Non-Cholesterol Sterol Concentrations as Biomarkers for Cholesterol Absorption and Synthesis in Different Metabolic Disorders: A Systematic Review

Sultan Mashnafi, Jogchum Plat, Ronald P. Mensink, Sabine Baumgartner*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

17 Citations (Web of Science)

Abstract

Non-cholesterol sterols are validated biomarkers for intestinal cholesterol absorption and endogenous cholesterol synthesis. However, their use in metabolic disturbances has not been systematically explored. Therefore, we conducted a systematic review to provide an overview of non-cholesterol sterols as markers for cholesterol metabolism in different metabolic disorders. Potentially relevant studies were retrieved by a systematic search of three databases in July 2018 and ninety-four human studies were included. Cholesterol-standardized levels of campesterol, sitosterol and cholestanol were collected to reflect cholesterol absorption and those of lathosterol and desmosterol to reflect cholesterol synthesis. Their use as biomarkers was examined in the following metabolic disorders: overweight/obesity (n = 16), diabetes mellitus (n = 15), metabolic syndrome (n = 5), hyperlipidemia (n = 11), cardiovascular disease (n = 17), and diseases related to intestine (n = 16), liver (n = 22) or kidney (n = 2). 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'. Future studies should be performed to confirm or refute these findings and to examine whether this information can be used for targeted (dietary) interventions.

Original languageEnglish
Article number124
Pages (from-to)1-31
Number of pages31
JournalNutrients
Volume11
Issue number1
DOIs
Publication statusPublished - Jan 2019

Keywords

  • non-cholesterol sterols
  • plant sterols
  • BMI
  • diabetes mellitus
  • metabolic syndrome
  • hyperlipidemia
  • cardiovascular disease
  • intestinal disease
  • liver disease
  • kidney disease
  • BILE-ACID SYNTHESIS
  • CORONARY-ARTERY-DISEASE
  • SERUM PLANT STEROLS
  • TYPE-2 DIABETES-MELLITUS
  • APOLIPOPROTEIN B-100 KINETICS
  • PRIMARY BILIARY-CIRRHOSIS
  • WEIGHT-LOSS
  • NONCHOLESTEROL STEROLS
  • HEART-DISEASE
  • LIPOPROTEIN METABOLISM

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