption or turnover. Changes in regional body composition were associated with variations in cholesterol metabolism. Understanding how weight loss affects cholesterol metabolism will help identify more effective treatment routes for overweight individuals undergoing weight loss resulting in earlier and more intensive therapy for the associated dyslipidemia.

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Section: Discussionmentioning

confidence: 99%

Cholesterol metabolism and body composition in women: the effects of moderate weight loss

et al. 2007

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“…2 ApoB isotopic enrichment was measured using GCMS, and production and fractional catabolic rate (FCR) of VLDL apoB was derived using multicompartmental modelling (SAAM-II). Plasma lathosterol and campesterol concentrations were measured by gas-liquid chromatography [5][6][7] and expressed in mmol Â 10 2 per mol of cholesterol. Data were analysed by analysis of covariance using general linear models.…”

Section: Methodsmentioning

confidence: 99%

“…3,4 Metabolic syndrome patients also have abnormal cholesterol homeostasis, reflected by increased body cholesterol synthesis and decreased cholesterol absorption efficiency. 2,5 Cholesterol absorption efficiency is reflected by the plasma concentrations of plant sterols, particularly campesterol. 6 The therapeutic consequences of inhibiting cholesterol synthesis on both hepatic secretion of apoB and cholesterol absorption have not yet been investigated in the metabolic syndrome.…”

Section: Introductionmentioning

confidence: 99%

Effect of a statin on hepatic apolipoprotein B-100 secretion and plasma campesterol levels in the metabolic syndrome

et al. 2003

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OBJECTIVE:We aimed to study the effect of atorvastatin, a statin, on cholesterol synthesis and absorption and VLDL-apoB metabolism in obese men with the metabolic syndrome. METHODS: A total of 25 dyslipidaemic obese men were randomized to atorvastatin (n ¼ 13) (40 mg/day) or matching placebo (n ¼ 12) for 6 weeks. Hepatic secretion and fractional catabolic rate (FCR) of VLDL-apoB was measured using an intravenous bolus of d 3 -leucine before and after treatment. ApoB isotopic enrichment was measured using GCMS and multicompartmental modelling. Plasma lathosterol: cholesterol and campesterol:cholesterol ratios were determined to assess cholesterol synthesis and cholesterol absorption, respectively. RESULTS: Compared with placebo, atorvastatin significantly decreased (Po0.05) total cholesterol, triglyceride, LDL-cholesterol and VLDL-apoB. Plasma lathosterol:cholesterol ratio decreased from 26.472.4 to 8.870.8, while the campesterol:cholesterol ratio increased from 26.574.4 to 38.675.8 (Po0.01). Atorvastatin also increased VLDL-apoB FCR from 3.8270.33 to 6.3070.75 pools/day (Po0.01), but did not significantly alter VLDL-apoB secretion (12.871.7 to 13.872.0 mg/kg/day). CONCLUSIONS: In obesity, atorvastatin inhibits cholesterogenesis but increases intestinal cholesterol absorption. The increased cholesterol absorption may counteract the inhibitory effect on hepatic VLDL-apoB secretion, but it does not apparently influence enhanced catabolism of VLDL-apoB.

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“…Prior studies had shown that higher BMI is associated with decreased LDL-cholesterol responses to hypolipidemic diets [85,86,87]. High cholesterol synthesis and reduced intestinal cholesterol absorption in insulin-resistant states [88,89] might explain these findings, as an enhanced cholesterol flux through the liver will down-regulate LDL receptors and make them refractory to additional regulation by dietary fatty acid changes, while a decreased cholesterol flux though enterocytes would lessen both the cholesterol-raising response to dietary cholesterol and the cholesterol-lowering effect of plant sterols. Nuts are rich in plant sterols, which are likely to contribute to their cholesterol lowering effect [24], but this would be less operative when cholesterol absorption is low.…”

Section: Nut Feeding Trials With Outcomes On Cardiovascular Risk Fmentioning

confidence: 99%

Health Benefits of Nut Consumption

2010

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Nuts (tree nuts and peanuts) are nutrient dense foods with complex matrices rich in unsaturated fatty and other bioactive compounds: high-quality vegetable protein, fiber, minerals, tocopherols, phytosterols, and phenolic compounds. By virtue of their unique composition, nuts are likely to beneficially impact health outcomes. Epidemiologic studies have associated nut consumption with a reduced incidence of coronary heart disease and gallstones in both genders and diabetes in women. Limited evidence also suggests beneficial effects on hypertension, cancer, and inflammation. Interventional studies consistently show that nut intake has a cholesterol-lowering effect, even in the context of healthy diets, and there is emerging evidence of beneficial effects on oxidative stress, inflammation, and vascular reactivity. Blood pressure, visceral adiposity and the metabolic syndrome also appear to be positively influenced by nut consumption. Thus it is clear that nuts have a beneficial impact on many cardiovascular risk factors. Contrary to expectations, epidemiologic studies and clinical trials suggest that regular nut consumption is unlikely to contribute to obesity and may even help in weight loss. Safety concerns are limited to the infrequent occurrence of nut allergy in children. In conclusion, nuts are nutrient rich foods with wide-ranging cardiovascular and metabolic benefits, which can be readily incorporated into healthy diets.

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Introducing a new component of the metabolic syndrome: low cholesterol absorption

Cited by 160 publications

References 33 publications

Cholesterol metabolism and body composition in women: the effects of moderate weight loss

Cholesterol metabolism and body composition in women: the effects of moderate weight loss

Effect of a statin on hepatic apolipoprotein B-100 secretion and plasma campesterol levels in the metabolic syndrome

Health Benefits of Nut Consumption

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