In general , markers for cholesterol absorption and synthesis displayed reciprocal patterns , showing that cholesterol metabolism is tightly regulated by the interplay of intestinal absorption and endogenous synthesis .
Distinctive patterns for cholesterol absorption or cholesterol synthesis could be identified , suggesting that metabolic disorders can be classified as ' cholesterol absorbers or cholesterol synthesizers ' .
Non-cholesterol sterols are vali date d biomarkers for intestinal cholesterol absorption and endogenous cholesterol synthesis .
However , their use in metabolic disturbances has not been systematic ally explored .
Therefore , we conducted a systematic review to provide an overview of non-cholesterol sterols as markers for cholesterol metabolism in different metabolic disorders .
Plasma sitosterol elevations are associated with an increased incidence of coronary events in men: results of a nested case-control analysis of the Prospective Cardiovascular Münster (PROCAM) study.
BACKGROUND AND AIM Sitosterolemia , a rare genetic disorder characterized by profoundly elevated plasma sitosterol concentrations , is associated with premature atherosclerosis in some individuals . This study was conducted to evaluate if the modest sitosterol elevations seen in the general population are also associated with the occurrence of coronary events . METHODS AND RESULTS A nested case-control study using stored sample s from male participants in the Prospect i ve Cardiovascular Münster ( PROCAM ) study was performed . Each of 159 men who suffered a myocardial infa rct ion or sudden coronary death ( major coronary event ) within 10 years of follow-up in PROCAM was matched with 2 controls ( N = 318 ) by age , smoking status , and date of investigation . Analysis was performed using conditional logistic regression . Plasma sitosterol concentrations were elevated in cases compared with controls ( 4.94 + /- 3.44 micromol/L versus 4.27 + /- 2.38 micromol/L ; P = 0.028 ) . The upper quartile of sitosterol ( > 5.25 micromol/L ) was associated with a 1.8-fold increase in risk ( P < 0.05 ) compared with the lower three quartiles . Among men with an absolute  coronary risk > or = 20 % in 10 years as calculated using the PROCAM algorithm , high sitosterol concentrations were associated with an additional 3-fold increase in the incidence of coronary events ( P = 0.032 ) ; a similar , significant relationship was observed between a high sitosterol/cholesterol ratio and coronary risk ( P = 0.030 ) . CONCLUSIONS Elevations in sitosterol concentrations and the sitosterol/cholesterol ratio appear to be associated with an increased occurrence of major coronary events in men at high global risk of coronary heart disease . Further evaluations are warranted to confirm these preliminary findings
In general , markers for cholesterol absorption and synthesis displayed reciprocal patterns , showing that cholesterol metabolism is tightly regulated by the interplay of intestinal absorption and endogenous synthesis .
Distinctive patterns for cholesterol absorption or cholesterol synthesis could be identified , suggesting that metabolic disorders can be classified as ' cholesterol absorbers or cholesterol synthesizers ' .
Non-cholesterol sterols are vali date d biomarkers for intestinal cholesterol absorption and endogenous cholesterol synthesis .
However , their use in metabolic disturbances has not been systematic ally explored .
Therefore , we conducted a systematic review to provide an overview of non-cholesterol sterols as markers for cholesterol metabolism in different metabolic disorders .