, Volume 37, Issue 8, pp 773–780

Serum cholesterol and cholesterol and lipoprotein metabolism in hypercholesterolaemic NIDDM patients before and during sitostanol ester-margarine treatment

  • H. Gylling
  • T. A. Miettinen

DOI: 10.1007/BF00404334

Cite this article as:
Gylling, H. & Miettinen, T.A. Diabetologia (1994) 37: 773. doi:10.1007/BF00404334


Cholesterol absorption and metabolism and LDL and HDL kinetics were investigated in 11 hypercholesterolaemic non-insulin-dependent diabetic men off and on a hypolipidaemic treatment with sitostanol ester, (3 g sitostanol daily) dissolved in rapeseed oil margarine, by a double-blind crossover study design. Serum total, VLDL and LDL cholesterol and apoprotein B fell significantly by 6±2, 12±6, 9±3 and 6±2%, mean ±SEM, and HDL cholesterol was increased by 11±4% (p<0.05) by sitostanol ester. LDL cholesterol and apoprotein B were significantly decreased in the dense (1.037–1.055 g/ml), but not light, LDL subfraction due to a significantly diminished transport rate for LDL apoprotein B, while the fractional catabolic rate was unchanged. HDL kinetics, measured with autologous apoprotein AI, was unaffected by sitostanol ester. Cholesterol absorption efficiency was markedly reduced from 25±2 to 9±2% (p<0.001) during sitostanol ester followed by proportionately decreased serum plant sterol proportions. Cholesterol precursor sterol proportions in serum, fecal neutral sterol excretion, and cholesterol synthesis, cholesterol transport, and biliary secretion were all significantly increased by sitostanol ester. We conclude that the sitostanol ester-induced decrease in cholesterol absorption compensatorily stimulated cholesterol synthesis, had no effect on fractional catabolic rate, but decreased transport rate for LDL apoprotein B so that serum total, VLDL and LDL cholesterol levels were decreased. Dietary rapeseed oil margarine rich in sitostanol ester was well tolerated, appears to be safe from the nutritional point of view and effective for lowering VLDL and LDL cholesterol and increasing HDL cholesterol in hypercholesterolaemic non-insulin-dependent diabetic subjects.

Key words

Cholesterol cholesterol absorption cholesterol synthesis lipoprotein kinetics sitostanol plant sterols precursor sterols non-insulin-dependent diabetes 





non-insulin-dependent diabetes mellitus


very low density lipoprotein


intermediate density lipoprotein


low density lipoprotein


high density lipoprotein


fractional catabolic rate


transport rate

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • H. Gylling
    • 1
  • T. A. Miettinen
    • 1
  1. 1.Second Department of MedicineUniversity of HelsinkiHelsinkiFinland