Plant sterols and cardiovascular disease: a systematic review and meta-analysis†
Identifieur interne : 000750 ( Main/Exploration ); précédent : 000749; suivant : 000751Plant sterols and cardiovascular disease: a systematic review and meta-analysis†
Auteurs : Bernd Genser [Allemagne, Brésil] ; Günther Silbernagel [Allemagne] ; Guy De Backer [Belgique] ; Eric Bruckert [France] ; Rafael Carmena [Espagne] ; M. John Chapman [France] ; John Deanfield [Royaume-Uni] ; Olivier S. Descamps [Belgique] ; Ernst R. Rietzschel [Belgique] ; Karen C. Dias [Brésil] ; Winfried M Rz [Allemagne, Autriche]Source :
- European Heart Journal [ 0195-668X ] ; 2012.
Abstract
The impact of increased serum concentrations of plant sterols on cardiovascular risk is unclear. We conducted a systematic review and meta-analysis aimed to investigate whether there is an association between serum concentrations of two common plant sterols (sitosterol, campesterol) and cardiovascular disease (CVD). We systematically searched the databases MEDLINE, EMBASE, and COCHRANE for studies published between January 1950 and April 2010 that reported either risk ratios (RR) of CVD in relation to serum sterol concentrations (either absolute or expressed as ratios relative to total cholesterol) or serum sterol concentrations in CVD cases and controls separately. We conducted two meta-analyses, one based on RR of CVD contrasting the upper vs. the lower third of the sterol distribution, and another based on standardized mean differences between CVD cases and controls. Summary estimates were derived by fixed and random effects meta-analysis techniques. We identified 17 studies using different designs (four case–control, five nested case–control, three cohort, five cross-sectional) involving 11 182 participants. Eight studies reported RR of CVD and 15 studies reported serum concentrations in CVD cases and controls. Funnel plots showed evidence for publication bias indicating small unpublished studies with non-significant findings. Neither of our meta-analyses suggested any relationship between serum concentrations of sitosterol and campesterol (both absolute concentrations and ratios to cholesterol) and risk of CVD. Our systematic review and meta-analysis did not reveal any evidence of an association between serum concentrations of plant sterols and risk of CVD.
Url:
DOI: 10.1093/eurheartj/ehr441
PubMed: 22334625
PubMed Central: 3279314
Affiliations:
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John Chapman</name><affiliation wicri:level="1"><nlm:aff id="af7"><addr-line>Dyslipidemia, Inflammation and Atherosclerosis Research Unit</addr-line>,<institution>National Institute for Health and Medical Research (INSERM)</institution>,<addr-line>Paris</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af8"><institution>Pitié-Salpetriere University Hospital</institution>,<addr-line>Paris</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Deanfield, John" sort="Deanfield, John" uniqKey="Deanfield J" first="John" last="Deanfield">John Deanfield</name><affiliation wicri:level="1"><nlm:aff id="af9"><institution>Institute of Cardiovascular Science, University College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Descamps, Olivier S" sort="Descamps, Olivier S" uniqKey="Descamps O" first="Olivier S." last="Descamps">Olivier S. Descamps</name><affiliation wicri:level="1"><nlm:aff id="af10"><institution>Center of Medical Research, Haine Saint Paul</institution>,<country>Belgium</country></nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Rietzschel, Ernst R" sort="Rietzschel, Ernst R" uniqKey="Rietzschel E" first="Ernst R." last="Rietzschel">Ernst R. Rietzschel</name><affiliation wicri:level="1"><nlm:aff id="af11"><addr-line>Department of Cardiovascular Diseases</addr-line>,<institution>Ghent University</institution>,<addr-line>Ghent</addr-line>,<country>Belgium</country></nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Dias, Karen C" sort="Dias, Karen C" uniqKey="Dias K" first="Karen C." last="Dias">Karen C. Dias</name><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Instituto de Saúde Coletiva, Federal University of Bahia, Salvador</wicri:regionArea><wicri:noRegion>Salvador</wicri:noRegion></affiliation></author><author><name sortKey="M Rz, Winfried" sort="M Rz, Winfried" uniqKey="M Rz W" first="Winfried" last="M Rz">Winfried M Rz</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim</addr-line>,<institution>University of Heidelberg</institution>,<addr-line>Heidelberg</addr-line>,<country>Germany</country></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af12"><institution>Synlab Centers of Leinfelden-Echterdingen and Bad Nauheim, Leinfelden-Echterdingen and Bad Nauheim</institution>,<country>Germany</country></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af13"><addr-line>Clinical Institute of Medical and Chemical Laboratory Diagnostics</addr-line>,<institution>Medical University of Graz</institution>,<country>Austria</country></nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">22334625</idno><idno type="pmc">3279314</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279314</idno><idno type="RBID">PMC:3279314</idno><idno type="doi">10.1093/eurheartj/ehr441</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">000462</idno><idno 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Mannheim</addr-line>,<institution>University of Heidelberg</institution>,<addr-line>Heidelberg</addr-line>,<country>Germany</country></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Instituto de Saúde Coletiva, Federal University of Bahia, Salvador</wicri:regionArea><wicri:noRegion>Salvador</wicri:noRegion></affiliation></author><author><name sortKey="Silbernagel, Gunther" sort="Silbernagel, Gunther" uniqKey="Silbernagel G" first="Günther" last="Silbernagel">Günther Silbernagel</name><affiliation wicri:level="1"><nlm:aff id="af3"><addr-line>Division of Endocrinology, Diabetology, Nephrology, Vascular Disease, and Clinical Chemistry, Department of Internal Medicine</addr-line>,<institution>Eberhard Karls University</institution>,<addr-line>Tübingen</addr-line>,<country>Germany</country></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="De Backer, Guy" sort="De Backer, Guy" uniqKey="De Backer G" first="Guy" last="De Backer">Guy De Backer</name><affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Department of Public Health</addr-line>,<institution>Ghent University</institution>,<addr-line>Ghent</addr-line>,<country>Belgium</country></nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Bruckert, Eric" sort="Bruckert, Eric" uniqKey="Bruckert E" first="Eric" last="Bruckert">Eric Bruckert</name><affiliation wicri:level="1"><nlm:aff id="af5"><addr-line>Division of Endocrinology and Metabolism</addr-line>,<institution>Hôpital de la Pitié-Salpétrière</institution>,<addr-line>Paris</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Carmena, Rafael" sort="Carmena, Rafael" uniqKey="Carmena R" first="Rafael" last="Carmena">Rafael Carmena</name><affiliation wicri:level="1"><nlm:aff id="af6"><addr-line>Division of Endocrinology and Nutrition, Department of Medicine</addr-line>,<institution>University Hospital</institution>,<addr-line>Valencia</addr-line>,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Chapman, M John" sort="Chapman, M John" uniqKey="Chapman M" first="M. John" last="Chapman">M. John Chapman</name><affiliation wicri:level="1"><nlm:aff id="af7"><addr-line>Dyslipidemia, Inflammation and Atherosclerosis Research Unit</addr-line>,<institution>National Institute for Health and Medical Research (INSERM)</institution>,<addr-line>Paris</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af8"><institution>Pitié-Salpetriere University Hospital</institution>,<addr-line>Paris</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Deanfield, John" sort="Deanfield, John" uniqKey="Deanfield J" first="John" last="Deanfield">John Deanfield</name><affiliation wicri:level="1"><nlm:aff id="af9"><institution>Institute of Cardiovascular Science, University College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Descamps, Olivier S" sort="Descamps, Olivier S" uniqKey="Descamps O" first="Olivier S." last="Descamps">Olivier S. Descamps</name><affiliation wicri:level="1"><nlm:aff id="af10"><institution>Center of Medical Research, Haine Saint Paul</institution>,<country>Belgium</country></nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Rietzschel, Ernst R" sort="Rietzschel, Ernst R" uniqKey="Rietzschel E" first="Ernst R." last="Rietzschel">Ernst R. Rietzschel</name><affiliation wicri:level="1"><nlm:aff id="af11"><addr-line>Department of Cardiovascular Diseases</addr-line>,<institution>Ghent University</institution>,<addr-line>Ghent</addr-line>,<country>Belgium</country></nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Dias, Karen C" sort="Dias, Karen C" uniqKey="Dias K" first="Karen C." last="Dias">Karen C. Dias</name><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil</addr-line></nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Instituto de Saúde Coletiva, Federal University of Bahia, Salvador</wicri:regionArea><wicri:noRegion>Salvador</wicri:noRegion></affiliation></author><author><name sortKey="M Rz, Winfried" sort="M Rz, Winfried" uniqKey="M Rz W" first="Winfried" last="M Rz">Winfried M Rz</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim</addr-line>,<institution>University of Heidelberg</institution>,<addr-line>Heidelberg</addr-line>,<country>Germany</country></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af12"><institution>Synlab Centers of Leinfelden-Echterdingen and Bad Nauheim, Leinfelden-Echterdingen and Bad Nauheim</institution>,<country>Germany</country></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af13"><addr-line>Clinical Institute of Medical and Chemical Laboratory Diagnostics</addr-line>,<institution>Medical University of Graz</institution>,<country>Austria</country></nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">European Heart Journal</title><idno type="ISSN">0195-668X</idno><idno type="eISSN">1522-9645</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The impact of increased serum concentrations of plant sterols on cardiovascular risk is unclear. We conducted a systematic review and meta-analysis aimed to investigate whether there is an association between serum concentrations of two common plant sterols (sitosterol, campesterol) and cardiovascular disease (CVD). We systematically searched the databases MEDLINE, EMBASE, and COCHRANE for studies published between January 1950 and April 2010 that reported either risk ratios (RR) of CVD in relation to serum sterol concentrations (either absolute or expressed as ratios relative to total cholesterol) or serum sterol concentrations in CVD cases and controls separately. We conducted two meta-analyses, one based on RR of CVD contrasting the upper vs. the lower third of the sterol distribution, and another based on standardized mean differences between CVD cases and controls. Summary estimates were derived by fixed and random effects meta-analysis techniques. We identified 17 studies using different designs (four case–control, five nested case–control, three cohort, five cross-sectional) involving 11 182 participants. Eight studies reported RR of CVD and 15 studies reported serum concentrations in CVD cases and controls. Funnel plots showed evidence for publication bias indicating small unpublished studies with non-significant findings. Neither of our meta-analyses suggested any relationship between serum concentrations of sitosterol and campesterol (both absolute concentrations and ratios to cholesterol) and risk of CVD. Our systematic review and meta-analysis did not reveal any evidence of an association between serum concentrations of plant sterols and risk of CVD.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Wilson, Pw" uniqKey="Wilson P">PW Wilson</name></author><author><name sortKey="D Agostino, Rb" uniqKey="D Agostino R">RB D'Agostino</name></author><author><name sortKey="Levy, D" uniqKey="Levy D">D Levy</name></author><author><name sortKey="Belanger, Am" uniqKey="Belanger A">AM Belanger</name></author><author><name sortKey="Silbershatz, H" uniqKey="Silbershatz H">H Silbershatz</name></author><author><name sortKey="Kannel, Wb" uniqKey="Kannel W">WB Kannel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sacks, Fm" uniqKey="Sacks F">FM Sacks</name></author><author><name sortKey="Pasternak, Rc" uniqKey="Pasternak R">RC Pasternak</name></author><author><name sortKey="Gibson, Cm" 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Miettinen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cohen, Jc" uniqKey="Cohen J">JC Cohen</name></author><author><name sortKey="Pertsemlidis, A" uniqKey="Pertsemlidis A">A Pertsemlidis</name></author><author><name sortKey="Fahmi, S" uniqKey="Fahmi S">S Fahmi</name></author><author><name sortKey="Esmail, S" uniqKey="Esmail S">S Esmail</name></author><author><name sortKey="Vega, Gl" uniqKey="Vega G">GL Vega</name></author><author><name sortKey="Grundy, Sm" uniqKey="Grundy S">SM Grundy</name></author><author><name sortKey="Hobbs, Hh" uniqKey="Hobbs H">HH Hobbs</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gylling, H" uniqKey="Gylling H">H Gylling</name></author><author><name sortKey="Hallikainen, M" uniqKey="Hallikainen M">M Hallikainen</name></author><author><name sortKey="Pihlajamaki, J" uniqKey="Pihlajamaki J">J Pihlajamaki</name></author><author><name sortKey="Agren, J" uniqKey="Agren J">J Agren</name></author><author><name sortKey="Laakso, M" uniqKey="Laakso M">M Laakso</name></author><author><name sortKey="Rajaratnam, Ra" uniqKey="Rajaratnam R">RA Rajaratnam</name></author><author><name sortKey="Rauramaa, R" uniqKey="Rauramaa R">R Rauramaa</name></author><author><name sortKey="Miettinen, Ta" uniqKey="Miettinen T">TA Miettinen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gami, As" uniqKey="Gami A">AS Gami</name></author><author><name sortKey="Witt, Bj" uniqKey="Witt B">BJ Witt</name></author><author><name sortKey="Howard, De" uniqKey="Howard D">DE Howard</name></author><author><name sortKey="Erwin, Pj" uniqKey="Erwin P">PJ Erwin</name></author><author><name sortKey="Gami, La" uniqKey="Gami L">LA Gami</name></author><author><name sortKey="Somers, Vk" uniqKey="Somers V">VK Somers</name></author><author><name sortKey="Montori, Vm" uniqKey="Montori V">VM Montori</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Haffner, Sm" uniqKey="Haffner S">SM Haffner</name></author><author><name sortKey="Lehto, S" uniqKey="Lehto S">S Lehto</name></author><author><name sortKey="Ronnemaa, T" uniqKey="Ronnemaa T">T Ronnemaa</name></author><author><name sortKey="Pyorala, K" uniqKey="Pyorala K">K Pyorala</name></author><author><name sortKey="Laakso, M" uniqKey="Laakso M">M Laakso</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Strandberg, Te" uniqKey="Strandberg T">TE Strandberg</name></author><author><name sortKey="Pitkala, Kh" uniqKey="Pitkala K">KH Pitkala</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Weingartner, O" uniqKey="Weingartner O">O Weingartner</name></author><author><name sortKey="Lutjohann, D" uniqKey="Lutjohann D">D Lutjohann</name></author><author><name sortKey="Ji, S" uniqKey="Ji S">S Ji</name></author><author><name sortKey="Weisshoff, N" uniqKey="Weisshoff N">N Weisshoff</name></author><author><name sortKey="List, F" uniqKey="List F">F List</name></author><author><name sortKey="Sudhop, T" uniqKey="Sudhop T">T Sudhop</name></author><author><name sortKey="Von Bergmann, K" uniqKey="Von Bergmann K">K von Bergmann</name></author><author><name sortKey="Gertz, K" uniqKey="Gertz K">K Gertz</name></author><author><name sortKey="Konig, J" uniqKey="Konig J">J Konig</name></author><author><name sortKey="Schafers, Hj" uniqKey="Schafers H">HJ Schafers</name></author><author><name sortKey="Endres, M" uniqKey="Endres M">M Endres</name></author><author><name sortKey="Bohm, M" uniqKey="Bohm M">M Bohm</name></author><author><name sortKey="Laufs, U" uniqKey="Laufs U">U Laufs</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Allemagne</li><li>Autriche</li><li>Belgique</li><li>Brésil</li><li>Espagne</li><li>France</li><li>Royaume-Uni</li></country></list><tree><country name="Allemagne"><noRegion><name sortKey="Genser, Bernd" sort="Genser, Bernd" uniqKey="Genser B" first="Bernd" last="Genser">Bernd Genser</name></noRegion><name sortKey="M Rz, Winfried" sort="M Rz, Winfried" uniqKey="M Rz W" first="Winfried" last="M Rz">Winfried M Rz</name><name sortKey="M Rz, Winfried" sort="M Rz, Winfried" uniqKey="M Rz W" first="Winfried" last="M Rz">Winfried M Rz</name><name sortKey="Silbernagel, Gunther" sort="Silbernagel, Gunther" uniqKey="Silbernagel G" first="Günther" last="Silbernagel">Günther Silbernagel</name></country><country name="Brésil"><noRegion><name sortKey="Genser, Bernd" sort="Genser, Bernd" uniqKey="Genser B" first="Bernd" last="Genser">Bernd Genser</name></noRegion><name sortKey="Dias, Karen C" sort="Dias, Karen C" uniqKey="Dias K" first="Karen C." last="Dias">Karen C. Dias</name></country><country name="Belgique"><noRegion><name sortKey="De Backer, Guy" sort="De Backer, Guy" uniqKey="De Backer G" first="Guy" last="De Backer">Guy De Backer</name></noRegion><name sortKey="Descamps, Olivier S" sort="Descamps, Olivier S" uniqKey="Descamps O" first="Olivier S." last="Descamps">Olivier S. Descamps</name><name sortKey="Rietzschel, Ernst R" sort="Rietzschel, Ernst R" uniqKey="Rietzschel E" first="Ernst R." last="Rietzschel">Ernst R. Rietzschel</name></country><country name="France"><noRegion><name sortKey="Bruckert, Eric" sort="Bruckert, Eric" uniqKey="Bruckert E" first="Eric" last="Bruckert">Eric Bruckert</name></noRegion><name sortKey="Chapman, M John" sort="Chapman, M John" uniqKey="Chapman M" first="M. John" last="Chapman">M. John Chapman</name><name sortKey="Chapman, M John" sort="Chapman, M John" uniqKey="Chapman M" first="M. John" last="Chapman">M. John Chapman</name></country><country name="Espagne"><noRegion><name sortKey="Carmena, Rafael" sort="Carmena, Rafael" uniqKey="Carmena R" first="Rafael" last="Carmena">Rafael Carmena</name></noRegion></country><country name="Royaume-Uni"><noRegion><name sortKey="Deanfield, John" sort="Deanfield, John" uniqKey="Deanfield J" first="John" last="Deanfield">John Deanfield</name></noRegion></country><country name="Autriche"><noRegion><name sortKey="M Rz, Winfried" sort="M Rz, Winfried" uniqKey="M Rz W" first="Winfried" last="M Rz">Winfried M Rz</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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