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 .
Cholesterol absorption and synthesis markers in individuals with and without a CHD event during pravastatin therapy: insights from the PROSPER trial
Cholesterol homeostasis , defined as the balance between absorption and synthesis , influences circulating cholesterol concentrations and subsequent coronary heart disease ( CHD ) risk . Statin therapy targets the rate-limiting enzyme in cholesterol bio synthesis and is efficacious in lowering CHD events and mortality . Nonetheless , CHD events still occur in some treated patients . To address differences in outcome during pravastatin therapy ( 40 mg/day ) , plasma markers of cholesterol synthesis ( desmosterol , lathosterol ) and fractional cholesterol absorption ( campesterol , sitosterol ) were measured , baseline and on treatment , in the Prospect i ve Study of Pravastatin in the Elderly at Risk trial participants with ( cases , n = 223 ) and without ( controls , n = 257 ) a CHD event .  Pravastatin therapy decreased plasma LDL-cholesterol and triglycerides and increased HDL-cholesterol concentrations to a similar extent in cases and controls . Decreased concentrations of the cholesterol synthesis markers desmosterol ( −12 % and −11 % ) and lathosterol ( −50 % and −56 % ) and increased concentrations of the cholesterol absorption markers campesterol ( 48 % and 51 % ) and sitosterol ( 25 % and 26 % ) were observed on treatment , but the magnitude of change was similar between cases and controls . These data suggest that decreases in cholesterol synthesis in response to pravastatin treatment were accompanied by modest compensatory increases in fractional cholesterol absorption . The magnitude of these alterations were similar between cases and controls and do not explain differences in outcomes with pravastatin treatment
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 .