Markers of enhanced cholesterol absorption are a strong predictor for cardiovascular diseases in patients without diabetes mellitus

• Published in: Chemistry and physics of lipids Vol. 164; no. 6; pp. 451 - 456
• Main Authors: Weingärtner, Oliver, Lütjohann, Dieter, Vanmierlo, Tim, Müller, Stephanie, Günther, Laureen, Herrmann, Wolfgang, Böhm, Michael, Laufs, Ulrich, Herrmann, Markus
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.09.2011
• Subjects: Absorption; accidents; Adult; Aged; atherosclerosis; Biomarkers - metabolism; body mass index; campesterol; Cardiovascular diseases; Cardiovascular Diseases - blood; Cardiovascular Diseases - diagnostic imaging; Cardiovascular Diseases - drug therapy; Cardiovascular Diseases - metabolism; Cholesterol; Cholesterol - biosynthesis; Cholesterol - blood; Cholesterol - metabolism; Coronary Angiography; coronary artery disease; Diabetes Complications - blood; Diabetes Complications - diagnostic imaging; Diabetes Complications - drug therapy; Diabetes Complications - metabolism; Diabetes mellitus; Female; Homeostasis; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; hypercholesterolemia; hypertension; Lathosterol; Male; medical history; Middle Aged; patients; Plant sterol; regression analysis; Risk Factors; synthesis; ultrasonics; Young Adult; Plant sterol; Lathosterol; Cardiovascular diseases; Diabetes mellitus; Cholesterol
• ISSN: 0009-3084; 1873-2941
• DOI: 10.1016/j.chemphyslip.2011.03.008

► Plant sterols and lathosterol as markers for cholesterol homeostasis. ► Incidence of cardiovascular diseases in patients referred for coronary angiography. ► Subgroup analysis in patients without diabetes mellitus and statin treatment. ► Markers of cholesterol absorption predict cardiovascular disease. Hypercholesterolemia is a major risk factor for cardiovascular disease (CVD), and diabetes mellitus and statin treatment affect cholesterol metabolism. The aim of the present study was to evaluate markers of cholesterol metabolism and determine their relationship with CVD in patients without diabetes mellitus who were not receiving statin treatment. In addition to conventional CVD risk factors, plasma levels of campesterol and sitosterol (indicators of cholesterol absorption) and lathosterol (an indicator of cholesterol synthesis) were determined in 835 consecutive patients referred for coronary angiography. Coronary artery disease was evaluated by coronary angiograms, carotid atherosclerosis and peripheral vascular disease were assessed by Doppler ultrasound, and cerebrovascular accidents and transient ischemic attacks were identified by medical history. After excluding patients with known diabetes mellitus and those receiving statin treatment, 177 patients were included in the analysis. Compared to patients without CVDs ( n = 111), patients with concomitant CVDs ( n = 66) had a reduced lathosterol-to-cholesterol ratio (1.25 ± 0.61 vs. 1.38 ± 0.63, P < 0.05) and an increased campesterol-to-cholesterol ratio (1.81 ± 1.04 vs. 1.50 ± 0.69, P < 0.05), indicating that enhanced absorption and reduced synthesis of cholesterol is associated with CVD development. Logistic regression analysis including all established cardiovascular risk factors (age, sex, total cholesterol, arterial hypertension, body mass index and smoking) revealed that campesterol and the campesterol-to-cholesterol ratio were significant predictors of concomitant CVD in this patient population. In patients without diabetes mellitus, markers of enhanced cholesterol absorption were a strong predictor for concomitant CVD.