VON-WILLEBRAND-FACTOR, A POSSIBLE INDICATOR OF ENDOTHELIAL-CELL DAMAGE, DECREASES DURING LONG-TERM COMPLIANCE WITH A LIPID-LOWERING DIET

Objectives. To test whether serum von Willebrand factor (vWf) would be lower in men with atherosclerosis who had been consuming a lipid-lowering diet for 3 years than in a control group of men with atherosclerosis who had been following their normal diet. Design, A randomized, population-based case-control study. Setting. A tertiary health care referral centre at a University Hospital. Subjects. Men age less than 66 years with angiographically proven coronary atherosclerosis and a cholesterol level > 6 mmol L(-1). Sixty started the study and 50 completed it. Interventions. Subjects were randomized to a lipid-lowering diet or to taking their normal diet for approximately 3 years. Main outcome measures. The components of the subjects' diets were assessed and blood was obtained for total, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol, triglycerides and for vWf. Results. Men on the lipid-lowering diet consumed less total, saturated and monounsaturated fats (all P < 0.001), cholesterol and retinol (both P < 0.002) but increased polyunsaturated fats (P < 0.001), fibre, vitamin E (both P < 0.005) and carbohydrate (P < 0.05). Those on the lipid-lowering diet also had lower serum levels of total and LDL cholesterol (P < 0.002 and P < 0.05, respectively), triglycerides (P < 0.02) and vWf (P < 0.05) than the men on their normal diet. There was no difference in HDL cholesterol. Levels of vWf correlated with both total cholesterol (P < 0.005) and inversely with dietary polyunsaturated fats (P < 0.02). Conclusion. von Willebrand factor, a possible indicator of endothelial cell damage, decreases during long-term compliance with a lipid-lowering diet.