title: [Cholesterol homeostasis and cardiovascular risk].
abstract: Hypercholesterolemia is a major risk factor for cardiovascular diseases. Serumcholesterol concentrations are regulated by enteral absorption and hepatic synthesis. Statins inhibit the rate-limiting enzyme of endogenous cholesterol synthesis, HMG-CoA-reductase and reduce serum cholesterol concentrations as well as cardiovascular morbidity. Indirect evidence from smaller studies shows, that patients with high baseline cholesterol absorption may show only a small response to statin treatment in terms of cholesterol lowering. Moreover, evidence from recent clinical studies suggests that increased cholesterol absorption and decreased hepatic cholesterol synthesis is associated with an increased cardiovascular risk. This article reviews the current literature on this issue and suggests prospective clinical studies to analyze whether determination of the baseline relation of cholesterol synthesis and absorption may facilitate an individualized lipid lowering therapy to further reduce cardiovascular risk.
authors.affiliation: Klinik für Innere Medizin III, Kardiologie, Angiologie und internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar. oweingartner@aol.com
authors.forename: O
authors.initials: O
authors.lastname: Weingärtner
authors.forename: D
authors.initials: D
authors.lastname: Lütjohann
authors.forename: M
authors.initials: M
authors.lastname: Böhm
authors.forename: U
authors.initials: U
authors.lastname: Laufs
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002784:Cholesterol / Q000096:biosynthesis / Q000097:blood* / Q000378:metabolism; D006801:Humans; D006903:Hydroxymethylglutaryl CoA Reductases / Q000097:blood; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000150:complications*; D007408:Intestinal Absorption; D008099:Liver / Q000378:metabolism; D012016:Reference Values; D018570:Risk Assessment
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol; D006903:Hydroxymethylglutaryl CoA Reductases