Probiotic Reduces LDL Cholesterol Level

Value-Based Care in Cardiometabolic Health Dec 2012, Vol 1, No 3
Wayne Kuznar

Los Angeles, CA—An over-the-counter probiotic that reduces total and low-density lipoprotein cholesterol (LDL-C) levels in adults with moderate hypercholesterolemia has also been shown to lower cholesteryl ester saturated fatty acids, according to data presented at the American Heart Association 2012 Scientific Sessions.

The probiotic, which contains Lactobacillus reuteri NCIMB 30242, was previously shown in a randomized, double-blind, placebo-controlled trial to reduce LDL-C by 11.6% in hypercholesterolemic adults through the production of bile salt hydrolase that deconjugates bile acids. When bile acids are deconjugated, dietary and biliary cholesterol absorption is reduced, and the recirculation of bile is altered.

“The metabolic activities of the gut microbiome have far-reaching metabolic impacts…driven by bacterial DNA,” said Mitchell Jones, MD, MEng, a research assistant at McGill University, Montreal, Canada, and Chief Scientific Officer at Micropharma Limited.

Prior studies have also established reduction in levels of high-sensitivity C-reactive protein and fibrinogen in subjects taking L reuteri NCIMB 30242.

In hypercholesterolemia, additional cholesteryl esters contain more saturated than other fatty acids. Oleic and saturated fatty acid cholesteryl esters are significantly elevated in atherosclerotic plaques. Lower levels of cholesteryl esters have been associated with a reduced risk of cardiovascular disease, said Dr Jones.

In the study that he presented at the meeting, 127 patients were randomized to receive L reuteri NCIMB 30242 capsules twice daily or placebo over 9 weeks. The group randomized to L reuteri NCIMB 30242 had significant reductions in total cholesteryl esters by 6.3%, cholesteryl ester fatty acids by 8.8%, palmitic acid by 8.8%, stearic acid by 16.8%, and cholesteryl ester saturated fatty acids plus oleic acid by 5.2% relative to placebo.

Levels of high-density lipoprotein cholesterol and triglycerides were unchanged.

In addition, there were significant reductions in sterols in the treated group, which indicates reduced sterol absorption is responsible for the reduction of cholesterol with the consumption of L reuteri NCIMB 30242.

“Over the intervention period, the reduction in cholesteryl esters and cholesteryl ester saturated fatty acids were significantly correlated with reduction of apolipoprotein B-100 and LDL cholesterol, and are consistent with the purported mechanism of action of bile salt hydrolase-active L reuteri NCIMB 30242,” Dr Jones concluded. Earlier studies have demonstrated no increase in the frequency and intensity of adverse events with L reuteri NCIMB 30242 compared with placebo, he said, and no difference in blood clinical chemistry or hematology results.

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