Influence of sucrose polyester on plasma lipoproteins, and cholesterol metabolism in obese patients with and without diabetes mellitus

Sucrose polyester (SPE) is a nonabsorbable substitute for fat. This study examined its effects in 10 obese patients, 6 with diabetes mellitus. Three diabetics had hypertriglyceridemia. Most patients were studied in three periods: weight maintenance, caloric restriction + SPE, and caloric restriction without SPE. Nondiabetics generally tolerated SPE better than diabetics. In non-diabetic patients caloric restriction + SPE produced a decrease in total cholesterol and in LDL-cholesterol of 20% and 26%, respectively. In normotriglyceridemic diabetic patients caloric restriction + SPE had an effect on plasma lipoproteins similar to that of nondiabetics. In diabetics with hypertriglyceridemia caloric restriction (with or without SPE) caused a marked reduction in plasma triglycerides. In all patients caloric restriction reduced cholesterol balance and presumably cholesterol synthesis. The feeding of SPE caused increased outputs of fecal neutral steroids suggestive of decreased absorption of cholesterol; SPE also frequently caused a mild increase in fecal acidic steroids (bile acids).