Effect of plant sterols compared with ezetimibe on oxidative stress in patients treated with statins

Abstract

Pleiotropic effects of cholesterol absorption inhibitors are still controversial. Thus, this study aimed to compare the action of a drug (ezetimibe) and a functional food containing plant sterol esters on oxidative stress biomarkers. In this double-blind study, 37 type 2 diabetic patients on statin treatment were randomly assigned to receive ezetimibe 10.0 mg/d or to consume a chocolate containing 2.1 g of plant sterol esters for 6 weeks. Individuals on ezetimibe intervention showed higher reduction of LDL-C (-29%) than individuals on plant sterol intervention (-7%). After 6 weeks, it was observed that ezetimibe promoted an increase of superoxide dismutase and glutathione reductase activities, while plant sterols did not change these biomarkers. However, patients responded differently to the same intervention. Among individuals who showed the greatest LDL-C and oxLDL-C reduction, the oxLDL-C reduction observed in individuals under plant sterol treatment (-20.0%) did not differ from the values found in individuals treated with ezetimibe (-21.1%). In addition, 16 patients on plant sterol treatment reached the optimal therapeutic goal for LDL-C (< 70 mg/dL). Plant sterols were added to a non-sugar chocolate bar, which can be easily added to the diet of individuals with diabetes or metabolic syndrome without any adverse effect, representing an alternative to statin co-therapy. (AU)