|Appearance||white crystalline powder |
148–150 °C 
360 °C (decomposes)
|Solubility in water||0.095 mg/L (30 °C)|
|Except where noted otherwise, data are given for materials in their standard state (at 25 °C, 100 kPa)|
Cholesterol is a lipidic, waxy alcohol found in the cell membranes and transported in the blood plasma of all animals. It is an essential component of mammalian cell membranes where it is required to establish proper membrane permeability and fluidity. Cholesterol is the principal sterol synthesized by animals, but small quantities are synthesized in other eukaryotes, such as plants and fungi. It is almost completely absent among prokaryotes, which include bacteria. Cholesterol is classified as a sterol (a contraction of steroid and alcohol).
Although cholesterol is essential for life, high levels in circulation are associated with atherosclerosis. Cholesterol is synthesized in virtually all cells, and significant amounts of it can be absorbed from the diet.
The name cholesterol originates from the Greek chole- (bile) and stereos (solid), and the chemical suffix -ol for an alcohol, as François Poulletier de la Salle first identified cholesterol in solid form in gallstones, in 1769. However, it was only in 1815 that chemist Eugène Chevreul named the compound "cholesterine".
Cholesterol is required to build and maintain cell membranes; it regulates membrane fluidity over a wide range of temperatures. The liver produces about 1 gram of cholesterol per day, in bile. The hydroxyl group on cholesterol interacts with the polar head groups of the membrane phospholipids and sphingolipids, while the bulky steroid and the hydrocarbon chain is embedded in the membrane, alongside the nonpolar fatty acid chains of the other lipids. Some research indicates that cholesterol may act as an antioxidant. Bile, which is stored in the gallbladder and helps digest fats, is important for the absorption of the fat soluble vitamins, vitamins A, D, E, and K. It is the main precursor of vitamin D and of the steroid hormones, which include cortisol and aldosterone (in the adrenal glands) and progesterone, estrogens, and testosterone (the sex hormones), and their derivatives. It provides the basic structure of all the steroids. In myelin, it envelopes and insulates nerves, helping greatly to conduct nerve impulses.
Recently, cholesterol has also been implicated in cell signaling processes, assisting in the formation of lipid rafts in the plasma membrane. It also reduces the permeability of the plasma membrane to protons (positive hydrogen ions) and sodium ions.
Cholesterol is essential for the structure and function of invaginated caveolae and clathrin-coated pits, including caveola-dependent and clathrin-dependent endocytosis. The role of cholesterol in such endocytosis can be investigated by using methyl beta cyclodextrin (MβCD) to remove cholesterol from the plasma membrane.
Synthesis and absorption [සංස්කරණය]
Most of the cholesterol in the body is synthesized therein; some is absorbed in the diet. Cholesterol is more abundant in tissues which either synthesize more, or have more abundant, densely-packed membranes, for example, the liver, spinal cord and brain. It plays a central role in many biochemical processes, such as the building of cell membranes and the synthesis of steroid hormones.
Cholesterol is required in the membranes of mammalian cells for normal cellular function, and is either synthesized in the endoplasmic reticulum, or derived from the diet, in which case it is transported by the bloodstream in low-density or high-density lipoproteins. Low-density lipoproteins are taken into the cell by LDL receptor-mediated endocytosis in clathrin-coated pits, and then hydrolysed in lysosomes.
Cholesterol is primarily synthesized from acetyl CoA through the HMG-CoA reductase pathway in many cells and tissues. About 20–25% of total daily production (~1 g/day) occurs in the liver; other sites of high synthesis rates include the intestines, adrenal glands and reproductive organs. For a person of about 150 pounds (68 kg), typical total body content is about 35 g, typical daily internal production is about 1 g and typical daily dietary intake is 200–300 mg in the United States and societies with similar dietary patterns. Of the cholesterol released into the intestines in bile, 92–97% is reabsorbed in the intestines and recycled via enterohepatic circulation.
Plasma transport [සංස්කරණය]
- See also: Blood lipids
Since cholesterol is insoluble in blood, it is transported in the circulatory system within lipoproteins, complex spherical particles which have an exterior composed of amphiphilic proteins and lipids whose outward-facing surface is water-soluble and inward-facing surfaces are lipid-soluble; fats and cholesterol esters are carried internally. There is a large range of lipoproteins within blood, generally called, from larger to smaller size: chylomicrons, very low density lipoprotein (VLDL), intermediate density lipoprotein (IDL), low density lipoprotein (LDL) and high density lipoprotein (HDL). The cholesterol within all the various lipoproteins is identical although some cholesterol is carried as the "free" alcohol and some is carried as fatty acyl esters referred to as cholesterol esters.
Cholesterol is minimally soluble in water; it can dissolve and travel in the water-based bloodstream only at exceedingly small concentrations. In order to carry large quantities of cholesterol it is transported in the bloodstream by lipoproteins—protein "molecular-suitcases" that are water-dispersible and carry cholesterol and triglycerides as well as phospholipids and cholesterol esters. Phospholipids and cholesterol, being amphipathic, are transported in the surface monolayer of the lipoprotein particle while neutral lipids including triglycerides and cholesterol esters are carried in the core of the lipoprotein particle. By serving as ligands for specific receptors on cell membranes, the apolipoproteins that reside on the surface of a given lipoprotein particle are thought to determine from what cells cholesterol will be removed and to where it will be delivered.
Cholesterol is transported towards peripheral tissues by the lipoproteins chylomicrons, very low density lipoproteins (VLDL) and low-density lipoproteins (LDL). Large numbers of small dense LDL (sdLDL) particles are strongly associated with the presence of atheromatous disease within the arteries. For this reason, LDL is referred to as "bad cholesterol".
On the other hand, high-density lipoprotein (HDL) particles are thought to transport cholesterol back to the liver for excretion in a process known as reverse cholesterol transport (RCT). Having large numbers of large HDL particles correlates with better health outcomes. In contrast, having small numbers of large HDL particles is independently associated with atheromatous disease progression within the arteries.
Biosynthesis of cholesterol is directly regulated by the cholesterol levels present, though the homeostatic mechanisms involved are only partly understood. A higher intake from food leads to a net decrease in endogenous production, while lower intake from food has the opposite effect. The main regulatory mechanism is the sensing of intracellular cholesterol in the endoplasmic reticulum by the protein SREBP (Sterol Regulatory Element Binding Protein 1 and 2). In the presence of cholesterol, SREBP is bound to two other proteins: SCAP (SREBP-cleavage activating protein) and Insig1. When cholesterol levels fall, Insig-1 dissociates from the SREBP-SCAP complex, allowing the complex to migrate to the Golgi apparatus, where SREBP is cleaved by S1P and S2P (site-1 and -2 protease), two enzymes that are activated by SCAP when cholesterol levels are low. The cleaved SREBP then migrates to the nucleus and acts as a transcription factor to bind to the SRE (sterol regulatory element) of a number of genes to stimulate their transcription. Among the genes transcribed are the LDL receptor and HMG-CoA reductase. The former scavenges circulating LDL from the bloodstream, whereas HMG-CoA reductase leads to an increase of endogenous production of cholesterol.
A large part of this signaling pathway was clarified by Dr. Michael S. Brown and Dr. Joseph L. Goldstein in the 1970s. In 1985, they received the Nobel Prize in Physiology or Medicine for their work. Their subsequent work shows how the SREBP pathway regulates expression of many genes that control lipid formation and metabolism and body fuel allocation.
Metabolism and excretion [සංස්කරණය]
Cholesterol is oxidized by the liver into a variety of bile acids. These in turn are conjugated with glycine, taurine, glucuronic acid, or sulfate. A mixture of conjugated and non-conjugated bile acids along with cholesterol itself is excreted from the liver into the bile. Approximately 95% of the bile acids are reabsorbed from the intestines and the remainder lost in the feces. The excretion and reabsorption of bile acids forms the basis of the enterohepatic circulation which is essential for the digestion and absorption of dietary fats. Under certain circumstances, when more concentrated, as in the gallbladder, cholesterol crystallises and is the major constituent of most gallstones, although lecithin and bilirubin gallstones also occur less frequently.
Dietary sources [සංස්කරණය]
Animal fats are complex mixtures of triglycerides, with lesser amounts of phospholipids and cholesterol. Consequently all foods containing animal fat contain cholesterol to varying extents. Cholesterol is not present in plant based food sources unless it has been added during the food's preparation. However plant products such as flax seeds and peanuts contain healthy cholesterol-like compounds called phytosterols, which are suggested to help lower serum cholesterol levels. Major dietary sources of cholesterol include cheese, egg yolks, beef, pork, poultry, and shrimp. Human breast milk also contains significant quantities of cholesterol.
Dietary cholesterol plays a smaller role in blood cholesterol levels in comparison to fat intake. A number of measures can be taken to reduce blood cholesterol levels through changes in lifestyle, one of which is a change in diet. Trans and saturated fats are significant contributors to elevated cholesterol levels in the blood stream. Avoiding animal products may decrease the cholesterol levels in the body not through dietary cholesterol reduction alone, but primarily through a reduced saturated fat intake. Those wishing to reduce their cholesterol through a change in diet should aim to consume less than 7% of their daily calories from saturated fat and less than 200mg of cholesterol per day.
Clinical significance [සංස්කරණය]
According to the lipid hypothesis, abnormally high cholesterol levels (hypercholesterolemia), or, more correctly, higher concentrations of LDL and lower concentrations of functional HDL are strongly associated with cardiovascular disease because these promote atheroma development in arteries (atherosclerosis). This disease process leads to myocardial infarction (heart attack), stroke and peripheral vascular disease. Since higher blood LDL, especially higher LDL particle concentrations and smaller LDL particle size, contribute to this process more than the cholesterol content of the LDL particles, LDL particles are often termed "bad cholesterol" because they have been linked to atheroma formation. On the other hand, high concentrations of functional HDL, which can remove cholesterol from cells and atheroma, offer protection and are sometimes referred to colloquially as "good cholesterol". These balances are mostly genetically determined but can be changed by body build, medications, food choices and other factors.
Conditions with elevated concentrations of oxidized LDL particles, especially "small dense LDL" (sdLDL) particles, are associated with atheroma formation in the walls of arteries, a condition known as atherosclerosis, which is the principal cause of coronary heart disease and other forms of cardiovascular disease. In contrast, HDL particles (especially large HDL) have been identified as a mechanism by which cholesterol and inflammatory mediators can be removed from atheroma. Increased concentrations of HDL correlate with lower rates of atheroma progressions and even regression. A 2007 study pooling data on almost 900,000 subjects in 61 cohorts demonstrated that blood total cholesterol levels have an exponential effect on cardiovascular and total mortality, with the association more pronounced in younger subjects. Still, because cardiovascular disease is relatively rare in the younger population, the impact of high cholesterol on health is still larger in older people.
Elevated levels of the lipoprotein fractions, LDL, IDL and VLDL are regarded as atherogenic (prone to cause atherosclerosis). Levels of these fractions, rather than the total cholesterol level, correlate with the extent and progress of atherosclerosis. Conversely, the total cholesterol can be within normal limits, yet be made up primarily of small LDL and small HDL particles, under which conditions atheroma growth rates would still be high. In contrast, however, if LDL particle number is low (mostly large particles) and a large percentage of the HDL particles are large, then atheroma growth rates are usually low, even negative, for any given total cholesterol concentration.[තහවුරු කරන්න] Recently, a post-hoc analysis of the IDEAL and the EPIC prospective studies found an association between high levels of HDL cholesterol (adjusted for apolipoprotein A-I and apolipoprotein B) and increased risk of cardiovascular disease, casting doubt on the cardioprotective role of "good cholesterol".
Multiple human trials utilizing HMG-CoA reductase inhibitors, known as statins, have repeatedly confirmed that changing lipoprotein transport patterns from unhealthy to healthier patterns significantly lowers cardiovascular disease event rates, even for people with cholesterol values currently considered low for adults.[තහවුරු කරන්න] As a result, people with a history of cardiovascular disease may derive benefit from statins irrespective of their cholesterol levels, and in men without cardiovascular disease there is benefit from lowering abnormally high cholesterol levels ("primary prevention"). Primary prevention in women is practiced only by extension of the findings in studies on men, since in women, none of the large statin trials has shown a reduction in overall mortality or in cardiovascular end points.
The 1987 report of National Cholesterol Education Program, Adult Treatment Panels suggest the total blood cholesterol level should be: < 200 mg/dL normal blood cholesterol, 200–239 mg/dL borderline-high, > 240 mg/dL high cholesterol.. The American Heart Association provides a similar set of guidelines for total (fasting) blood cholesterol levels and risk for heart disease:
|Level mg/dL||Level මිමවුල/L||Interpretation|
|< 200||< 5.0||Desirable level corresponding to lower risk for heart disease|
|200–240||5.2–6.2||Borderline high risk|
|> 240||> 6.2||High risk|
However, as today's testing methods determine LDL ("bad") and HDL ("good") cholesterol separately, this simplistic view has become somewhat outdated. The desirable LDL level is considered to be less than 100 mg/dL (2.6 mmol/L), although a newer target of < 70 mg/dL can be considered in higher risk individuals based on some of the above-mentioned trials. A ratio of total cholesterol to HDL—another useful measure—of far less than 5:1 is thought to be healthier. Of note, typical LDL values for children before fatty streaks begin to develop is 35 mg/dL.
Most testing methods for LDL do not actually measure LDL in their blood, much less particle size. For cost reasons, LDL values have long been estimated using the Friedewald formula: [total cholesterol] − [total HDL] − 20% of the triglyceride value = estimated LDL. The basis of this is that Total cholesterol is defined as the sum of HDL, LDL, and VLDL. Ordinarily just the total, HDL, and triglycerides are actually measured. The VLDL is estimated as one-fifth of the triglycerides. It is important to fast for at least eight hours before the blood test because the triglyceride level varies significantly with food intake.
Given the well-recognized role of cholesterol in cardiovascular disease, it is surprising that some studies have shown an inverse correlation between cholesterol levels and mortality in subjects over 50 years of age—an 11% increase overall and 14% increase in CVD mortality per 1 mg/dL per year drop in cholesterol levels. In the Framingham Heart Study, the researchers attributed this phenomenon to the fact that people with severe chronic diseases or cancer tend to have below-normal cholesterol levels. This explanation is not supported by the Vorarlberg Health Monitoring and Promotion Programme, in which men of all ages and women over 50 with very low cholesterol were increasingly likely to die of cancer, liver diseases, and mental diseases. This result indicates that the low cholesterol effect occurs even among younger respondents, contradicting the previous assessment among cohorts of older people that this is a proxy or marker for frailty occurring with age.
A small group of scientists, united in The International Network of Cholesterol Skeptics, continues to question the link between cholesterol and atherosclerosis. However, the vast majority of doctors and medical scientists accepts the link as fact.
Abnormally low levels of cholesterol are termed hypocholesterolemia. Research into the causes of this state is relatively limited, but some studies suggest a link with depression, cancer and cerebral hemorrhage. Generally, the low cholesterol levels seem to be a consequence of an underlying illness, rather than a cause.
Cholesterol testing [සංස්කරණය]
It is recommended by the American Heart Association to test cholesterol every 5 years for people aged 20 years or older.  A blood sample taken after fasting is taken by a doctor or a home cholesterol monitoring device to determine a lipoprotein profile. This measures total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides. It is recommended to have cholesterol tested more frequently than 5 years if a person: has total cholesterol of 200 mg/dL or more, if a man over age 45 or a woman over age 50, has HDL (good) cholesterol less than 40 mg/dL, or other risk factors for heart disease and stroke.
Cholesteric liquid crystals [සංස්කරණය]
Some cholesterol derivatives, (among other simple cholesteric lipids) are known to generate the liquid crystalline cholesteric phase. The cholesteric phase is in fact a chiral nematic phase, and changes colour when its temperature changes. Therefore, cholesterol derivatives are commonly used in liquid crystal thermometers and temperature-sensitive paints.
See also [සංස්කරණය]
- Diet and heart disease
- Bile salts
- Lieberman-Burchard test to detect cholesterol
- Niemann Pick disease Type C
Additional images [සංස්කරණය]
- "Safety (MSDS) data for cholesterol". http://physchem.ox.ac.uk/MSDS/CH/cholesterol.html. සම්ප්රවේශය කෙරුණු දිනය 2007-10-20.
- Pearson A, Budin M, Brocks JJ (December 2003). "Phylogenetic and biochemical evidence for sterol synthesis in the bacterium Gemmata obscuriglobus". Proc. Natl. Acad. Sci. U.S.A. 100 (26): 15352–7. doi:10.1073/pnas.2536559100. PMID 14660793.
- Olson RE (01 Feb 1998). "Discovery of the lipoproteins, their role in fat transport and their significance as risk factors". J. Nutr. 128 (2 Suppl): 439S–443S. PMID 9478044. http://jn.nutrition.org/cgi/content/full/128/2/439S.
- Smith LL (1991). "Another cholesterol hypothesis: cholesterol as antioxidant". Free Radic. Biol. Med. 11 (1): 47–61. doi:10.1016/0891-5849(91)90187-8. PMID 1937129.
- Haines TH (2001). "Do sterols reduce proton and sodium leaks through lipid bilayers?". Prog. Lipid Res. 40 (4): 299–324. doi:10.1016/S0163-7827(01)00009-1. PMID 11412894.
- Stryer, Lubert (1995). Biochemistry (4th ed. සංස්.). New York: W.H. Freeman & co.. pp. 280, 703. ISBN 0-7167-2009-4.
- Lewis GF and Rader DJ. (2005). "New insights into the regulation of HDL metabolism and reverse cholesterol transport". Circ. Res. 96 (12): 1221–1232. doi:10.1161/01.RES.0000170946.56981.5c. PMID 15976321.
- Gordon DJ, Probstfield JL, et al. (1989). "High-density lipoprotein cholesterol and cardiovascular disease. Four prospective American studies". Circulation 79 (1): 8–15. PMID 2642759.
- Espenshade PJ, Hughes AL (2007). "Regulation of sterol synthesis in eukaryotes". Annu. Rev. Genet. 41: 401–27. doi:10.1146/annurev.genet.41.110306.130315. PMID 17666007.
- Brown MS, Goldstein JL (1997). "The SREBP pathway: regulation of cholesterol metabolism by proteolysis of a membrane-bound transcription factor". Cell 89: 331. doi:10.1016/S0092-8674(00)80213-5. PMID 9150132. http://www.cell.com/content/article/abstract?uid=PIIS0092867400802135.
- Wolkoff AW, Cohen DE (February 2003). "Bile acid regulation of hepatic physiology: I. Hepatocyte transport of bile acids". Am. J. Physiol. Gastrointest. Liver Physiol. 284 (2): G175–9. doi:10.1152/ajpgi.00409.2002. PMID 12529265.
- Christie, W. W. (2003). Lipid analysis. PJ Barnes and associates. pp. 416. ISBN 0-9531949-5-7.
- "USDA National Nutrient Database for Standard Reference, Release 21" (PDF). United States Department of Agriculture. http://www.nal.usda.gov/fnic/foodcomp/Data/SR21/nutrlist/sr21w601.pdf. සම්ප්රවේශය කෙරුණු දිනය 2008-10-24.
- Ostlund RE, Racette, SB, and Stenson WF (2003). "Inhibition of cholesterol absorption by phytosterol-replete wheat germ compared with phytosterol-depleted wheat germ". Am J Clin Nutr 77 (6): 1385–1589. PMID 12791614.
- Jensen RG, Hagerty MM, McMahon KE (01 Jun 1978). "Lipids of human milk and infant formulas: a review" (PDF). Am J Clin Nutr 31 (6): 990–1016. PMID 352132. http://www.ajcn.org/cgi/reprint/31/6/990.
- "High blood cholesterol: what you need to know". National cholesterol education program. http://www.nhlbi.nih.gov/health/public/heart/chol/wyntk.htm. සම්ප්රවේශය කෙරුණු දිනය 2008-10-24.
- Brunzell JD et al (April 2008). "Consensus statement from the American Diabetes Association and the American College of Cardiology Foundation – Lipoprotein management in patients with cardiometabolic risk". Diabetes Care 31 (4): 811–822. doi:10.2337/dc08-9018. PMID 18375431. http://care.diabetesjournals.org/cgi/reprint/31/4/811.
- Durrington P (2003). "Dyslipidaemia". Lancet 362 (9385): 717–31. doi:10.1016/S0140-6736(03)14234-1. PMID 12957096.
- Lewington S, Whitlock G, Clarke R, et al (December 2007). "Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths". Lancet 370 (9602): 1829–39. doi:10.1016/S0140-6736(07)61778-4. PMID 18061058.
- "Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report" (PDF). National Institutes of Health. National Heart, Lung and Blood Institute. http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3full.pdf. සම්ප්රවේශය කෙරුණු දිනය 2008-10-27.
- van der Steeg WA (2008). "High-density lipoprotein cholesterol, high-density lipoprotein particle size, and apolipoprotein A-I: significance for cardiovascular risk: the IDEAL and EPIC-Norfolk studies". J Am Coll Cardiol. 51 (6): 634–642. doi:10.1016/j.jacc.2007.09.060. PMID 18261682.
- "MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial". Lancet 360 (9326): 7–22. 2002. doi:10.1016/S0140-6736(02)09327-3. PMID 12114036.
- Shepherd J, Cobbe SM, Ford I, et al (1995). "Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland Coronary Prevention Study Group". N. Engl. J. Med. 333 (20): 1301–7. doi:10.1056/NEJM199511163332001. PMID 7566020.
- Grundy SM (2007). "Should women be offered cholesterol lowering drugs to prevent cardiovascular disease? Yes". BMJ 334 (7601): 982. doi:10.1136/bmj.39202.399942.AD. PMID 17494017.
- Kendrick M (2007). "Should women be offered cholesterol lowering drugs to prevent cardiovascular disease? No". BMJ 334 (7601): 983. doi:10.1136/bmj.39202.397488.AD. PMID 17494018.
- , (1988). "Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. The Expert Panel". Arch. Intern. Med. 148 (1): 36–69. doi:10.1001/archinte.148.1.36. PMID 3422148.
- "About cholesterol" – American Heart Association
- Anderson KM., Castelli WP, Levy D. (1987). "Cholesterol and mortality. 30 years of follow-up from the Framingham study". JAMA 257: 2176–80. doi:10.1001/jama.257.16.2176. PMID 3560398.
- Ulmer H., Kelleher C., Diem G., Concin H. (2004). "Why Eve is not Adam: prospective follow-up in 149650 women and men of cholesterol and other risk factors related to cardiovascular and all-cause mortality". J Women's Health (Larchmt) 13: 41–53. doi:10.1089/154099904322836447. PMID 15006277.
- Uffe Ravnskov (2000). The Cholesterol Myths : Exposing the Fallacy that Saturated Fat and Cholesterol Cause Heart Disease. New Trends Publishing, Incorporated. ISBN 0-96708-970-0.
- Daniel Steinberg (2007). The Cholesterol Wars: The Cholesterol Skeptics vs the Preponderance of Evidence. Boston: Academic Press. ISBN 0-12-373979-9.
- American Heart Association. "How To Get Your Cholesterol Tested". http://www.americanheart.org/presenter.jhtml?identifier=541.
- Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults US National Institutes of Health Adult Treatment Panel III
- Aspects of fat digestion and metabolism – UN/WHO Report 1994
- American Heart Association – "About Cholesterol"