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      Efecto de los probióticos sobre el colesterol plasmático: Ensayo clínico controlado aleatorizado Translated title: Effect of probiotics on plasma cholesterol: Randomized controlled clinical trial

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          Abstract

          Objetivo: Determinar si la disminución promedio del colesterol total y LDL- colesterol es mayor en pacientes adultos con diagnóstico de hipercolesterolemia que reciben una dieta hipocolesterolémica sumada a un probiótico en comparación con aquellos que reciben sólo dieta. Materiales y métodos: Ensayo clínico controlado y aleatorizado. La muestra estuvo conformada por 46 pacientes de ambos sexos que asistieron a los consultorios externos del Hospital Piñero con diagnóstico de hipercolesterolemia durante los meses de Agosto de 2009 a Abril de 2011. Los mismos fueron asignados a dos grupos: uno que recibió una dieta hipocolesterolémica y otro la misma dieta sumada a un producto lácteo que contiene la cepa probiótica Lactobacillus Casei Shirota. Resultados: En el caso del colesterol total no se hallaron diferencias significativas en el promedio de descenso del mismo entre el grupo que realizó la dieta hipocolesterolémica y el que realizó la misma dieta sumada al consumo del probiótico (p=0,386), al mismo tiempo que sí se pudo observar una diferencia significativa (p<0,001) entre el colesterol total inicial y el final en ambos. En lo que respecta al LDL-colesterol tampoco se hallaron diferencias significativas en el promedio de descenso del mismo entre ambos grupos (p=0,313), aunque hubo una diferencia significativa (p<0,001) entre el LDL-colesterol inicial y el final. Conclusiones: En este estudio no se han encontrado diferencias significativas en el descenso promedio del colesterol total y el LDL-colesterol en el grupo que realizó la dieta hipocolesterolémica sola en comparación con el que realizó la dieta y consumió el probiótico. Sin embargo, los resultados obtenidos permiten confirmar que la adopción de un plan alimentario destinado a lograr la reducción de los niveles de colesterol total y LDL- colesterol resulta efectivo, constituyéndose en un pilar fundamental para la prevención y tratamiento de las enfermedades cardiovasculares.

          Translated abstract

          Objective: To determine whether the average drop in total cholesterol and LDL-cholesterol is higher in adult patients diagnosed with hypercholesterolemia who receive an hypocholesterolemic diet combined with a probiotic compared with those who receive only diet. Materials and methods: A randomized controlled clinical trial. The sample consisted of 46 patients of both sexes who attended the Piñero Hospital outpatient center with a diagnosis of hypercholesterolemia from August 2009 to April 2011. They were assigned to two groups: one received an hypocholesterolemic diet and another the same diet plus a dairy product containing probiotic Lactobacillus casei strain Shirota. Results: no significant differences were found in the average drop in total cholesterol between the group that followed the hypocholesterolemic diet and the one that followed the same diet combined with the probiotic (p = 0.386), whereas a significant difference (p <0.001) was observed between the initial and final total cholesterol in both. In the case of LDLcholesterol, no significant differences were found in its average drop between both groups (p = 0.313) as well, but there was a significant difference (p <0.001) between the initial and final LDL . Conclusions: in this study no significant differences were found in the average drop in total cholesterol and LDL-cholesterol between the group that followed only the hypocholesterolemic diet and the group that followed the diet with the probiotic. However, the results obtained confirm that the adoption of a meal plan designed to achieve a reduction in total cholesterol and LDL-cholesterol is effective, becoming a mainstay for the prevention and treatment of cardiovascular diseases.

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          Assimilation of cholesterol by Lactobacillus acidophilus.

          Considerable variation was found among strains of Lactobacillus acidophilus isolated from the fecal flora of pigs with regard to the ability to grow well in the presence of bile and to assimilate cholesterol from a laboratory growth medium. The uptake of cholesterol occurred only when the culture(s) was growing in the presence of bile under anaerobic conditions. Consumption of L. acidophilus RP32, which was selected for its ability to grow well in the presence of bile and to assimilate cholesterol from the laboratory medium, significantly inhibited increases in serum cholesterol levels of pigs (P less than 0.05) fed a high-cholesterol diet. Consumption of L. acidophilus P47, which was selected for its ability to grow in the presence of bile and lack of ability to remove cholesterol from the growth medium, failed to have a similar effect. This indicates that certain strains of L. acidophilus act directly on cholesterol in the gastrointestinal tract, and thus may be beneficial in reducing serum cholesterol levels.
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            Probiotics: Growth-Promoting Factors Produced by Microorganisms

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              The assumed assimilation of cholesterol by Lactobacilli and Bifidobacterium bifidum is due to their bile salt-deconjugating activity.

              To study the mechanism of the propsed assimilation of cholesterol, we cultured various strains of Lactobacillus acidophilus and a Bifidobacterium sp. in the presence of cholesterol and oxgall. During culturing, both cholesterol and bile salts were precipitated. Because of bacterial bile salt deconjugation, no conjugated bile salts were observed in either the culture fluids or the pellets. During incubation, the cell count and optical density decreased. The degree of precipitation of bile salts and of cholesterol was dependent on the culture conditions. If L. acidophilus RP32 was cultured under acidifying conditions, the degree of precipitation of deconjugated bile salts was higher than if the pH was maintained at 6.0. Under acidifying conditions, cholesterol was coprecipitated with the bile salts, whereas in pH-controlled cultures, no coprecipitation of cholesterol was observed. From control experiments with different mixtures of bile salts, it appeared that coprecipitation of cholesterol during culturing was a result of formation of deconjugated bile salts, which have a decreased solubility at pH values lower than 6.0. It is concluded that the removal of cholesterol from the culture medium by L. acidophilus RP32 and other species is not due to bacterial uptake of cholesterol, but results from bacterial bile salt-deconjugating activity.
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                Author and article information

                Journal
                diaeta
                Diaeta
                Diaeta
                Asociación Argentina de Dietistas y Nutricionistas Dietista (Ciudad Autónoma de Buenos Aires, , Argentina )
                1852-7337
                June 2012
                : 30
                : 139
                Article
                S1852-73372012000200003 S1852-7337(12)03013900003
                e6e2a059-6589-43da-aceb-c50b268274cf

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 13 April 2012
                : 01 December 2011
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 8, Pages: 0
                Product

                SciELO Argentina

                Categories
                Artículos originales

                Total cholesterol,Probiotics,Hypocholesterolemic diet,LDL-cholesterol,Probióticos,Dieta hipocolesterolémica,LDL- colesterol,Colesterol total

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