Impact of a Plant Sterol Food Supplement on Eryptotic and Associated Cardiometabolic Parameters: A Randomized Placebo-Controlled Trial in Statin-Treated Patients

Eryptotic erythrocytes are prone to adhere to the vascular endothelium, provoking atherosclerosis. As statins do not prevent eryptosis compounds with anti-eryptotic effects could help treated hypercholesterolemic subjects in decreasing cardiovascular disease risk. Plant sterols (PSs) have shown this anti-eryptotic effect ex vivo, along with their cholesterol-lowering activity. A parallel double-blind placebo-controlled randomized trial was conducted using a PS-food supplement (2 g of PS/day) (case, n = 13) or a placebo supplement (control, n = 13) in statin-treated hypercholesterolemic subjects. Blood samples were extracted before (T0) and after (T1) a 6-week treatment, and erythrocytes were isolated for biochemical determination, phosphatidylserine externalization (EPHS), cell size and reduced glutathione (GSH) analyses, and endothelium adhesion evaluation. A reduction in glucose (4.3%) and LDL cholesterol (9.2%) was observed only in the control group, whereas in the case group, an increase in ApoA1 (6.4%) was observed. Neither EPHS, cell size nor GSH were modified by the treatment with any of the supplements, whilst endothelium adhesion was reduced (55.1%) only in the case group. These results suggest that the PS supplement may improve some cardiovascular health parameters in the target population even though eryptosis status is not modified by this treatment.