Cholesterol absorption and synthesis markers in Portuguese hypercholesterolemic adults: A cross-sectional study

• Average cholesterol absorption markers levels were higher than the synthesis markers.
• The predictors of higher levels of cholesterol absorption markers were higher age and female sex.
• Cholesterol absorption and synthesis markers can complement traditional lipid profile.

ObjectiveThe dynamics of cholesterol homeostasis and the development of cardiovascular disease (CVD) are complex and multifactorial, to which adds individual variability in the proportion of cholesterol from exogenous versus endogenous sources. The aim of this study was to undertake the first characterization of cholesterol absorption and synthesis profiles in Portuguese hypercholesterolemic adults through the quantification of surrogate markers, and the analysis of the predictive value of age and sex on the cholesterol homeostasis biomarkers.MethodsSerum samples for the measurement of lipid profiles and cholesterol homeostasis markers were obtained for 100 men and 112 women, aged 30–65, with TC ≥ 5.2 mmol/L (~ 200 mg/dL) and/or LDL-C ≥ 2.6 mmol/L (~ 100 mg/dL), none of whom were on any lipid-lowering therapy.ResultsOverall, sex-specific significant differences were observed in the cholesterol homeostasis markers and lipid profiles; women had lower cholesterol synthesis marker concentrations (P < 0.01 for lathosterol) and lipid parameters (except for HDL-C concentrations). Age-related significant differences were also found, including higher concentrations of cholesterol absorption markers in association with increasing age.ConclusionIn our study, the predictors of higher levels of cholesterol absorption markers were higher age and female gender.