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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2009.tde-12032010-154714
Document
Author
Full name
Angela de Oliveira Godoy Ilha
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2009
Supervisor
Committee
Lottenberg, Ana Maria Pita (President)
Bertolami, Marcelo Chiara
Silva, Maria Elizabeth Rossi da
Title in Portuguese
Fitoesteróides reduzem endotelina-1 em indivíduos moderadamente hipercolesterolêmicos
Keywords in Portuguese
Colesterol
Dieta
Endotelina-1
Fitosteróis
Triglicerídeos
Abstract in Portuguese
Introdução: Os fitoesteróis são indicados no tratamento da hipercolesterolemia. Embora sua ação sobre a redução do colesterol já tenha sido exaustivamente estudada, não se encontra bem elucidada na literatura, a forma como atua sobre biomarcadores inflamatórios e endoteliais em indivíduos hipercolesterolêmicos. Objetivo: Avaliar o efeito do fitoesterol adicionado ao leite de soja sobre as concentrações plasmáticas de lípides e biomarcadores, além de alterações em vias transcricionais envolvidos na patogênese da aterosclerose em células linfomononucleares em indivíduos moderadamente hipercolesterolêmicos. Metodologia: Foram estudados 38 pacientes, recrutados no Ambulatório do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Inicialmente, os pacientes foram submetidos a um período basal de três semanas para avaliar a aderência e tolerabilidade ao leite de soja padrão (Placebo). Foram orientados a manter os hábitos alimentares e a atividade física. Receberam 400 mL/dia de leite de soja padrão ou enriquecido com fitoesteróis (1,6 g/dia) por dois períodos de quatro semanas em que o estudo foi randomizado, cego e cruzado. Resultados: O peso corporal foi mantido durante o estudo. O tratamento com fitoesterol reduziu o colesterol total em 5,5 % (P<0,001), a lipoproteína de baixa densidade (LDL) em 6,4 % e os triglicérides em 8,3 % (P<0,05) e aumentaram as concentrações de campesterol e sitosterol no plasma em 18,9% e 21,6%, respectivamente. Não houve alteração nos valores de lipoproteína de alta densidade (HDL). Com relação aos biomarcadores de aterosclerose, os fitoesteróis provocaram redução apenas na endotelina-1 em 11 % (P<0,05). Esta ação foi independente da redução do LDL-C. Não houve alteração no RNAm para 3-hydroxy-3-methylglutaryl coenzyme A redutase e receptor de LDL. Conclusão: Os fitoesteróis são eficientes na redução da concentração plasmática do colesterol total, triglicérides, LDL-C e da endotelina-1, sendo esta última independente da redução do colesterol
Title in English
Phytosterols decrease endothelin-1 in moderate hypercholesterolemic individuals
Keywords in English
Cholesterol
Diet
Endothelin-1
Phytosterol
Triglycerides
Abstract in English
Background: Phytosterols are recommended in the treatment of moderate hypercholesterolemia. Although their mechanisms of action on cholesterol reduction has been exhaustively studied, other activities, such as their effects on inflammatory arterial markers and on endothelial function, have not yet been fully investigated. Objective: To evaluate the efficacy of phytosterols added to soy milk on the reduction of plasma lipids, on biomarkers involved in the pathogenesis of atherosclerosis and on transcriptional changes in 3-hydroxy-3-methylglutaryl coenzyme A (HMGCoA) reductase and low density lipoprotein receptor in moderately hypercholesterolemic individuals. Design: Moderately hypercholesterolemic patients (n=38, mean age 58 y) were initially followed over a 3-wk baseline period to evaluate their adherence to the program and their tolerance to the added milk. Patients received soy milk (400 mL/d) or soy milk + phytosterol (1.6 g/d) for 2 periods of 4-wk each. The study was randomized, blinded and crossed. Results: Body weight was maintained during the study. Phytosterol treatment reduced the total cholesterol concentration 5.5 % (P < 0.001), low density lipoprotein (LDL) 6.4 % and triglycerides 8.3 % (P<0.05), without modifying high density lipoprotein (HDL). Phytosterol reduced plasma endothelin-1 by 11 % (P<0.05), independently of LDL-C lowering activity. No effects on LDL receptor or on HMGCoA reductase mRNA expression in mononuclear blood cells were found. Sitosterol and campesterol plasma concentrations increased with phytosterol consumption by 18.9% and 21.6%, respectively. Conclusions: Phytosterol effectively lowered plasma total cholesterol, LDL-C, triglycerides and endothelin-1 concentration. The reduction in endothelin-1 concentration was independent of the decrease in the LDL-C concentration
 
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Publishing Date
2010-03-16
 
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