Studies of plant stanol esters in different patient populations

Aims The efficacy and safety of plant stanol esters dissolved in margarine alone or combined with statins, neomycin or statins plus cholestyramine wer e investigated in children with familial hypercholesterolaemia (FH) and in patients with type 2 diabetes mellitus (DM). Results In FH children, low-density lipoprotein (LDL) cholesterol was signi ficantly reduced by 15-18%. High-density lipoprotein (HDL) cholesterol and triglycerides were unchanged. Serum plant sterol concentrations were signif icantly reduced by 29-42%. In DM, stanol esters reduced LDL cholesterol lev els by 9% and increased HDL cholesterol levels by 11% (both P<0.05). Metabo lic alterations included an inhibition of cholesterol absorption efficiency , a compensatory increase in cholesterol synthesis and inhibition of new LD L particle production. Stanol esters added to statin therapy lowered LDL ch olesterol levels by 12-20% (P<0.001). Neomycin and stanol esters significan tly lowered LDL cholesterol levels by 37% and triglycerides by 30%. Statin, cholestyramine and stanol eaters together lowered LDL cholesterol levels b y 67% from baseline (P<0.001) and increased HDL cholesterol levels by 11% ( P<0.05). In all studies, stanol esters were well tolerated when used alone or in combination with other drugs. Conclusion Stanol esters are well tolerated and effective in children with FH and in adults with DM. Stanol esters combined with statins, neomycin or cholestyramine potentiate the cholesterol-lowering effect.