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Nutrients. 2018 Dec 1;10(12). pii: E1842. doi: 10.3390/nu10121842.

Decreasing the Cholesterol Burden in Heterozygous Familial Hypercholesterolemia Children by Dietary Plant Stanol Esters.

Author information

1
Mehiläinen Airport Health Centre, 01530 Vantaa, Finland. alpo.vuorio@gmail.com.
2
Department of Forensic Medicine, University of Helsinki, 00014 Helsinki, Finland. alpo.vuorio@gmail.com.
3
Wihuri Research Institute, 00290 Helsinki, Finland. petri.kovanen@wri.fi.

Abstract

This review covers the current knowledge about plant stanol esters as a dietary treatment option for heterozygous familial hypercholesterolemia (he-FH) children. The current estimation of the prevalence of he-FH is about one out of 200⁻250 persons. In this autosomal dominant disease, the concentration of plasma low-density lipoprotein cholesterol (LDL-C) is strongly elevated since birth. Quantitative coronary angiography among he-FH patients has revealed that stenosing atherosclerotic plaques start to develop in he-FH males in their twenties and in he-FH females in their thirties, and that the magnitude of the plaque burden predicts future coronary events. The cumulative exposure of coronary arteries to the lifelong LDL-C elevation can be estimated by calculating the LDL-C burden (LDL-C level × years), and it can also be used to demonstrate the usefulness of dietary stanol ester treatment. Thus, when compared with untreated he-FH patients, the LDL-C burden of using statin from the age of 10 is 15% less, and if he-FH patients starts to use dietary stanol from six years onwards and a combination of statin and dietary stanol from 10 years onwards, the LDL-C burden is 21% less compared to non-treated he-FH patients. We consider dietary stanol treatment of he-FH children as a part of the LDL-C-lowering treatment package as safe and cost-effective, and particularly applicable for the family-centered care of the entire he-FH families.

KEYWORDS:

atherosclerosis; children; coronary heart disease; diet; familial hypercholesterolemia; family; hypercholesterolemia; low-density cholesterol; phytosterol; stanol

PMID:
30513705
PMCID:
PMC6315790
DOI:
10.3390/nu10121842
[Indexed for MEDLINE]
Free PMC Article

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