The effect of longer-term plant sterol and stanol consumption on apolipoprotein CII and apolipoprotein CIII concentrations in humans
AbstractBackground: Elevated fasting and postprandial serum levels of triacylglycerol (TAG) are a risk factor for cardiovascular disease (CVD). The dietary components plant sterols and stanols can be used as strategy against elevated TAG levels. In a recent study it was found that longer-term plant stanol consumption resulted in a higher postprandial TAG response compared to sterol consumption after a second meal. The explanation for this observed difference remained unclear. Possibly the clearance of TAG from the blood might be affected differently. Specialized particles are responsible for the transportation of TAG in the blood, called the lipoproteins. These particles contain apolipoproteins CII (apoCII) and CIII (apoCIII) which have an activating and inhibiting effect on the enzyme lipoprotein lipase (LPL) responsible for the clearance of TAG from the blood. Objective: The objective was to examine if postprandial apoCII and apoCIII responses could explain observed differences in postprandial TAG response after longer-term sterol and stanol consumption. Methods: Healthy subjects (n=42) participated in a randomized control trial consisting of three intervention periods during which the participants consumed either control margarine, or margarine enriched with plant sterols or plant stanols. Blood was sampled under fasting conditions and after the consumption of breakfast and lunch. ApoCII and apoCIII concentrations in serum were measured by an immunoturbimetric immunoassay. Results: Both iAUC and iAUCmin of postprandial apoCII concentrations were similar between all three conditions ( p=0.965 and p=0.563 respectively). Postprandial iAUC and iAUCmin of apoCIII concentrations also showed no difference between conditions (p=0.342 and p=0.955 respectively). In the control group, the iAUC of postprandial apoCIII concentrations was higher after the second meal compared to the first meal. (p=0.037).Conclusion: Postprandial apoCII and apoCIII responses were not affected by longer-term plant sterol and stanol consumption, therefore changes in concentrations of these two apolipoproteins can be ruled out as explanation for the observed differences in TAG response
Nichols M, Townsend N, Scarborough P, Rayner M. Cardiovascular disease in Europe: epidemiological update. Eur Heart J. 2013;34:3028-34.
Baumgartner S, Mensink RP, Plat J. Plant sterols and stanols in the treatment of dyslipidemia: new insights into targets and mechanisms related to cardiovascular risk. Curr Pharm Des. 2011;17:922-32.
Chan DC, Pang J, Romic G, Watts GF. Postprandial hypertriglyceridemia and cardiovascular disease: current and future therapies. Curr Atheroscler Rep. 2013;15:309
Abumweis SS, Barake R, Jones PJ. Plant sterols/stanols as cholesterol lowering agents: A meta-analysis of randomized controlled trials. Food Nutr Res. 2008;52.
Demonty I, Ras RT, van der Knaap HC, Duchateau GS, Meijer L, Zock PL, et al. Continuous dose-response relationship of the LDL-cholesterol-lowering effect of phytosterol intake. J Nutr. 2009;139:271-84.
Katan MB, Grundy SM, Jones P, Law M, Miettinen T, Paoletti R. Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clin Pros. 2003;78:965-78.
Law MR. Plant sterol and stanol margarines and health. Western J Med. 2000;173:43-7.
Frayn KN, Metabolic regulation a human perspective, Oxford, Wiley-blackwell, 2010, pag 180-187, 276,277,280- 283,300.
Barr SI, Kottke BA, Mao SJ. Postprandial distribution of apolipoproteins C-II and C-III in normal subjects and patients with mild hypertriglyceridemia: comparison of meals containing corn oil and medium-chain triglyceride oil. Metabolism. 1985;34:983-92.
Jong MC, Hofker MH, Havekes LM. Role of ApoCs in lipoprotein metabolism: functional differences between ApoC1, ApoC2, and ApoC3. Arterioscler Thromb Vasc Biol. 1999;19:472-84.
Olivieri O, Bassi A, Stranieri C, Trabetti E, Martinelli N, Pizzolo F, et al. Apolipoprotein C-III, metabolic syndrome, and risk of coronary artery disease. J Lipid Res. 2003;44:2374-81.
Kei AA, Filippatos TD, Tsimihodimos V, Elisaf MS. A review of the role of apolipoprotein C-II in lipoprotein metabolism and cardiovascular disease. Metabolism. 2012;61:906-21.
Malati T, Mahesh MR. Reference intervals for serum total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, Lp (a), apolipoprotein A-I, A-II, B, C-II, C-III, and E in healthy South Indians from Andhra Pradesh. Indian J Clin Biochem. 2009;24:343-55.
Sakurabayashi I, Saito Y, Kita T, Matsuzawa Y, Goto Y. Reference intervals for serum apolipoproteins A-I, A-II, B, C-II, C-III, and E in healthy Japanese determined with a commercial immunoturbidimetric assay and effects of sex, age, smoking, drinking, and Lp(a) level. Clin Chim Acta 2001;312:87-95.
Lee JY, Hong HR, Kang HS. Ethnicity differences in plasma apoC-III levels between African American and Caucasian youths. World J Pediatr. 2011;7:136-42.
Baumgartner S, Mensink RP, Husche C, Lutjohann D, Plat J. Effects of plant sterol- or stanol-enriched margarine on fasting plasma oxyphytosterol concentrations in healthy subjects. Atherosclerosis. 2013;227:414-9.
Samuel VT, Petersen KF, Shulman GI. Lipid-induced insulin resistance: unravelling the mechanism. Lancet. 2010;375:2267-77.
Frayn KN, Metabolic regulation a human perspective, Oxford, Wiley-blackwell, 2010, pag 72-73,199,281-283.
Matikainen N, Adiels M, Soderlund S, Stennabb S, Ahola T, Hakkarainen A, et al. Hepatic lipogenesis and a marker of hepatic lipid oxidation, predict postprandial responses of triglyceride-rich lipoproteins. Obesity,2014.
Brinton EA, Nanjee MN, Hopkins PN. Triglyceride-rich lipoprotein remnant levels and metabolism: time to adopt these orphan risk factors? J Am Col Cardiol. 2004;43:2233-5.
Ooi EM, Barrett PH, Chan DC, Watts GF. Apolipoprotein C-III: understanding an emerging cardiovascular risk factor. Clin Sci. 2008;114:611-24.
Evans K, Kuusela PJ, Cruz ML, Wilhelmova I, Fielding BA, Frayn KN. Rapid chylomicron appearance following sequential meals: effects of second meal composition. The Br J Nutr. 1998;79:425-9.
Hiukka A, Fruchart-Najib J, Leinonen E, Hilden H, Fruchart JC, Taskinen MR. Alterations of lipids and apolipoprotein CIII in very low density lipoprotein subspecies in type 2 diabetes. Diabetologia. 2005;48:1207-15.
van Dijk KW, Rensen PC, Voshol PJ, Havekes LM. The role and mode of action of apolipoproteins CIII and AV: synergistic actors in triglyceride metabolism? Curr Opin Lipidol. 2004;15:239-46.