Association of dietary components with dyslipidemia and low-grade inflammation biomarkers in adults with heterozygous familial hypercholesterolemia from different countries


The association of components of a low saturated fat (SFA) and of a Mediterranean diet was tested with atherosclerosis biomarkers in 190 familial hypercholesterolemia adults (FH) from Brazil (BR) and Spain (SP). Median blood LDL-C, Apolipoprotein B (apoB), and C reactive protein (hs-CRP) concentrations were higher in BR than in SP: 179.0 vs.161 mg/dL; 141 vs. 103 mg/dL; and 1.6 vs. 0.8 mg/L respectively (all p < 0.001). In BR there was lower median total fat (22.3 vs. 38.3%) and SFA (8.1 vs. 12.5%) but higher cholesterol (283.3 mg vs.188.9 mg) and carbohydrate (57.1 vs. 42.5%) consumption (all p < 0.001). Inverse associations were encountered between fibers, mono, and polyunsaturated fats and their ratios to SFA with LDL-C and ApoB (all p < 0.001). There was a direct association respectively of cholesterol with lipid biomarkers and of carbohydrates and trans-fatty acids with hs-CRP while other fats showed inverse relations with the latter (p < 0.001).

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RDS is a recipient of a scholarship from the Conselho Nacional de Pesquisa e Desenvolvimento Tecnologico (CNPq) process # 303734/2018-3.


The funding of Sociedade Hospital Samaritano and Ministério da Saúde (PROADI-SUS; SIPAR: 25000.180.672/2011-81) and FAPESP (grant no 2013/17368-0) are gratefully acknowledged.

Authors contributions

LA and RAO contributed equally to the study. Both worked on the following stages of work: conceptualization; data curation; formal analysis; investigation; methodology and writing, reviewing and editing. RDS, MSB, and PM conceptualized the study, RDS wrote the study. All other authors worked on data acquisition, reviewed the study and approved its final version.

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Correspondence to Raul D. Santos.

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RDS has received honoraria related to consulting, research and or speaker activities from Ache, Akcea, Amgen, Astra Zeneca, Biolab, Esperion, Kowa, Merck, Novo-Nordisk, Pfizer, and Sanofi Regeneron. Other authors declare that they have no conflict of interest.

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Antoniazzi, L., Arroyo-Olivares, R., Bittencourt, M.S. et al. Association of dietary components with dyslipidemia and low-grade inflammation biomarkers in adults with heterozygous familial hypercholesterolemia from different countries. Eur J Clin Nutr 73, 1622–1625 (2019).

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