Skip to main content
Top
Published in: Cardiovascular Drugs and Therapy 5-6/2010

01-12-2010

The Metabolic Effects of Omega-3 Plant Sterol Esters in Mixed Hyperlipidemic Subjects

Authors: Rafael Bitzur, Hofit Cohen, Tzafra Cohen, Tali W. Dror, Yael Herzog, Yael Lifshitz, Tamar Lubish, Dror Harats, Ardon Rubinstein

Published in: Cardiovascular Drugs and Therapy | Issue 5-6/2010

Login to get access

Abstract

Purpose

The aim of the current study was to evaluate the therapeutic effects of omega-3 plant sterol esters (n-3-PSE) on lipid profile and other coronary heart disease risk factors in subjects with mixed hyperlipidemia.

Methods

Ninety-one patients with mixed hyperlipidemia were randomized in a double blind fashion to receive either placebo (corn oil) or n-3-PSE. Twenty four patients dropped out or were excluded from the efficacy analysis due to protocol violation. The primary efficacy endpoint was mean change in plasma low-density lipoprotein cholesterol (LDL-C) levels after 12 weeks of treatment. Other efficacy measures included plasma lipids, lipoproteins, and high-sensitivity C-reactive protein (hsCRP) levels. Participants who completed the double-blind study were given the option to continue into an open-label, 12-weeks follow up phase.

Results

n-3-PSE treatment did not result in a significant change in LDL-C levels. Triglyceride levels were reduced significantly by 19% (51 mg/dL, p < 0.0001) in the n-3-PSE group in comparison with the placebo group (p = 0.025). Diastolic blood pressure and hsCRP were reduced by 7% (5.9 mmHg) and 7.8% (0.6 mg/L), respectively, and were significantly different from the placebo group (p = 0.036 and p = 0.018, respectively).

Conclusions

In patients with mixed hyperlipidemia, n-3-PSE treatment may offer a safe and effective therapy for triglyceride level reduction while avoiding the typical increase in LDL-C levels associated with n-3 fatty acid treatment. The observed reduction in blood pressure and inflammation markers warrants further evaluation. The positive effect of n-3-PSE treatment was preserved at the end of the follow up phase.
Literature
1.
go back to reference Jemal A, Ward E, Hao Y, Thun M. Trends in the leading causes of death in the United States, 1970–2002. JAMA. 2005;294(10):1255–9.PubMedCrossRef Jemal A, Ward E, Hao Y, Thun M. Trends in the leading causes of death in the United States, 1970–2002. JAMA. 2005;294(10):1255–9.PubMedCrossRef
2.
go back to reference Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001;285(19):2486–97. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001;285(19):2486–97.
3.
go back to reference Chiuve SE, McCullough ML, Sacks FM, Rimm EB. Healthy lifestyle factors in the primary prevention of coronary heart disease among men: benefits among users and nonusers of lipid-lowering and antihypertensive medications. Circulation. 2006;114(2):160–7.PubMedCrossRef Chiuve SE, McCullough ML, Sacks FM, Rimm EB. Healthy lifestyle factors in the primary prevention of coronary heart disease among men: benefits among users and nonusers of lipid-lowering and antihypertensive medications. Circulation. 2006;114(2):160–7.PubMedCrossRef
4.
go back to reference Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90, 056 participants in 14 randomised trials of statins. Lancet. 2005;366(9493):1267–78.PubMedCrossRef Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90, 056 participants in 14 randomised trials of statins. Lancet. 2005;366(9493):1267–78.PubMedCrossRef
5.
go back to reference McTaggart F, Jones P. Effects of statins on high-density lipoproteins: a potential contribution to cardiovascular benefit. Cardiovasc Drugs Ther. 2008;22(4):321–38.PubMedCrossRef McTaggart F, Jones P. Effects of statins on high-density lipoproteins: a potential contribution to cardiovascular benefit. Cardiovasc Drugs Ther. 2008;22(4):321–38.PubMedCrossRef
6.
go back to reference Gaede P, Lund-Andersen H, Parving HH, Pedersen O. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008;358(6):580–91.PubMedCrossRef Gaede P, Lund-Andersen H, Parving HH, Pedersen O. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008;358(6):580–91.PubMedCrossRef
7.
go back to reference Gaw A. HDL-C and triglyceride levels: relationship to coronary heart disease and treatment with statins. Cardiovasc Drugs Ther. 2003;17(1):53–62.PubMedCrossRef Gaw A. HDL-C and triglyceride levels: relationship to coronary heart disease and treatment with statins. Cardiovasc Drugs Ther. 2003;17(1):53–62.PubMedCrossRef
8.
go back to reference Ninomiya JK, L’Italien G, Criqui MH, Whyte JL, Gamst A, Chen RS. Association of the metabolic syndrome with history of myocardial infarction and stroke in the Third National Health and Nutrition Examination Survey. Circulation. 2004;109(1):42–6.PubMedCrossRef Ninomiya JK, L’Italien G, Criqui MH, Whyte JL, Gamst A, Chen RS. Association of the metabolic syndrome with history of myocardial infarction and stroke in the Third National Health and Nutrition Examination Survey. Circulation. 2004;109(1):42–6.PubMedCrossRef
9.
go back to reference Sarwar N, Danesh J, Eiriksdottir G, Sigurdsson G, Wareham N, Bingham S, et al. Triglycerides and the risk of coronary heart disease: 10, 158 incident cases among 262, 525 participants in 29 Western prospective studies. Circulation. 2007;115(4):450–8.PubMedCrossRef Sarwar N, Danesh J, Eiriksdottir G, Sigurdsson G, Wareham N, Bingham S, et al. Triglycerides and the risk of coronary heart disease: 10, 158 incident cases among 262, 525 participants in 29 Western prospective studies. Circulation. 2007;115(4):450–8.PubMedCrossRef
10.
go back to reference Jacobson TA. Myopathy with statin-fibrate combination therapy: clinical considerations. Nat Rev Endocrinol. 2009;5(9):507–18.PubMedCrossRef Jacobson TA. Myopathy with statin-fibrate combination therapy: clinical considerations. Nat Rev Endocrinol. 2009;5(9):507–18.PubMedCrossRef
11.
go back to reference Polanco N, Hernandez E, Gonzalez E, Gutierrez Martinez E, Bello I, Gutierrez-Millet V, et al. Fibrate-induced deterioration of renal function. Nefrologia. 2009;29(3):208–13.PubMed Polanco N, Hernandez E, Gonzalez E, Gutierrez Martinez E, Bello I, Gutierrez-Millet V, et al. Fibrate-induced deterioration of renal function. Nefrologia. 2009;29(3):208–13.PubMed
12.
go back to reference Rader JI, Calvert RJ, Hathcock JN. Hepatic toxicity of unmodified and time-release preparations of niacin. Am J Med. 1992;92(1):77–81.PubMedCrossRef Rader JI, Calvert RJ, Hathcock JN. Hepatic toxicity of unmodified and time-release preparations of niacin. Am J Med. 1992;92(1):77–81.PubMedCrossRef
13.
go back to reference Harris WS, Bulchandani D. Why do omega-3 fatty acids lower serum triglycerides? Curr Opin Lipidol. 2006;17(4):387–93.PubMedCrossRef Harris WS, Bulchandani D. Why do omega-3 fatty acids lower serum triglycerides? Curr Opin Lipidol. 2006;17(4):387–93.PubMedCrossRef
14.
go back to reference Kris-Etherton PM, Harris WS, Appel LJ. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation. 2002;106(21):2747–57.PubMedCrossRef Kris-Etherton PM, Harris WS, Appel LJ. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation. 2002;106(21):2747–57.PubMedCrossRef
15.
go back to reference Rauch B, Schiele R, Schneider S, Gohlke H, Diller F, Gottwik M, et al. Highly purified omega-3 fatty acids for secondary prevention of sudden cardiac death after myocardial infarction-aims and methods of the OMEGA-study. Cardiovasc Drugs Ther. 2006;20(5):365–75.PubMedCrossRef Rauch B, Schiele R, Schneider S, Gohlke H, Diller F, Gottwik M, et al. Highly purified omega-3 fatty acids for secondary prevention of sudden cardiac death after myocardial infarction-aims and methods of the OMEGA-study. Cardiovasc Drugs Ther. 2006;20(5):365–75.PubMedCrossRef
16.
go back to reference Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico. Lancet 1999;354(9177):447–55. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico. Lancet 1999;354(9177):447–55.
17.
go back to reference Yokoyama M, Origasa H, Matsuzaki M, Matsuzawa Y, Saito Y, Ishikawa Y, et al. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet. 2007;369(9567):1090–8.PubMedCrossRef Yokoyama M, Origasa H, Matsuzaki M, Matsuzawa Y, Saito Y, Ishikawa Y, et al. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet. 2007;369(9567):1090–8.PubMedCrossRef
18.
go back to reference Bays H. Clinical overview of Omacor: a concentrated formulation of omega-3 polyunsaturated fatty acids. Am J Cardiol. 2006;98(4A):71i–6.PubMedCrossRef Bays H. Clinical overview of Omacor: a concentrated formulation of omega-3 polyunsaturated fatty acids. Am J Cardiol. 2006;98(4A):71i–6.PubMedCrossRef
19.
go back to reference Moreau RA, Whitaker BD, Hicks KB. Phytosterols, phytostanols, and their conjugates in foods: structural diversity, quantitative analysis, and health-promoting uses. Prog Lipid Res. 2002;41(6):457–500.PubMedCrossRef Moreau RA, Whitaker BD, Hicks KB. Phytosterols, phytostanols, and their conjugates in foods: structural diversity, quantitative analysis, and health-promoting uses. Prog Lipid Res. 2002;41(6):457–500.PubMedCrossRef
21.
go back to reference Pollak OJ, Kritchevsky D. Sitosterol. Monogr Atheroscler. 1981;10:1–219.PubMed Pollak OJ, Kritchevsky D. Sitosterol. Monogr Atheroscler. 1981;10:1–219.PubMed
22.
go back to reference Grundy SM. Stanol esters as a component of maximal dietary therapy in the National Cholesterol Education Program Adult Treatment Panel III report. Am J Cardiol. 2005;96(1A):47D–50.PubMedCrossRef Grundy SM. Stanol esters as a component of maximal dietary therapy in the National Cholesterol Education Program Adult Treatment Panel III report. Am J Cardiol. 2005;96(1A):47D–50.PubMedCrossRef
23.
go back to reference Ewart HS, Cole LK, Kralovec J, Layton H, Curtis JM, Wright JL, et al. Fish oil containing phytosterol esters alters blood lipid profiles and left ventricle generation of thromboxane a(2) in adult guinea pigs. J Nutr. 2002;132(6):1149–52.PubMed Ewart HS, Cole LK, Kralovec J, Layton H, Curtis JM, Wright JL, et al. Fish oil containing phytosterol esters alters blood lipid profiles and left ventricle generation of thromboxane a(2) in adult guinea pigs. J Nutr. 2002;132(6):1149–52.PubMed
24.
go back to reference Russell JC, Ewart HS, Kelly SE, Kralovec J, Wright JL, Dolphin PJ. Improvement of vascular dysfunction and blood lipids of insulin-resistant rats by a marine oil-based phytosterol compound. Lipids. 2002;37(2):147–52.PubMedCrossRef Russell JC, Ewart HS, Kelly SE, Kralovec J, Wright JL, Dolphin PJ. Improvement of vascular dysfunction and blood lipids of insulin-resistant rats by a marine oil-based phytosterol compound. Lipids. 2002;37(2):147–52.PubMedCrossRef
25.
go back to reference Demonty I, Chan YM, Pelled D, Jones PJ. Fish-oil esters of plant sterols improve the lipid profile of dyslipidemic subjects more than do fish-oil or sunflower oil esters of plant sterols. Am J Clin Nutr. 2006;84(6):1534–42.PubMed Demonty I, Chan YM, Pelled D, Jones PJ. Fish-oil esters of plant sterols improve the lipid profile of dyslipidemic subjects more than do fish-oil or sunflower oil esters of plant sterols. Am J Clin Nutr. 2006;84(6):1534–42.PubMed
26.
go back to reference Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002;106(25):3143–421. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002;106(25):3143–421.
27.
go back to reference Normen L, Shaw CA, Fink CS, Awad AB. Combination of phytosterols and omega-3 fatty acids: a potential strategy to promote cardiovascular health. Curr Med Chem Cardiovasc Hematol Agents. 2004;2(1):1–12.PubMedCrossRef Normen L, Shaw CA, Fink CS, Awad AB. Combination of phytosterols and omega-3 fatty acids: a potential strategy to promote cardiovascular health. Curr Med Chem Cardiovasc Hematol Agents. 2004;2(1):1–12.PubMedCrossRef
28.
go back to reference Roche HM, Gibney MJ. Effect of long-chain n-3 polyunsaturated fatty acids on fasting and postprandial triacylglycerol metabolism. Am J Clin Nutr. 2000;71(1 Suppl):232S–7.PubMed Roche HM, Gibney MJ. Effect of long-chain n-3 polyunsaturated fatty acids on fasting and postprandial triacylglycerol metabolism. Am J Clin Nutr. 2000;71(1 Suppl):232S–7.PubMed
29.
go back to reference Din JN, Newby DE, Flapan AD. Omega 3 fatty acids and cardiovascular disease—fishing for a natural treatment. Bmj. 2004;328(7430):30–5.PubMedCrossRef Din JN, Newby DE, Flapan AD. Omega 3 fatty acids and cardiovascular disease—fishing for a natural treatment. Bmj. 2004;328(7430):30–5.PubMedCrossRef
30.
go back to reference Harris WS. n-3 fatty acids and serum lipoproteins: animal studies. Am J Clin Nutr. 1997;65(5 Suppl):1611S–6.PubMed Harris WS. n-3 fatty acids and serum lipoproteins: animal studies. Am J Clin Nutr. 1997;65(5 Suppl):1611S–6.PubMed
31.
go back to reference Jacobson TA. Role of n-3 fatty acids in the treatment of hypertriglyceridemia and cardiovascular disease. Am J Clin Nutr. 2008;87(6):1981S–90.PubMed Jacobson TA. Role of n-3 fatty acids in the treatment of hypertriglyceridemia and cardiovascular disease. Am J Clin Nutr. 2008;87(6):1981S–90.PubMed
32.
go back to reference Lee JH, O’Keefe JH, Lavie CJ, Marchioli R, Harris WS. Omega-3 fatty acids for cardioprotection. Mayo Clin Proc. 2008;83(3):324–32.PubMedCrossRef Lee JH, O’Keefe JH, Lavie CJ, Marchioli R, Harris WS. Omega-3 fatty acids for cardioprotection. Mayo Clin Proc. 2008;83(3):324–32.PubMedCrossRef
33.
go back to reference Pownall HJ, Brauchi D, Kilinc C, Osmundsen K, Pao Q, Payton-Ross C, et al. Correlation of serum triglyceride and its reduction by omega-3 fatty acids with lipid transfer activity and the neutral lipid compositions of high-density and low-density lipoproteins. Atherosclerosis. 1999;143(2):285–97.PubMedCrossRef Pownall HJ, Brauchi D, Kilinc C, Osmundsen K, Pao Q, Payton-Ross C, et al. Correlation of serum triglyceride and its reduction by omega-3 fatty acids with lipid transfer activity and the neutral lipid compositions of high-density and low-density lipoproteins. Atherosclerosis. 1999;143(2):285–97.PubMedCrossRef
34.
go back to reference Swahn E, von Schenck H, Olsson AG. Omega-3 ethyl ester concentrate decreases total apolipoprotein CIII and increases antithrombin III in postmyocardial infarction patients. Clin Drug Investig. 1998;15(6):473–82.PubMedCrossRef Swahn E, von Schenck H, Olsson AG. Omega-3 ethyl ester concentrate decreases total apolipoprotein CIII and increases antithrombin III in postmyocardial infarction patients. Clin Drug Investig. 1998;15(6):473–82.PubMedCrossRef
35.
go back to reference Harris WS, Ginsberg HN, Arunakul N, Shachter NS, Windsor SL, Adams M, et al. Safety and efficacy of Omacor in severe hypertriglyceridemia. J Cardiovasc Risk. 1997;4(5–6):385–91.PubMedCrossRef Harris WS, Ginsberg HN, Arunakul N, Shachter NS, Windsor SL, Adams M, et al. Safety and efficacy of Omacor in severe hypertriglyceridemia. J Cardiovasc Risk. 1997;4(5–6):385–91.PubMedCrossRef
36.
go back to reference Davidson MH, Maki KC, Kalkowski J, Schaefer EJ, Torri SA, Drennan KB. Effects of docosahexaenoic acid on serum lipoproteins in patients with combined hyperlipidemia: a randomized, double-blind, placebo-controlled trial. J Am Coll Nutr. 1997;16(3):236–43.PubMed Davidson MH, Maki KC, Kalkowski J, Schaefer EJ, Torri SA, Drennan KB. Effects of docosahexaenoic acid on serum lipoproteins in patients with combined hyperlipidemia: a randomized, double-blind, placebo-controlled trial. J Am Coll Nutr. 1997;16(3):236–43.PubMed
37.
go back to reference Meyer BJ, Hammervold T, Rustan AC, Howe PR. Dose-dependent effects of docosahexaenoic acid supplementation on blood lipids in statin-treated hyperlipidaemic subjects. Lipids. 2007;42(2):109–15.PubMedCrossRef Meyer BJ, Hammervold T, Rustan AC, Howe PR. Dose-dependent effects of docosahexaenoic acid supplementation on blood lipids in statin-treated hyperlipidaemic subjects. Lipids. 2007;42(2):109–15.PubMedCrossRef
38.
go back to reference Radack KL, Deck CC, Huster GA. n-3 fatty acid effects on lipids, lipoproteins, and apolipoproteins at very low doses: results of a randomized controlled trial in hypertriglyceridemic subjects. Am J Clin Nutr. 1990;51(4):599–605.PubMed Radack KL, Deck CC, Huster GA. n-3 fatty acid effects on lipids, lipoproteins, and apolipoproteins at very low doses: results of a randomized controlled trial in hypertriglyceridemic subjects. Am J Clin Nutr. 1990;51(4):599–605.PubMed
39.
go back to reference Kelley DS, Siegel D, Fedor DM, Adkins Y, Mackey BE. DHA supplementation decreases serum C-reactive protein and other markers of inflammation in hypertriglyceridemic men. J Nutr. 2009;139(3):495–501.PubMedCrossRef Kelley DS, Siegel D, Fedor DM, Adkins Y, Mackey BE. DHA supplementation decreases serum C-reactive protein and other markers of inflammation in hypertriglyceridemic men. J Nutr. 2009;139(3):495–501.PubMedCrossRef
40.
go back to reference Madsen T, Christensen JH, Schmidt EB. C-reactive protein and n-3 fatty acids in patients with a previous myocardial infarction: a placebo-controlled randomized study. Eur J Nutr. 2007;46(7):428–30.PubMedCrossRef Madsen T, Christensen JH, Schmidt EB. C-reactive protein and n-3 fatty acids in patients with a previous myocardial infarction: a placebo-controlled randomized study. Eur J Nutr. 2007;46(7):428–30.PubMedCrossRef
41.
go back to reference Devaraj S, Autret BC, Jialal I. Reduced-calorie orange juice beverage with plant sterols lowers C-reactive protein concentrations and improves the lipid profile in human volunteers. Am J Clin Nutr. 2006;84(4):756–61.PubMed Devaraj S, Autret BC, Jialal I. Reduced-calorie orange juice beverage with plant sterols lowers C-reactive protein concentrations and improves the lipid profile in human volunteers. Am J Clin Nutr. 2006;84(4):756–61.PubMed
42.
go back to reference Clifton PM, Mano M, Duchateau GS, van der Knaap HC, Trautwein EA. Dose-response effects of different plant sterol sources in fat spreads on serum lipids and C-reactive protein and on the kinetic behavior of serum plant sterols. Eur J Clin Nutr. 2008;62(8):968–77.PubMedCrossRef Clifton PM, Mano M, Duchateau GS, van der Knaap HC, Trautwein EA. Dose-response effects of different plant sterol sources in fat spreads on serum lipids and C-reactive protein and on the kinetic behavior of serum plant sterols. Eur J Clin Nutr. 2008;62(8):968–77.PubMedCrossRef
43.
go back to reference De Jong A, Plat J, Bast A, Godschalk RW, Basu S, Mensink RP. Effects of plant sterol and stanol ester consumption on lipid metabolism, antioxidant status and markers of oxidative stress, endothelial function and low-grade inflammation in patients on current statin treatment. Eur J Clin Nutr. 2008;62(2):263–73.PubMedCrossRef De Jong A, Plat J, Bast A, Godschalk RW, Basu S, Mensink RP. Effects of plant sterol and stanol ester consumption on lipid metabolism, antioxidant status and markers of oxidative stress, endothelial function and low-grade inflammation in patients on current statin treatment. Eur J Clin Nutr. 2008;62(2):263–73.PubMedCrossRef
44.
go back to reference Morris MC, Sacks F, Rosner B. Does fish oil lower blood pressure? A meta-analysis of controlled trials. Circulation. 1993;88(2):523–33.PubMed Morris MC, Sacks F, Rosner B. Does fish oil lower blood pressure? A meta-analysis of controlled trials. Circulation. 1993;88(2):523–33.PubMed
45.
go back to reference Appel LJ, Miller 3rd ER, Seidler AJ, Whelton PK. Does supplementation of diet with ‘fish oil’ reduce blood pressure? A meta-analysis of controlled clinical trials. Arch Intern Med. 1993;153(12):1429–38.PubMedCrossRef Appel LJ, Miller 3rd ER, Seidler AJ, Whelton PK. Does supplementation of diet with ‘fish oil’ reduce blood pressure? A meta-analysis of controlled clinical trials. Arch Intern Med. 1993;153(12):1429–38.PubMedCrossRef
46.
go back to reference Vissers MN, Trip MD, Pritchard PH, Tam P, Lukic T, de Sain-van der Velden MG, et al. Efficacy and safety of disodium ascorbyl phytostanol phosphates in men with moderate dyslipidemia. Eur J Clin Pharmacol. 2008;64(7):651–61.PubMedCrossRef Vissers MN, Trip MD, Pritchard PH, Tam P, Lukic T, de Sain-van der Velden MG, et al. Efficacy and safety of disodium ascorbyl phytostanol phosphates in men with moderate dyslipidemia. Eur J Clin Pharmacol. 2008;64(7):651–61.PubMedCrossRef
47.
go back to reference Jones PJ, Demonty I, Chan YM, Herzog Y, Pelled D. Fish-oil esters of plant sterols differ from vegetable-oil sterol esters in triglycerides lowering, carotenoid bioavailability and impact on plasminogen activator inhibitor-1 (PAI-1) concentrations in hypercholesterolemic subjects. Lipids Health Dis. 2007;6:28.PubMedCrossRef Jones PJ, Demonty I, Chan YM, Herzog Y, Pelled D. Fish-oil esters of plant sterols differ from vegetable-oil sterol esters in triglycerides lowering, carotenoid bioavailability and impact on plasminogen activator inhibitor-1 (PAI-1) concentrations in hypercholesterolemic subjects. Lipids Health Dis. 2007;6:28.PubMedCrossRef
Metadata
Title
The Metabolic Effects of Omega-3 Plant Sterol Esters in Mixed Hyperlipidemic Subjects
Authors
Rafael Bitzur
Hofit Cohen
Tzafra Cohen
Tali W. Dror
Yael Herzog
Yael Lifshitz
Tamar Lubish
Dror Harats
Ardon Rubinstein
Publication date
01-12-2010
Publisher
Springer US
Published in
Cardiovascular Drugs and Therapy / Issue 5-6/2010
Print ISSN: 0920-3206
Electronic ISSN: 1573-7241
DOI
https://doi.org/10.1007/s10557-010-6249-5

Other articles of this Issue 5-6/2010

Cardiovascular Drugs and Therapy 5-6/2010 Go to the issue