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Comment published on 4 April 2019, see Nutrients 2019, 11(4), 780.

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Non-Cholesterol Sterol Concentrations as Biomarkers for Cholesterol Absorption and Synthesis in Different Metabolic Disorders: A Systematic Review

Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, 6200 MD Maastricht, The Netherlands
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Nutrients 2019, 11(1), 124; https://doi.org/10.3390/nu11010124
Received: 30 November 2018 / Revised: 21 December 2018 / Accepted: 28 December 2018 / Published: 9 January 2019
(This article belongs to the Special Issue Plant Sterols/Stanols and Human Health)
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Abstract

Non-cholesterol sterols are validated biomarkers for intestinal cholesterol absorption and endogenous cholesterol synthesis. However, their use in metabolic disturbances has not been systematically explored. Therefore, we conducted a systematic review to provide an overview of non-cholesterol sterols as markers for cholesterol metabolism in different metabolic disorders. Potentially relevant studies were retrieved by a systematic search of three databases in July 2018 and ninety-four human studies were included. Cholesterol-standardized levels of campesterol, sitosterol and cholestanol were collected to reflect cholesterol absorption and those of lathosterol and desmosterol to reflect cholesterol synthesis. Their use as biomarkers was examined in the following metabolic disorders: overweight/obesity (n = 16), diabetes mellitus (n = 15), metabolic syndrome (n = 5), hyperlipidemia (n = 11), cardiovascular disease (n = 17), and diseases related to intestine (n = 16), liver (n = 22) or kidney (n = 2). In general, markers for cholesterol absorption and synthesis displayed reciprocal patterns, showing that cholesterol metabolism is tightly regulated by the interplay of intestinal absorption and endogenous synthesis. Distinctive patterns for cholesterol absorption or cholesterol synthesis could be identified, suggesting that metabolic disorders can be classified as ‘cholesterol absorbers or cholesterol synthesizers’. Future studies should be performed to confirm or refute these findings and to examine whether this information can be used for targeted (dietary) interventions. View Full-Text
Keywords: non-cholesterol sterols; plant sterols; BMI; diabetes mellitus; metabolic syndrome; hyperlipidemia; cardiovascular disease; intestinal disease; liver disease; kidney disease non-cholesterol sterols; plant sterols; BMI; diabetes mellitus; metabolic syndrome; hyperlipidemia; cardiovascular disease; intestinal disease; liver disease; kidney disease
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Mashnafi, S.; Plat, J.; Mensink, R.P.; Baumgartner, S. Non-Cholesterol Sterol Concentrations as Biomarkers for Cholesterol Absorption and Synthesis in Different Metabolic Disorders: A Systematic Review. Nutrients 2019, 11, 124.

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