Cholesterol Lowering and Inhibition of Sterol Absorption by Lactobacillus Reuteri NCIMB 30242: A Randomized Controlled Trial

Eur J Clin Nutr. 2012 Nov;66(11):1234-41. doi: 10.1038/ejcn.2012.126. Epub 2012 Sep 19.

Abstract

Background/objectives: The percentage of hypercholesterolemic individuals not reaching their LDL-cholesterol (LDL-C) goal remains high and additional therapeutic strategies should be evaluated. The objective of this study was to evaluate the cholesterol-lowering efficacy and mechanism of action of bile salt hydrolase-active Lactobacillus reuteri NCIMB 30242 capsules in hypercholesterolemic adults.

Subjects/methods: A total of 127 subjects completed a randomized, double-blind, placebo-controlled, parallel-arm, multicenter study. Subjects were randomized to consume L. reuteri NCIMB 30242 capsules or placebo capsules over a 9-week intervention period. The primary outcome was LDL-C relative to placebo at the study end point.

Results: L. reuteri NCIMB 30242 capsules reduced LDL-C by 11.64% (P<0.001), total cholesterol by 9.14%, (P<0.001), non-HDL-cholesterol (non-HDL-C) by 11.30% (P < 0.001) and apoB-100 by 8.41% (P = 0.002) relative to placebo. The ratios of LDL-C/HDL-cholesterol (HDL-C) and apoB-100/apoA-1 were reduced by 13.39% (P = 0.006) and 9.00% (P = 0.026), respectively, relative to placebo. Triglycerides and HDL-C were unchanged. High-sensitivity C-reactive protein and fibrinogen were reduced by 1.05 mg/l (P = 0.005) and 14.25% (P = 0.004) relative to placebo, respectively. Mean plasma deconjugated bile acids were increased by 1.00 nmol/l (P=0.025) relative to placebo, whereas plasma campesterol, sitosterol and stigmasterol were decreased by 41.5%, 34.2% and 40.7%, respectively.

Conclusions: The present results suggest that the deconjugation of intraluminal bile acids results in reduced absorption of non-cholesterol sterols and indicate that L. reuteri NCIMB 30242 capsules may be useful as an adjunctive therapy for treating hypercholesterolemia.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Apolipoprotein A-I / blood
  • Apolipoprotein B-100 / blood
  • Bile Acids and Salts / blood*
  • C-Reactive Protein / metabolism
  • Cholesterol / analogs & derivatives
  • Cholesterol / blood*
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood*
  • Double-Blind Method
  • Female
  • Fibrinogen / metabolism
  • Humans
  • Hypercholesterolemia / blood
  • Hypercholesterolemia / drug therapy*
  • Intestinal Absorption
  • Lactobacillus reuteri*
  • Male
  • Middle Aged
  • Phytosterols / blood*
  • Sitosterols / blood
  • Stigmasterol / blood

Substances

  • Apolipoprotein A-I
  • Apolipoprotein B-100
  • Bile Acids and Salts
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Phytosterols
  • Sitosterols
  • campesterol
  • gamma-sitosterol
  • Fibrinogen
  • C-Reactive Protein
  • Cholesterol
  • Stigmasterol