Noncholesterol sterols (NCS) are lipids that are structurally similar to cholesterol and include cholesterol precursors in humans (e.g. desmosterol) and cholesterol counterparts in other organisms: phytosterols, e.g., sitosterol and campesterol (from plants), fucosterols (from shellfish), and ergosterol (from yeasts). NCS are important in modulating cell membrane fluidity and influencing cell signaling. Stanols (e.g., cholestanol) are also close relatives of sterols and are derived from the diet or as a gut microbial byproduct of cholesterol metabolism. Both phytosterols and stanols compete with cholesterol for absorption, hence are used as functional foods or supplements in the treatment of hypercholesterolemia.1,2
As excess cellular cholesterol may crystallize and cause cell death, cholesterol homeostasis within the body is a tightly regulated balance between endogenous synthesis, exogenous (dietary) absorption, and excretion (bile acids or biliary cholesterol). However, measuring serum cholesterol directly does not reveal whether its origin is cellular synthesis or intestinal absorption. Because they cannot be synthesized in the body and are not readily absorbed compared to cholesterol, the serum measurement of NCS can establish whether elevated cholesterol levels are due mostly to hyperabsorption, hypersynthesis, both, or neither.3
Individual variation in cholesterol absorption/synthesis will determine the response to different lipid-lowering medications and can thus guide the most appropriate lipoprotein treatment regimens (e.g., statins, which block cholesterol synthesis, will be less effective as a monotherapy in somebody who is a “hyperabsorber,” as is the case for many apoE4 allele carriers).3 NCS are also used to monitor cardiovascular risk in individuals who are using phytosterol food supplements as an adjunctive LDL-C–lowering therapy. As NCS are prone to oxidation, very high blood levels (as in rare genetic cases of phytosterolemia) are linked to increased risk for CVD.4
- Baila-Rueda L,et al. Curr Med Chem 2016;23(20):2132–2145.
- Gylling H. Curr Opin Lipidol 2014;25(3):207–212.
- Dayspring T, et al. J Clin Lipidol 2015;9:807–816.
- Teupser D, et al. Circ Cardiovasc Genet 2010;3:331–339.
Why Gut Health?
Poor gut health is at the heart of many chronic conditions. A healthy gastrointestinal (GI) tract is vital to overall well-being and even survival. A recent explosion of scientific research worldwide, including the Human Microbiome Project (HMP), is providing new insights into the importance of the gut as the “gateway to good health” and giving new meaning to the phrase “you are what you eat.”
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