The associations of cholesterol metabolism and plasma plant sterols with all-cause and cardiovascular mortality |
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Authors: | Guenther Silbernagel Guenter Fauler Michael M Hoffmann Dieter Lütjohann Bernhard R Winkelmann Bernhard O Boehm Winfried M?rz |
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Institution: | 1. Division of Endocrinology, Diabetology, Nephrology, Vascular Disease, and Clinical Chemistry, Department of Internal Medicine, Eberhard-Karls-University, Tübingen, Germany;2. Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria;4. Division of Clinical Chemistry, Department of Internal Medicine, University Medical Centre Freiburg, Freiburg, Germany;7. Institute of Clinical Chemistry and Pharmacology, University of Bonn, Bonn, Germany;11. Cardiology Group Frankfurt-Sachsenhausen, Frankfurt, Germany;8. Division of Endocrinology, Department of Internal Medicine, Ulm University, Ulm, Germany;71. Department of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany;112. Synlab Center of Laboratory Diagnostics Heidelberg, Heidelberg, Germany |
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Abstract: | Moderately elevated levels of plasma plant sterols have been suspected to be causally involved in atherosclerosis. The aim of this study was to investigate whether plant sterols and other markers of sterol metabolism predicted all-cause and cardiovascular mortality in participants of the Ludwigshafen Risk and Cardiovascular health (LURIC) study. A total of 1,257 individuals who did not use statins and at baseline had a mean (± SD) age of 62.8 (± 11.0) years were included in the present analysis. Lathosterol, cholestanol, campesterol, and sitosterol were measured to estimate cholesterol synthesis and absorption. The mean (± SD) time of the follow-up for all-cause and cardiovascular mortality was 7.32 (± 2.3) years. All-cause (P = 0.001) and cardiovascular (P = 0.006) mortality were decreased in the highest versus the lowest lathosterol to cholesterol tertile. In contrast, subjects in the third cholestanol to cholesterol tertile had increased all-cause (P < 0.001) and cardiovascular mortality (P = 0.010) compared with individuals in the first tertile. The third campesterol to cholesterol tertile was associated with increased all-cause mortality (P = 0.025). Sitosterol to cholesterol tertiles were not significantly related to all-cause or cardiovascular mortality. The data suggest that high absorption and low synthesis of cholesterol predict increased all-cause and cardiovascular mortality in LURIC participants. |
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Keywords: | cholesterol absorption cholesterol synthesis campesterol sitosterol cholestanol lathosterol |
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