Efectos de la fibra soluble cáscaras de plantago ovata sobre factores lípidicos de riesgo cardiovascular

Identificador:  TDX:1686

Handle: https://hdl.handle.net/20.500.11797/TDX1686

Autors:  Anguera i Vilà, Anna

Resum:
DOCTORAL TESISAnna Anguera Vilà3rd May 2007Effect of the soluble fiber Plantago ovata husk on the lipidic factors of cardiovascular risk.Background: The dietary fiber could reduce the risk of cardiovascular disease. Nevertheless, the effects of Plantago ovata husk, a soluble fiber, or the seeds of Plantago, an insoluble fiber, on the lipidic factors of cardiovascular risk are little known, especially in patients with cardiovascular disease (CVD).Aim: To study the therapeutic effects of plantago ovata husk in metabolic disorders of lipids observed in clinical trials performed with patients controlled with a placebo or a non-active treatment, through a meta-analysis.To study the effect on the lipidic profile, lipoproteins and apolipoproteins and their interaction with genes involved in the lipidic metabolism in patients with CVD.Material and Methods: This work has been divided in two parts:a) In the first part, it has been performed a meta-analysis following the guides of the group QUORUM.b) In the second part of this work it was designed a randomized, crossover, controlled, single-blind design, 28 men with CVD (myocardial infarction or stable angina) and low-density lipoprotein cholesterol (cLDL) concentration &#8804;3.35 mmol/L (&#8804;130mg/dl) consumed, under controlled conditions of 8 weeks, a low-saturated fat diet with added 10.5g/d of Po husk or 10.5g/d of insoluble fiber. Fasting plasma lipid concentrations and polymorphisms of genes involved in lipid metabolism, such as apo A-IV, apo E and fatty acid binding protein (FABP-2), were determined.Results: The data of the meta-analysis has been shown that the soluble fiber decreases significantly the total cholesterol (p<0.001) and cLDL (p<0.001). The effect on the reduction in triacylglycerol has not been significant (p = 0.213, but p= 0.021 in the fixed random effects). The increase of high-density lipoprotein cholesterol (cHDL) was not significant. In the subgroups analysis there were identified greater magnitudes of the effect when it was used a fiber dietetic supplement, with the duration of the treatment, between 4 and 8 weeks and the daily doses >10g/d in adults, as well for the total cholesterol as cLDL. Despite of the positives results their interpretation remains not clear, because the high heterogeneity observed in the selected studies.The results of the clinical trial indicates that Po husk consumers showed decreases in plasma triacylglycerols (-6.7%; P<0.02), reductions in apo B 100/apo A-I ratio (4.7%; P <0.02) and increases in apo A-I (4.3%; P<0.01) concentrations.Compared with the insoluble fiber intake, Po husk increased cHDL concentrations by 6.7% (P: 0.006), while total cholesterol/HDL-cholesterol ratio and the LDL-cholesterol/HDL-cholesterol ratio decreased by 10.6% (P: 0.002) and 14.2% (P: 0.003), respectively.Conclusions: In secondary prevention of CVD, Po husk induces a more protective cardiovascular lipid risk-factor profile than does an equivalent insoluble fiber.