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Plant sterols and cardiovascular disease: a systematic review and meta-analysis

(2012) EUROPEAN HEART JOURNAL. 33(4). p.444-451
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Abstract
The impact of increased serum concentrations of plant sterols on cardiovascular risk is unclear. We conducted a systematic review and meta-analysis aimed to investigate whether there is an association between serum concentrations of two common plant sterols (sitosterol, campesterol) and cardiovascular disease (CVD). We systematically searched the databases MEDLINE, EMBASE, and COCHRANE for studies published between January 1950 and April 2010 that reported either risk ratios (RR) of CVD in relation to serum sterol concentrations (either absolute or expressed as ratios relative to total cholesterol) or serum sterol concentrations in CVD cases and controls separately. We conducted two meta-analyses, one based on RR of CVD contrasting the upper vs. the lower third of the sterol distribution, and another based on standardized mean differences between CVD cases and controls. Summary estimates were derived by fixed and random effects meta-analysis techniques. We identified 17 studies using different designs (four casecontrol, five nested casecontrol, three cohort, five cross-sectional) involving 11 182 participants. Eight studies reported RR of CVD and 15 studies reported serum concentrations in CVD cases and controls. Funnel plots showed evidence for publication bias indicating small unpublished studies with non-significant findings. Neither of our meta-analyses suggested any relationship between serum concentrations of sitosterol and campesterol (both absolute concentrations and ratios to cholesterol) and risk of CVD. Our systematic review and meta-analysis did not reveal any evidence of an association between serum concentrations of plant sterols and risk of CVD.
Keywords
Phytosterols, DIETARY-CHOLESTEROL, PLASMA-CONCENTRATIONS, NONCHOLESTEROL STEROLS, POSTMENOPAUSAL WOMEN, MYOCARDIAL-INFARCTION, SERUM PLANT, METABOLIC SYNDROME, ARTERY-DISEASE, CHOLESTEROL ABSORPTION, CORONARY-HEART-DISEASE, Coronary heart disease, LDL-C, Plant sterols, Cardiovascular disease

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MLA
Genser, Bernd, Günther Silbernagel, Gui De Backer, et al. “Plant Sterols and Cardiovascular Disease: a Systematic Review and Meta-analysis.” EUROPEAN HEART JOURNAL 33.4 (2012): 444–451. Print.
APA
Genser, B., Silbernagel, G., De Backer, G., Bruckert, E., Carmena, R., Chapman, M. J., Deanfield, J., et al. (2012). Plant sterols and cardiovascular disease: a systematic review and meta-analysis. EUROPEAN HEART JOURNAL, 33(4), 444–451.
Chicago author-date
Genser, Bernd, Günther Silbernagel, Gui De Backer, Eric Bruckert, Rafael Carmena, M John Chapman, John Deanfield, et al. 2012. “Plant Sterols and Cardiovascular Disease: a Systematic Review and Meta-analysis.” European Heart Journal 33 (4): 444–451.
Chicago author-date (all authors)
Genser, Bernd, Günther Silbernagel, Gui De Backer, Eric Bruckert, Rafael Carmena, M John Chapman, John Deanfield, Olivier S Descamps, Ernst Rietzschel, Karen C Dias, and Winfried März. 2012. “Plant Sterols and Cardiovascular Disease: a Systematic Review and Meta-analysis.” European Heart Journal 33 (4): 444–451.
Vancouver
1.
Genser B, Silbernagel G, De Backer G, Bruckert E, Carmena R, Chapman MJ, et al. Plant sterols and cardiovascular disease: a systematic review and meta-analysis. EUROPEAN HEART JOURNAL. 2012;33(4):444–51.
IEEE
[1]
B. Genser et al., “Plant sterols and cardiovascular disease: a systematic review and meta-analysis,” EUROPEAN HEART JOURNAL, vol. 33, no. 4, pp. 444–451, 2012.
@article{3054997,
  abstract     = {The impact of increased serum concentrations of plant sterols on cardiovascular risk is unclear. We conducted a systematic review and meta-analysis aimed to investigate whether there is an association between serum concentrations of two common plant sterols (sitosterol, campesterol) and cardiovascular disease (CVD). We systematically searched the databases MEDLINE, EMBASE, and COCHRANE for studies published between January 1950 and April 2010 that reported either risk ratios (RR) of CVD in relation to serum sterol concentrations (either absolute or expressed as ratios relative to total cholesterol) or serum sterol concentrations in CVD cases and controls separately. We conducted two meta-analyses, one based on RR of CVD contrasting the upper vs. the lower third of the sterol distribution, and another based on standardized mean differences between CVD cases and controls. Summary estimates were derived by fixed and random effects meta-analysis techniques. We identified 17 studies using different designs (four casecontrol, five nested casecontrol, three cohort, five cross-sectional) involving 11 182 participants. Eight studies reported RR of CVD and 15 studies reported serum concentrations in CVD cases and controls. Funnel plots showed evidence for publication bias indicating small unpublished studies with non-significant findings. Neither of our meta-analyses suggested any relationship between serum concentrations of sitosterol and campesterol (both absolute concentrations and ratios to cholesterol) and risk of CVD. Our systematic review and meta-analysis did not reveal any evidence of an association between serum concentrations of plant sterols and risk of CVD.},
  author       = {Genser, Bernd and Silbernagel, Günther and De Backer, Gui and Bruckert, Eric and Carmena, Rafael and Chapman, M John and Deanfield, John and Descamps, Olivier S and Rietzschel, Ernst and Dias, Karen C and März, Winfried},
  issn         = {0195-668X},
  journal      = {EUROPEAN HEART JOURNAL},
  keywords     = {Phytosterols,DIETARY-CHOLESTEROL,PLASMA-CONCENTRATIONS,NONCHOLESTEROL STEROLS,POSTMENOPAUSAL WOMEN,MYOCARDIAL-INFARCTION,SERUM PLANT,METABOLIC SYNDROME,ARTERY-DISEASE,CHOLESTEROL ABSORPTION,CORONARY-HEART-DISEASE,Coronary heart disease,LDL-C,Plant sterols,Cardiovascular disease},
  language     = {eng},
  number       = {4},
  pages        = {444--451},
  title        = {Plant sterols and cardiovascular disease: a systematic review and meta-analysis},
  url          = {http://dx.doi.org/10.1093/eurheartj/ehr441},
  volume       = {33},
  year         = {2012},
}

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