BACKGROUND There are limited studies on the effects of
cholesterol homeostasis in populations at high risk for
cardiovascular disease. We aimed to use gas chromatography and flame-ionization detection (GC-FID) of non-
cholesterol sterols as indicators of
cholesterol absorption and synthesis.
Sterol indicators of
cholesterol absorption included
campesterol,
stigmasterol, and
sitosterol.
Sterol indicators of
cholesterol synthesis included
squalene, 7-lathosterol, and
desmosterol. MATERIAL AND METHODS A total of 158 participants were enrolled in 3 groups: healthy control (n=64),
hyperlipidemia (n=69), and
familial hypercholesterolemia (FH, n=25). Age, sex, blood pressure,
blood glucose, and
lipoprotein were collected, and
cholesterol absorption and synthesis markers were determined by GC-FID. RESULTS All 6
cholesterol concentration indicators, except
squalene, were significantly different among the 3 groups (all P<0.05); whereas in the ratio to
cholesterol (%,
sterols/
cholesterol), only
desmosterol and
lathosterol were significantly different (P<0.05). Multifactorial regression analysis showed that
triglycerides, total
cholesterol, and
desmosterol were independent risk factors affecting the development of
hyperlipidemia (P<0.05). The efficacy of the ROC curve for the diagnosis of
dyslipidemia was also higher for all 3 indices (Model 1, AUC=0.960). Model 1 was superior to Model 2 for the 6 indicators of
cholesterol. For the FH and
dyslipidemia groups, the 6-indicator model (Model 3) was shown to have a good diagnostic value (AUC=1.000). CONCLUSIONS The 6
sterol indicators of
cholesterol absorption and synthesis had a dynamic course in all study participants.
Desmosterol was an
indicator of
dyslipidemia. The combined use of the 6
sterol indicators differentiated between healthy individuals and patients with
dyslipidemia and FH.