Genetic variants affecting responses of plasma lipids and cholesterol kinetics to dietary cholesterol versus plant sterol consumption in a founder population

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Alphonse, Peter AS
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Lowering plasma LDL-cholesterol (LDL-C) and increasing HDL-cholesterol (HDL-C) concentrations remain the primary targets in cardiovascular disease (CVD) risk reduction. Dietary cholesterol and plant sterols differentially modulate cholesterol kinetics and lipoprotein distribution. Inter-individual variations in the rates of cholesterol absorption and synthesis, and the reciprocal interaction between them affect the responses to dietary sterols. Genetic heterogeneity profoundly influences such responsiveness. However, limited research exists on the genetic determinants of dietary cholesterol versus plant sterols responsiveness in healthy individuals, especially in a founder population, such as the Hutterites in Manitoba of European descent who practice a communal living system. Our study examined the differential effects of dietary cholesterol versus plant sterol consumption on plasma lipoprotein levels, subclasses, and cholesterol kinetics and assessed how genetic variants influenced these responses. A double-blind, randomized, crossover study with three interventional periods of 4 wk duration each was conducted. Healthy Hutterite individuals (n=49) from Manitoba consumed daily either 2 g of plant sterols or 600 mg of cholesterol incorporated into milkshakes, or a placebo during each period. Plasma lipid profile and lipoprotein subclass distribution were determined. Cholesterol absorption and synthesis were assessed by stable isotopic tracer techniques. Participants were genotyped for 38 candidate single nucleotide polymorphisms across 25 genes involved in cholesterol and lipoprotein metabolism. Dietary cholesterol consumption increased plasma TC, HDL-C concentrations and large HDL subclasses with no changes in cholesterol absorption or synthesis. In contrast, plant sterol intake failed to reduce LDL-C concentrations, with a modest reduction in cholesterol absorption, and did not affect lipoprotein subclasses. However, a large non-compensatory increase in cholesterol synthesis was observed due to plant sterol consumption. Gender and common genetic variants affected plasma HDL-C and HDL subclass distribution to dietary cholesterol and plant sterol consumption. ACAT2 and NPC1L1 gene variants affected plasma campesterol and β-sitosterol concentrations respectively, to plant sterol intake by modifying cholesterol absorption. In summary, our results demonstrate that dietary cholesterol and plant sterol intake differentially modulate cholesterol trafficking in a manner dependent on common genetic variants and gender in healthy individuals. Such knowledge facilitates the development of effective cholesterol lowering strategies for the alleviation of CVD burden.
Cholesterol, plant sterols, Hutterites, Genetics, SNP
Alphonse PA, Jones PJ (2016) Revisiting human cholesterol synthesis and absorption: The reciprocity paradigm and its key regulators. Lipids 51:519-536.