Cholesterol Homeostasis in Framingham Offspring Study

This study has been completed.
National Heart, Lung, and Blood Institute (NHLBI)
Information provided by (Responsible Party):
Tufts University Identifier:
First received: December 12, 2003
Last updated: May 3, 2013
Last verified: May 2013
To investigate the predictive value of using measures of cholesterol homeostasis to identify individuals at high risk of developing cardiovascular disease relative to established risk factors.

Cardiovascular Diseases
Heart Diseases
Coronary Disease

Study Type: Observational
Study Design: Time Perspective: Cross-Sectional

Resource links provided by NLM:

Further study details as provided by Tufts University:

Primary Outcome Measures:
  • quantification of circulating indicators of cholesterol homeostasis [ Time Frame: 1 time point ] [ Designated as safety issue: No ]
    phytosterols and cholestanol (surrogate measures of cholesterol absorption) cholesterol precursors (surrogate measures of cholesterol synthetic rates)

Enrollment: 3378
Study Start Date: August 2003
Study Completion Date: July 2008
Primary Completion Date: July 2008 (Final data collection date for primary outcome measure)
Detailed Description:


Cholesterol is a major risk factor for coronary heart disease. The current approach to assessing this risk factor is to measure levels in the blood as if blood levels were a static and fixed phenomenon. Cholesterol levels in the blood are in fact a complex product of transport of cholesterol and lipids into and out of various compartments: (1) from the gut, liver or periphery into the blood; (2) from the blood into the periphery and the liver; (3) de novo synthesis of cholesterol in the liver; and (4) excretion from the liver as bile acids. It is possible that one or more of these processes may serve as better risk factors for atherosclerosis or coronary events than simple measures of cholesterol. This study addresses a new and potentially important question.

The study will utilize plasma samples from subjects participating in Cycle 6 of the Framingham Offspring Study. The Framingham Offspring Study is a longitudinal community based study initiated in 1971. A sample of 5,135 men and women, consisting of the offspring of the original Framingham Heart Study and their spouses were enrolled for the study, the objective of which was to identify common factors or characteristics that contribute to cardiovascular disease (CVD) by following its incidence over a long period of time in a large group of participants who had not yet developed overt symptoms of CVD or suffered a heart attack or stroke.


The project includes a case-control study relating the new lipid findings to cardiovascular disease (CVD), a cross-sectional study to establish normal values and associations with diet and genotypes, and a prospective study of cardiovascular events during a 10-year follow-up period. The specific aims are to 1) quantify circulating indicators of cholesterol homeostasis [levels of phytosterols and cholestanol (surrogate measures of cholesterol absorption) and cholesterol precursors (surrogate measures of cholesterol synthetic rates)] in plasma samples from Framingham Offspring Study participants diagnosed with established CVD and/or >50% carotid stenosis (N=165) not taking lipid-lowering medication and control subjects matched for age, sex, body mass index, hypertension and smoking status (n=330); 2) evaluate the validity of using indicators of cholesterol homeostasis to predict CVD risk in the Framingham Offspring Study-Cycle 6 participants by a) establishing adult normal ranges for circulating levels of phytosterol, cholestanol and cholesterol precursor (N=3378), b) defining the relationship between phytosterol, cholestanol and cholesterol precursor levels, and lipid, lipoprotein and apolipoprotein levels in plasma, c) defining the relationship between phytosterol, cholestanol and cholesterol precursor levels and selected dietary intake data (energy, protein, fat, saturated, monounsaturated, polyunsaturated and trans fatty acids, cholesterol, fiber and antioxidant supplements) and d) determining the relationship between phytosterol, cholestanol and cholesterol precursor levels and selected genotype data related to CVD risk (gene loci of apo E, apo A-IV, scavenger receptor class B type 1 [SRB1], and ATP-binding cassette [ABC] G5 and ABCG8 transporters); and 3) monitor clinical events in the Framingham Offspring Study cohort throughout a 10-year period (1995-2005) and relate these data to the phytosterol, cholestanol and cholesterol precursor levels. Measures of cholesterol homeostasis will be quantified first in subjects identified in specific aim #1 and then the balance of subjects identified in specific aim #2, achievable now due to the development of a gas chromatographic method using a single plasma sample. These data will be assessed relative to dietary, biochemical and genotype data currently available for the cohort. The results of the study will define the relationship between markers of cholesterol absorption and synthesis, and CVD outcomes; establish reference values for measures of cholesterol absorption and synthesis; and assess the predictive value of these measures to identify high risk individuals relative to established risk factors.


Ages Eligible for Study:   25 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population
Framingham Offspring Study Cycle 6 Participants
No eligibility criteria
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00074464

Sponsors and Collaborators
Tufts University
National Heart, Lung, and Blood Institute (NHLBI)
Principal Investigator: Alice Lichtenstein Tufts University
  More Information

No publications provided by Tufts University

Additional publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Tufts University Identifier: NCT00074464     History of Changes
Other Study ID Numbers: 1242  R01HL074388 
Study First Received: December 12, 2003
Last Updated: May 3, 2013
Health Authority: United States: Federal Government

Additional relevant MeSH terms:
Cardiovascular Diseases
Coronary Artery Disease
Coronary Disease
Arterial Occlusive Diseases
Heart Diseases
Myocardial Ischemia
Vascular Diseases processed this record on February 08, 2016