Non-cholesterol sterols in different forms of primary hyperlipemias.
OBJECTIVE
We investigated the behaviour of non-cholesterol sterols, surrogate markers of cholesterol absorption (campesterol and sitosterol) and synthesis (lathosterol), in primary hyperlipemias.


RESULTS
We studied 53 patients with polygenic hypercholesterolemia (PH), 38 patients with familial combined hyperlipemia (FCH), and 19 age- and sex-matched healthy control subjects. In all participants, plasma sitosterol, campesterol and lathosterol were determined by gas chromatography coupled to mass spectrometry. To correct for the effect of plasma lipid levels, non-cholesterol sterol concentrations were adjusted for plasma cholesterol (10² μmol/mmol cholesterol). Patients with FCH were more frequently men, and had higher body mass index (BMI), fasting glucose, insulin and HOMA-IR. Lathosterol was higher in FCH than in pH or controls (p < 0.05). Campesterol was significantly lower in FCH (p < 0.05), while no differences were found between pH and controls. Sitosterol displayed higher values in pH compared to FCH (p < 0.001) and controls (p < 0.05). Spearman's rank correlations showed positive correlations of lathosterol with BMI, waist circumference, HOMA-IR, triglycerides, apoprotein B, and a negative one with HDL-cholesterol. Sitosterol had a negative correlation with BMI, waist circumference, HOMA-IR, triglycerides, and a positive one with HDL-cholesterol and apoprotein AI. Multivariate regression analyses showed that cholesterol absorption markers predicted higher HDL-cholesterol levels, while HOMA-IR was a negative predictor of sitosterol and BMI a positive predictor of lathosterol.


CONCLUSIONS
Our findings suggest the occurrence of an increased cholesterol synthesis in FCH, and an increased cholesterol absorption in pH. Markers of cholesterol synthesis cluster with clinical and laboratory markers of obesity and insulin resistance.
Lupattelli
G
G
Internal Medicine, Angiology and Atherosclerosis, Department of Clinical and Experimental Medicine, University of Perugia, Italy. glupa@unipg.it
Pirro
M
M
Siepi
D
D
Mannarino
M R
MR
Roscini
A R
AR
Vaudo
G
G
Pasqualini
L
L
Schillaci
G
G
Mannarino
E
E
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002784:Cholesterol / Q000031:analogs & derivatives / Q000097:blood; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood* / Q000453:epidemiology / Q000235:genetics; D006950:Hyperlipidemia, Familial Combined / Q000097:blood* / Q000453:epidemiology / Q000235:genetics; D007408:Intestinal Absorption; D007558:Italy / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D020412:Multifactorial Inheritance; D015999:Multivariate Analysis; D010840:Phytosterols / Q000097:blood; D018570:Risk Assessment; D012307:Risk Factors; D012855:Sitosterols / Q000097:blood; D013261:Sterols / Q000097:blood*; D055815:Young Adult
D015415:Biomarkers; D010840:Phytosterols; D012855:Sitosterols; D013261:Sterols; C021273:campesterol; C025473:gamma-sitosterol; C001521:lathosterol; D002784:Cholesterol