Plant Stanol Ester - Dual Effect of Plant Stanol

Dual Effect of Plant Stanol

Plant stanol reduce both cholesterol and plant sterol levels in serum. This may be of importance since elevated plant sterol concentrations have been identified as an independent risk factor for coronary heart disease (CHD). Two ABC transporters (ABCG5 and ABCG8) play an important role in the regulating the intestinal absorption of plant sterols by resecreting previously absorbed plant sterols from the enterocytes back into the intestinal lumen.

Mutations in these transporter proteins lead to a rare congenital disease called sitosterolaemia, which is characterised by:

• severely elevated serum plant sterol concentrations,
• normal to moderately increased serum cholesterol concentrations, and
• a high risk of developing CHD at a very early age.

It was recently shown that polymorphisms in the ABCG5 and ABCG8 genes contribute to modifying serum plant sterol levels in healthy, non-sitosterolaemic individuals. Furthermore, several epidemiological studies have shown that the risk of developing heart disease seems to be increased even at more "normal" plant sterol levels. Since statins were shown to increase serum plant sterol concentrations, patients should probably not be treated with statins alone but with a combination therapy focusing simultaneously on improving the serum lipoprotein profile and lowering serum plant sterol concentrations.