Associação entre consumo de fitosteróis e marcadores de aterosclerose subclínica na população do ELSA Brasil

• Autor(a) principal: Pereira, Tuany Silva [UNIFESP]
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=7688537; https://repositorio.unifesp.br/handle/11600/59453
• topic: Phytosterol; Cardiovascular Disease; Diet; Adult Health; Sterol; Fitosteróis; Doenças Cardiovasculares; Dietética; Saúde Do Adulto; Esteróis

The efficacy of plant sterol supplementation, and usual intake of plant sterols, to obtain significant levels of LDL-cholesterol reduction, is well documented; however, little is known about the usual consumption of phytosterols on maintenance of serum levels of LDL-cholesterol and the presence of subclinical atherosclerosis. Objective: To estimate the consumption of phytosterols in the usual diet by the population of ELSA Brazil, and to determine its association with markers of subclinical atherosclerosis. Methods: Prospective study was composed of participants of the Longitudinal Study of Health in Adults, known as ELSA Brazil. From a total of 15,105 participants, we selected 5,061 individuals from the Center of Investigation of Sao Paulo, in primary prevention, with available food frequency questionnaires (FFQ), carotid intima-media thickness (cIMT), coronary calcium score (CCS) and pulse wave velocity (PWV), and excluded those using lipid-lowering drugs or in secondary prevention. Food consumption was evaluated and those with total energy expenditure (TEE) <500 kcal/d or >4000 kcal/d were excluded. Our final sample population consisted of 2,560 participants. CIMT and PWV were categorized in quartiles and <P75 or > P75, CAC was categorized as = or > zero. To estimate the total plant sterol consumption (mg/day) we plotted the information of FFQ using a nutrition software developed by the Federal University of São Paulo. Analysis of the association between phytosterols consumption and subclinical atherosclerosis markers was performed using adjusted and unadjusted logistic and linear regression models. A P-value <0.05 was considered significant. Results: Mean (SD) phytosterol consumption was 256.08 (±197.87), CCS 22.78(±110.53), PWV 9.07(±1.59), and cIMT 0.57(±0.11). Phytosterol consumption, CCS, PWV and cIMT were higher in men than women (P<0.001). Consumption of phytosterols >P75 was associated with lower levels of total, HDL- and LDL-cholesterol, higher triglycerides (P<0,01), higher TEE, higher consumption of fibers, and PWV (P<0.01). Univariate logistic and linear regression showed that increased phytosterols consumption levels was associated with increased pulse wave velocity (P<0.02 and P<0.001, respectively). However, after adjusting for other cardiovascular risk factors, this association disappeared (P=NS). In univariate analysis, phytosterols consumption was not associated with CCS, and c-IMT.Conclusion: Using the baseline information of the ELSA Brasil study, in this cohort of apparently healthy individuals, we demonstrated that usual intake of phytosterols from the diet was associated with lower concentrations of total and LDL-c, with no evidence of association with markers of subclinical atherosclerosis. To date, this is the largest population-based study evaluating usual intake of plant sterols and markers of subclinical atherosclerosis, opening perspectives about the importance of natural sources of phytosterols in cardiovascular health.