Influencia del consumo de esteroles vegetales y su relación con la enfermedad cardiovascular
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2017
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20/10/2016
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Universidad Complutense de Madrid
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Abstract
La enfermedad cardiovascular responde a un conjunto de patologías que se deben a trastornos del corazón y los vasos sanguíneos. En España, suponen la primera causa de muerte y de hospitalización en la población, con cerca del 30 % de las muertes anuales. Aproximadamente el 20% de los adultos tiene el colesterol total ≥250 mg/dl. Por encima de 200 mg/dl se encuentran entre el 50% y el 69% de los adultos de edades medias. Dentro de los factores modificables y de riesgo, algunas medidas de actuación son los hábitos dietéticos, y la ingesta de esteroles vegetales. Estos son compuestos naturales de algunos productos vegetales, de estructura similar al colesterol y con mayor afinidad por la absorción del colesterol procedente de la dieta (vía exógena), así como de la vía endógena y de la vía para el transporte del colesterol reverso del colesterol (vía hepática). De esta forma, se protege la formación de la placa de ateroma, disminuyendo el riesgo de enfermedad cardiovascular. Objetivos: Analizar la efectividad de la ingesta de esteroles vegetales en el manejo del riesgo de enfermedad cardiovascular, mediante la reducción de la hipercolesterolemia en sujetos adultos. Objetivos secundarios: Analizar la reducción del colesterol total, del LDLc, HDLc y Tg, tras la ingesta de esteroles vegetales. Estudiar la relación entre el HDLc y la ApoA1. Métodos: Se diseñó y desarrolló un doble ensayo clínico en dos hospitales de la Comunidad de Madrid. Ambos ensayos fueron diseñados bajo el mismo protocolo y desarrollados por el doctorando, incluyendo a un total de 54 sujetos, controlados, aleatorizados, doble ciego y cruzados. Durante 3 semanas, un grupo de sujetos ingirieron una cantidad de 700 ml de leche con una cantidad diaria de 2,24 gr de esteroles vegetale y, otro grupo con leche desnatada sin esteroles (placebo). Después de cada periodo de ingesta, de 3 semanas, tras un periodo de lavado y el análisis de las lipoproteínas sanguíneas, los sujetos cambiaron de grupo. Resultados: Se comprobó la efectividad de la disminución del colesterol total, afectando especialmente al LDLc (p<0,05), sin diferencias significativas en el HDLc (p>0,05). Se encontró una correlación positiva (p<0,05) entre el HDLc y la ApoA1. Conclusión: La introducción de esteroles vegetales en la alimentación, puede suponer una vía efectiva y segura para el control leve de la hipercolesterolemia en adultos.
Cardiovascular disease responds to a number of diseases that are due to disorders of the heart and blood vessels. In Spain, they represent the leading cause of death and hospitalization in the population, with about 30% of annual deaths. Approximately 20% of adults have total cholesterol ≥250 mg / dl. Above 200 mg / dl are between 50% and 69% of adults in middle age. Among the modifiable risk factors, some means of action are the dietary habits and intake of plant sterols. These natural compounds of certain plant products, similar to cholesterol and higher affinity for cholesterol absorption from the diet (exogenous pathway) structure and the endogenous pathway and the route for transportation of reverse cholesterol (liver) pathway. Thus, the formation of atheroma is protected, reducing the risk of cardiovascular disease. AIM: Analyze the effectiveness of the intake of plant sterols in managing the risk of cardiovascular disease by reducing cholesterol in adult subjects. Secondary objectives: Analyze reducing total cholesterol, LDLc, HDLc and Tg, after ingestion of plant sterols. To study the relationship between HDLc and ApoA1. Methods: Design and development is a double trial in two hospitals of the Community of Madrid. Both trials were designed under the same protocol and developed by the doctoral student, including a total of 54 subjects, including both clinical trials, controlled, aletorizados, double-blind cross. For 3 weeks, an amount subjects ingested 700 ml of milk with a daily amount of 2.24 g of vegetable or without sterols skimmed milk (placebo) sterols. After each period of intake of 3 weeks, subjects switched groups, after a washout period, and the analysis of blood lipoproteins. Results: The effectiveness of the decrease in total cholesterol was found, especially affecting LDLc (p <0.05), no significant differences in HDLc (p> 0.05). A positive correlation (p <0.05) between HDLc and ApoA1 was found. Conclusion: The introduction of plant sterols in food can be an effective and safe way to control mild hypercholesterolemia in adults.
Cardiovascular disease responds to a number of diseases that are due to disorders of the heart and blood vessels. In Spain, they represent the leading cause of death and hospitalization in the population, with about 30% of annual deaths. Approximately 20% of adults have total cholesterol ≥250 mg / dl. Above 200 mg / dl are between 50% and 69% of adults in middle age. Among the modifiable risk factors, some means of action are the dietary habits and intake of plant sterols. These natural compounds of certain plant products, similar to cholesterol and higher affinity for cholesterol absorption from the diet (exogenous pathway) structure and the endogenous pathway and the route for transportation of reverse cholesterol (liver) pathway. Thus, the formation of atheroma is protected, reducing the risk of cardiovascular disease. AIM: Analyze the effectiveness of the intake of plant sterols in managing the risk of cardiovascular disease by reducing cholesterol in adult subjects. Secondary objectives: Analyze reducing total cholesterol, LDLc, HDLc and Tg, after ingestion of plant sterols. To study the relationship between HDLc and ApoA1. Methods: Design and development is a double trial in two hospitals of the Community of Madrid. Both trials were designed under the same protocol and developed by the doctoral student, including a total of 54 subjects, including both clinical trials, controlled, aletorizados, double-blind cross. For 3 weeks, an amount subjects ingested 700 ml of milk with a daily amount of 2.24 g of vegetable or without sterols skimmed milk (placebo) sterols. After each period of intake of 3 weeks, subjects switched groups, after a washout period, and the analysis of blood lipoproteins. Results: The effectiveness of the decrease in total cholesterol was found, especially affecting LDLc (p <0.05), no significant differences in HDLc (p> 0.05). A positive correlation (p <0.05) between HDLc and ApoA1 was found. Conclusion: The introduction of plant sterols in food can be an effective and safe way to control mild hypercholesterolemia in adults.
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 21/10/2016