Relation of non-cholesterol sterols to coronary risk factors and carotid intima-media thickness: The Cardiovascular Risk in Young Finns Study

ObjectivesThe aim of the present study was to evaluate the role of cholesterol metabolism in the development of atheromatous artery disease.MethodsSerum synthesis (cholesterol precursors) and absorption markers (cholestanol, campesterol, sitosterol, and avenasterol) were related to coronary risk factors and vascular structure in a population-based sample of 468 randomly selected 33–39-year-old men on their regular habitual diet. Carotid artery intima-media thickness (IMT) and serum lipids (including cholesterol) and sterols were measured in 2001, and the subjects were ranked to decreasing cholesterol synthesis depicted by serum cholestanol quartiles defined 21 years earlier in adolescence.ResultsSerum cholesterol was correlated with absorption (e.g. serum campesterol, p < 0.05), but not with synthesis, or with cholestanol quartiles. Cholesterol metabolism (synthesis/absorption markers) decreased linearly (about 50%) with the increasing cholestanol quartiles. IMT differed between the age groups, but not between cholestanol quartiles. Serum triglycerides, apoprotein B, and body mass index decreased, and non-HDL cholesterol/apoprotein B values increased between the cholestanol quartiles, whereas LDL cholesterol was unchanged. Cholesterol synthesis markers were related to blood pressure and serum triglycerides, and negatively to HDL cholesterol level in total population and in most of the cholestanol quartiles (p from 0.05 to 0.001).ConclusionsVariables of metabolic syndrome accumulated in quartiles of high synthesis of cholesterol. Non-cholesterol sterols were related to many classic coronary risk factors, but virtually not to serum cholesterol or vascular structure.