In patients with the inherited disease of
phytosterolemia, elevated concentrations of
plant sterols (eg,
campesterol and
sitosterol) have been implicated as a risk factor for premature
atherosclerosis. Whether plasma concentrations of
campesterol and
sitosterol are risk factors for
coronary heart disease (CHD) in nonphytosterolemia subjects has not been established. Therefore, the present study examined the role of
plant sterols in patients admitted for elective artery coronary bypass graft (ACBG). Serum concentrations of
campesterol and
sitosterol, as well as
lathosterol,
desmosterol,
cholestanol, and
lipoproteins were analyzed in 42 men and 11 women without
lipid-lowering treatment during the past. Twenty-six patients reported a positive family history in their first-degree relatives for CHD.
Lipid profile and other risk factors were comparable in both groups. Patients with a positive family history for CHD had significant higher plasma levels of
campesterol (.50 +/-.17 v.38 +/-.16 mg/dL; P =.011),
sitosterol (.40 +/-.11 v.31 +/-.11 mg/dL; P =.004) and their ratios to
cholesterol.
Lathosterol,
desmosterol,
cholestanol, and their ratios to
cholesterol were not significantly different. Analysis of covariance (ANCOVA) analysis showed no influence of sex, age,
triglycerides, total-,
low-density lipoprotein (
LDL)-, and
high-density lipoprotein (
HDL)-cholesterol on the results, but confirmed a strong influence of
plant sterols. These findings support the hypothesis that
plant sterols might be an additional risk factor for CHD.