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DOI: 10.1055/s-2008-1077238
© Georg Thieme Verlag KG Stuttgart · New York
Pflanzliche Sterole als Nahrungsmitteladditiva zur Prävention kardiovaskulärer Erkrankungen
Plant sterols as dietary supplements for the prevention of cardiovascular diseasesPublication History
eingereicht: 9.11.2007
akzeptiert: 14.4.2008
Publication Date:
20 May 2008 (online)

Zusammenfassung
Sterol-angereichtere Nahrungsmittel „Functional Foods” werden zur Senkung des Cholesterinspiegels von vielen Menschen konsumiert. Ein Wirksamkeitsbeleg von Phytosterolen im Hinblick auf kardiovaskuläre Ereignisse liegt nicht vor. Das Krankheitsbild der Sitosterolämie, epidemiologische Daten und neue experimentelle Ergebnisse ergeben Hinweise, dass pflanzliche Sterole negative kardiovaskuläre Effekte induzieren könnten. Vor einer generellen Empfehlung dieser Produkte sind daher weitere Daten zur Wirksamkeit und Sicherheit erforderlich.
Summary
„Functional foods” supplemented with plant sterols are advertised and added to regular meals to reduce serum cholesterol concentrations. The effects of increased phytosterol levels on cardiovascular diseases, however, are not known. Findings in patients with sitosterolemia, data from epidemiological studies, and experimental data from animal studies suggest that plant sterols may potentially exert negative cardiovascular effects. Additional studies investigating relevant clinical endpoints are needed before a diet supplemented with plant sterols can be recommended in the prevention of cardiovascular diseases.
Schlüsselwörter
pflanzliche Sterole - Prävention - Ernährung - kardiovaskuläres Risiko - Nahrungsergänzungsstoffe
Key words
plant sterols - prevention - nutrition - cardiovascular risk - functional food
Literatur
- 1
Anttolainen M, Luoto R, Uutela A. et al .
Characteristics of users and nonusers of plant sterol ester margarine in Finland:
an approach to study functional food.
J Am Diet Assoc.
2001;
101
1365-1368
Reference Ris Wihthout Link
- 2 Arzneimittelkommission der deutschen Ärzteschaft .Newsletter 2004 - 2045. vom 15.01.2004
Reference Ris Wihthout Link
- 3
Assmann G, Cullen P, Erby J. et al .
Plasma sitosterol elevations are associated with an increased incidence of coronary
events in men: results of a nested case-control analysis of the Prospective Cardiovascular
Munster (PROCAM) study.
Nutr Metab Cardiovasc Dis.
2006;
16
13-21
Reference Ris Wihthout Link
- 4
Bhattacharyya A K, Connor W E.
Beta-sitosterolemia and xanthomatosis. A newly described lipid storage disease in
two sisters.
J Clin Invest.
1974;
53
1033-1043
Reference Ris Wihthout Link
- 5
Brendsel J, Green S J.
Regarding the potential perils of phytosterols.
Atherosclerosis.
2007;
192
(1)
227-229
Reference Ris Wihthout Link
- 6
Dietz R, Rauch B.
Leitlinie zur Diagnose und Behandlung der chronischen koronaren Herzerkrankung der
Deutschen Gesellschaft für Kardiologie.
Z Kardiol.
2003;
92
501-521
Reference Ris Wihthout Link
- 7
Glueck C J, Speirs J, Tracy T. et al .
Relationships of plasma plant sterols (phytosterols) and cholesterol in 595 hypercholesterolemic
subjects, and familial aggregation of phytosterols, cholesterol, and premature coronary
heart disease in hyperphytosterolemic probands and their first-degree relatives.
Metabolism.
1991;
40
842-848
Reference Ris Wihthout Link
- 8
Gohlke H, Kübler W, Mathes P.
Positionspapier zur Primärprävention kardiovaskulärer Erkrankungen.
Z Kardiol.
2003;
92
522-524
Reference Ris Wihthout Link
- 9
Hallikainen M A, Sarkkinen E S, Uusitupa M I.
Comparison of the effects of plant sterol ester and plant stanol ester-enriched margarines
in lowering serum cholesterol concentrations in hypercholesterolaemic subjects on
a low-fat diet.
Eur J Clin Nutr.
2000;
54
715-725
Reference Ris Wihthout Link
- 10
Hendriks H F, Weststrate J A, van Vliet T. et al .
Spreads enriched with three different levels of vegetable oil sterols and the degree
of cholesterol lowering in normocholesterolaemic and mildly hypercholesterolaemic
subjects.
Eur J Clin Nutr.
1999;
53
319-327
Reference Ris Wihthout Link
- 11
Katan M B, Grundy S M.
Efficacy and safety of plant stanols and sterols in the management of blood cholesterol
levels.
Mayo Clin Proc.
2003;
78
965-978
Reference Ris Wihthout Link
- 12
Lees R S, Lees A M.
Effects of sitosterol on plasma lipid and lipoprotein concentration.
Lipoprotein Metab.
1976;
8
119-130
Reference Ris Wihthout Link
- 13
Miettinen T A, Puska P, Gylling H. et al .
Reduction of serum cholesterol with sitostanol-ester margarine in a mildly hypercholesterolemic
population.
N Eng J Med.
1995;
333
1308-1312
Reference Ris Wihthout Link
- 14
Miettinen T A, Standberg T E, Gylling H.
Noncholesterol sterols and cholesterol lowering by long-term simvastatin treatment
in coronary patients: relation to basal serum cholestanol.
Arterioscler Thromb Vasc Biol.
2000;
20
1340-1346
Reference Ris Wihthout Link
- 15
National Cholesterol Education Program Expert Panel. Executive summary of the third
report of the national cholesterol education program (NCEP) expert panel on detection,
evaluation, and treatment of high blood cholesterol in adults (adult treatment panel
III).
JAMA.
2001;
285
(19)
2486-2497
Reference Ris Wihthout Link
- 16
Patel M D, Thompson P D.
Phytosterols and vascular disease.
Athero-sclerosis.
2006;
186
(1)
12-19
Reference Ris Wihthout Link
- 17
Plat J, Brzezinka H, Lütjohann D. et al .
Oxidized plant sterols in human serum and lipid infusions as measured by combined
gas-liquid chromatography-mass spectrometry.
J Lipid Res.
2001;
42
2030-2038
Reference Ris Wihthout Link
- 18
Peterson D W.
Effect of soybean sterols in the diet on plasma and liver cholesterol in chicks.
Proc Soc Exp Biol Med.
1951;
78
143-147
Reference Ris Wihthout Link
- 19
Rajaratnam R A, Gylling H, Miettinen T A.
Independent association of plasma sequalene and noncholesterol sterols with coronary
artery disease in postmenopausal women.
J Am Coll Cardiol.
2000;
35
1185-1191
Reference Ris Wihthout Link
- 20
Salen G, Starc T, Sisk C M. et al .
Intestinal cholesterol absorption inhibitor ezetimibe added to cholestyramine for
sitosterolemia and xanthomatosis.
Gasteroenterology.
2006;
130
1853-1857
Reference Ris Wihthout Link
- 21
Salo P, Wester I.
Low-fat formulations of plant stanols and sterols.
Am J Cardiol.
2005;
96
51D-54D
Reference Ris Wihthout Link
- 22
Sudhop T, Bergmann K von.
Sitosterolemia - a rare disease. Are elevated plant sterols an additional risk factor?.
Z Kardiol.
2004;
93
921-928
Reference Ris Wihthout Link
- 23
Sudhop T, Gottwald B M, Bergmann K von.
Plasma plant sterols as a potential risk factor for coronary heart disease.
Metabolism.
2002;
51
1519-1521
Reference Ris Wihthout Link
- 24
Sutherland W HF, Williams M JA, Nye E R. et al .
Associations of plasma noncholesterol sterol levels with severity of coronary heart
disease.
Nutr Metab Cardiovasc Dis.
1998;
8
386-391
Reference Ris Wihthout Link
- 25
Tierry J, Ceglarek U, Fiedler G M. et al .
Elevated campesterol serum levels - a significant predictor of incident myocardial
infarction: results of the population-based MONICA/KORA follow-up study 1994 - 2005.
Circulation suppl.
2006;
144
4099 A
Reference Ris Wihthout Link
- 26 USA Food and Drug Administration .Summary of all GRAS notices. Center for Food Safety and Applied Nutrition. Office
of Food Additive Safety. http://www.cfsan.fda.gov/∼rdb/. 2003
Reference Ris Wihthout Link
- 27
Vanhanen H T, Blomqvist S, Ehnholm C. et al .
Serum cholesterol, cholesterol precursors, and plant sterols in hypercholesterolemic
subjects with different apoE phenotypes during dietary sitostanol ester treatment.
J Lipid Res.
1993;
34
1535-1544
Reference Ris Wihthout Link
- 28
Weingärtner O, Lütjohann D, Ji S. et al .
Vascular effects of a diet supplementation with plant sterols.
J Am Coll Cardiol.
2008;
51
1553-1561
Reference Ris Wihthout Link
- 29
Weststrate J A, Meijer G W.
Plant sterol-enriched margarines and reduction of plasma total- and LDL-cholesterol
concentrations in normocholesterolaemic and mildly hypercholesterolaemic subjects.
Eur J Clin Nutr.
1998;
52
334-343
Reference Ris Wihthout Link
Dr. med. Oliver Weingärtner
Universitätsklinikum des Saarlandes, Abteilung für Kardiologie, Angiologie und internistische
Intensivmedizin
Kirrberger Strasse, Gebäude 40
66421 Homburg Saar
Phone: 06841/1621-333
Fax: 06841/1621-331
Email: oweingartner@aol.com