Diet and drug therapy for phytosterolemia

Date
1989
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Abstract
This thesis examines the therapeutic outcome of a low plant sterol diet and adjunctive drug therapy (cholestyramine) in the long term treatment of phytosterolemia. The primary dietary parameters examined were the levels of cholesterol and the major plant sterols, comprising of beta sitosterol, campesterol and stigmasterol. The definition of the level of sterols administered during the test period was obtained by laboratory quantitation of a prescribed dietary regimen. These levels were established at 184±47 mg of cholesterol and 112±27 mg plant sterols per day . In addition, a diet with an average macronutrient composition of 48.7±3.7% carbohydrate, 22.3±2.4% protein and 27. 6±3. 9% fat was implemented and maintained for the 18 month duration of the study. The effect of the diet over a period of 6 months, on the sterol levels of plasma, individual lipoprotein fractions (VLDL, LDL, HDL) and erythrocytes was evaluated, in a phytosterolemic patient. Apolipoproteins A and B were quantitated. The same parameters were assessed over an additional 12 months, with the adjunctive use of cholestyramine. iii The established diet was effective in lowering the total plant sterols in plasma by 37% (p<0.01). Erythrocyte cholesterol, as a percentage of total sterols increased by 10% (p<0.01) during dietary treatment. This corresponded to an actual rise in cholesterol alone, of 64% from the baseline (p<O. 01) . While there was a concomitant decline (p<O.01) in total plant sterols as a percentage of total sterols in erythrocytes, the change in their absolute value was insignificant (p>O. 05) . Diet and drug therapy did not have an additional significant effect (p>O. 05) on sterol content and percentage composition of erythrocytes. The most pronounced effect of the diet on the lipoproteins, was in the VLDL and the LDL. The observed decline in the VLDL was 5 9% (p<O. 05) for total plant sterols and 4 9% for cholesterol (p<O. 05) . A 32% decline in total plant sterols in the LDL (p<0.01) was evident. The addit ional biochemical response to adjunctive drug therapy was overwhelming, . particularly in the decline of the total and the individual sterols of the plasma of 66% (p<0.01) and in the LDL of 76% (p<0.01). The changes in HDL in both treatment phases were insignificant (p>0.05). Diet therapy had insignificant effect (p>0.05) on the apolipoproteins. Diet and drug treatment caused a sharp decline in apo B of 75% (p<0.01), accompanied by a rise in apo A of 65% (p<0.01).
Description
Bibliography: p. 128-140.
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Citation
Jamal, R. (1989). Diet and drug therapy for phytosterolemia (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/20620
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