Hafif-Orta Düzeyde Hiperkolesterolemili Bireylerde Bitkisel Stanol İçeren Yoğurt Tüketiminin Oksidatif Stres Üzerine Etkisi

Amaç: Bu çalışmanın amacı, kolesterol düşürücü özelliği olduğu bilinen bitkisel stanol esteri alımı sonucu gerçekleşen serum kolesterol düzeylerindeki düşüşün, antioksidan kapasite ve bazı oksidatif stres göstergeleri üzerindeki etkisini incelemektir. Bireyler ve Yöntem: Çalışma, bitkisel stanol esteri içeren yoğurt tüketimine bağlı olarak serum LDL kolesterol düzeyinde önemli düzeyde azalma gerçekleşen 8 hiperkolesterolemi hastası ile plasebo kontrol yoğurdu tüketen ve serum LDL kolesterol düzeyinde değişim gerçekleşmeyen 8 hiperkolesterolemi hastası üzerinde yürütülmüştür. Çalışma süresince çalışmaya katılan kişilerin yaşam tarzlarında veya beslenme düzenlerinde bir değişiklik yapmamaları istenmiştir. Çalışmada bireylerin serum lipit düzeylerine ek olarak, araştırma yoğurtlarının tüketiminin öncesinde ve 4 hafta sonundaki serum total antioksidan kapasite, okside LDL ve 8-prostaglandin F2α düzeyleri karşılaştırılmıştır. Bulgular: Çalışma sonunda bitkisel stanol esteri içeren yoğurt tüketen kişilerin serum total kolesterol, LDL kolesterol düzeylerinde önemli düzeyde azalma gerçekleşmiştir. Öte yandan bu azalmanın, kişilerin antioksidan kapasite ve oksidatif stres düzeylerine aynı miktarda yansımadığı belirlenmiştir. Sonuç: Hafif-orta düzeyde hiperkolesterolemisi olan kişilerin 4 hafta süresince bitkisel stanol tüketmelerinin serum total kolesterol ve LDL kolesterol düzeylerini azalttığı, ancak bu azalmanın serum oksidatif stres göstergeleri üzerine istatistiksel açıdan önemli bir etkisinin olmadığı sonucuna varılmıştır.

The Effects of Plant Stanol Ester Containing Yoghurt on Oxidative Stress in Mild-Moderate Hypercholesterolemic Individuals

Aim: The main aim of the current study was to examine the effects of plant stanol esters, which are well known with their cholesterol lowering effects, on antioxidant capacity and certain oxidative stress markers. Subjects and Method: This study was conducted on 8 hypercholesterolemia patients whose serum LDL cholesterol level was significantly decreased after plant stanol ester containing yoghurt consumption for 4 weeks and another 8 hypercholesterolemia patients whose LDL cholesterol levels stayed stable after consumption of placebo yoghurts. During the study the patients were requested not to change their lifestyles and dietary habits. In addition to serum lipid levels, serum total antioxidant capacity, oxidized LDL and 8 prostoglandin F2α levels of the patients were compared before and 4 weeks after the intervention period. Results: As a result of the study, serum total and LDL cholesterol levels were significantly decreased in patients who consumed plant stanol ester containing yoghurt for 4 weeks. However, the decrease in serum lipid levels did not reflect to antioxidant capacity and oxidative stress biomarkers. Conclusion: It has been determined that consumption of plant stanol ester containing yoghurt in patients with mild to moderate hypercholesterolemia for 4 weeks have lowered serum total and LDL cholesterol levels but this decrease does not have a statistically significant effect on serum antioxidant capacity and oxidative stress biomarkers.

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  • 1. Catapano AL, Graham I, De Backer G, Wiklund O, Chapman MJ, Drexel H, et al. 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias: The Task Force for the Management of Dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) Developed with the special contribution of the European Assocciation for Cardiovascular Prevention & Rehabilitation (EACPR). Atherosclerosis 2016;253:281-344.
  • 2. Expert Panel on Detection E, Treatment of High Blood Cholesterol in A, 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):2486-97.
  • 3. Gylling H, Plat J, Turley S, Ginsberg HN, Ellegard L, Jessup W, et al. Plant sterols and plant stanols in the management of dyslipidaemia and prevention of cardiovascular disease. Atherosclerosis 2014;232(2):346- 60.
  • 4. Calpe-Berdiel L, Escola-Gil JC, Blanco-Vaca F. New insights into the molecular actions of plant sterols and stanols in cholesterol metabolism. Atherosclerosis 2009;203(1):18-31.
  • 5. Chan YM, Varady KA, Lin Y, Trautwein E, Mensink RP, Plat J, et al. Plasma concentrations of plant sterols: physiology and relationship with coronary heart disease. Nutr Rev 2006;64(9):385-402.
  • 6. De Smet E, Mensink RP, Plat J. Effects of plant sterols and stanols on intestinal cholesterol metabolism: suggested mechanisms from past to present. Mol Nutr Food Res 2012;56(7):1058-72.
  • 7. Stocker R, Keaney JF. Role of oxidative modifications in atherosclerosis. Physiol Rev 2004;84(4):1381-478.
  • 8. Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO, 3rd, Criqui M, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 2003;107(3):499-511.
  • 9. Buyuktuncer Z, Fisunoglu M, Guven GS, Unal S, Besler HT. The cholesterol lowering efficacy of plant stanol ester yoghurt in a Turkish population: a double-blind, placebo-controlled trial. Lipids Health Dis 2013;12:91.
  • 10. Zern TL, Fernandez ML. Cardioprotective effects of dietary polyphenols. J Nutr 2005;135(10):2291-4.
  • 11. Gylling H, Hallikainen M, Nissinen MJ, Miettinen TA. The effect of a very high daily plant stanol ester intake on serum lipids, carotenoids, and fat-soluble vitamins. Clin Nutr 2010;29(1):112-8.
  • 12. Baumgartner S, Ras RT, Trautwein EA, Mensink RP, Plat J. Plasma fat-soluble vitamin and carotenoid concentrations after plant sterol and plant stanol consumption: a meta-analysis of randomized controlled trials. Eur J Nutr 2017;56(3):909-23.
  • 13. De Jong A, Plat J, Bast A, Godschalk RW, Basu S, Mensink RP. Effects of plant sterol and stanol ester consumption on lipid metabolism, antioxidant status and markers of oxidative stress, endothelial function and low-grade inflammation in patients on current statin treatment. Eur J Clin Nutr 2008;62(2):263-73.
  • 14. Franzoni F, Quinones-Galvan A, Regoli F, Ferrannini E, Galetta F. A comparative study of the in vitro antioxidant activity of statins. Int J Cardiol 2003;90(2-3):317-21.
  • 15. Murrow JR, Sher S, Ali S, Uphoff I, Patel R, Porkert M, et al. The differential effect of statins on oxidative stress and endothelial function: atorvastatin versus pravastatin. J Clin Lipidol 2012;6(1):42-9.
  • 16. Yilmaz MI, Baykal Y, Kilic M, Sonmez A, Bulucu F, Aydin A, et al. Effects of statins on oxidative stress. Biol Trace Elem Res 2004;98(2):119-27.
  • 17. Bakker MF, Peeters PH, Klaasen VM, Bueno-de-Mesquita HB, Jansen EH, Ros MM, et al. Plasma carotenoids, vitamin C, tocopherols, and retinol and the risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition cohort. Am J Clin Nutr 2016;103(2):454-64.
  • 18. Morris DL, Kritchevsky SB, Davis CE. Serum carotenoids and coronary heart disease. The Lipid Research Clinics Coronary Primary Prevention Trial and Follow-up Study. JAMA 1994;272(18):1439-41.
  • 19. Wu J, Cho E, Willett WC, Sastry SM, Schaumberg DA. Intakes of lutein, zeaxanthin, and other carotenoids and age-related macular degeneration during 2 decades of prospective follow-up. JAMA Ophthalmol 2015;133(12):1415-24.
  • 20. Katan MB, Grundy SM, Jones P, Law M, Miettinen T, Paoletti R, et al. Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clin Proc 2003;78(8):965-78.
  • 21. Banuls C, Martinez-Triguero ML, Lopez-Ruiz A, Morillas C, Lacomba R, Victor VM, et al. Evaluation of cardiovascular risk and oxidative stress parameters in hypercholesterolemic subjects on a standard healthy diet including low-fat milk enriched with plant sterols. J Nutr Biochem 2010;21(9):881-6.
  • 22. Sialvera TE, Koutelidakis AE, Richter DJ, Yfanti G, Kapsokefalou M, Micha R, et al. Phytosterol supplementation does not affect plasma antioxidant capacity in patients with metabolic syndrome. Int J Food Sci Nutr 2013;64(1):21-7.
  • 23. Deng Q, Yu X, Xu J, Liu C, Huang F, Huang Q, et al. Effect of flaxseed oil fortified with vitamin E and phytosterols on antioxidant defense capacities and lipids profile in rats. J Food Sci 2012;77(6):135-40.
  • 24. Levitan I, Volkov S, Subbaiah PV. Oxidized LDL: Diversity, patterns of recognition, and pathophysiology. Antioxid Redox Sign 2010;13(1):39-75.
  • 25. Bertolami A, Botelho PB, Macedo LF, Abdalla DS, Faludi AA, Galasso M, et al. Effect of plant sterols compared with ezetimibe on oxidative stress in patients treated with statins. J Funct Foods 2014;10:178-86.
  • 26. Sola R, Valls RM, Godas G, Perez-Busquets G, Ribalta J, Girona J, et al. Cocoa, hazelnuts, sterols and soluble fiber cream reduces lipids and inflammation biomarkers in hypertensive patients: a randomized controlled trial. PLoS One 2012;7(2):e31103.
  • 27. Dietrich M, Block G, Hudes M, Morrow JD, Norkus EP, Traber MG, et al. Antioxidant supplementation decreases lipid peroxidation biomarker F2-isoprostanes in plasma of smokers. Cancer Epidemiology and Prevention Biomarkers 2002;11(1):7-13.
  • 28. Mannarino E, Pirro M, Cortese C, Lupattelli G, Siepi D, Mezzetti A, et al. Effects of a phytosterol-enriched dairy product on lipids, sterols and 8-isoprostane in hypercholesterolemic patients: a multicenter Italian study. Nutr Metab Cardiovasc Dis 2009;19(2):84-90.
  • 29. Devaraj S, Autret BC, Jialal I. Reduced-calorie orange juice beverage with plant sterols lowers C-reactive protein concentrations and improves the lipid profile in human volunteers. Am J Clin Nutr 2006;84(4):756-61.
  • 30. Micallef MA, Garg ML. Anti-inflammatory and cardioprotective effects of n-3 polyunsaturated fatty acids and plant sterols in hyperlipidemic individuals. Atherosclerosis 2009;204(2):476-82.
  • 31. Rocha VZ, Ras RT, Gagliardi AC, Mangili LC, Trautwein EA, Santos RD. Effects of phytosterols on markers of inflammation: A systematic review and meta-analysis. Atherosclerosis 2016;248:76-83.