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Human Nutrition pp 33–50Cite as

Atherosclerosis in perspective: the pathophysiology of human cholesterol metabolism

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Abstract

All animal cells share a common need for cholesterol which they obtain either by endogenous synthesis or by assimilation from the diet. The steroid nucleus plays both structural and metabolic roles. In cell membranes it is considered to act as a regulator of the micro-environment, maintaining a fluidity appropriate to the normal operation of membrane-linked enzyme systems and transport proteins. In specialized tissues such as the adrenal, gonad and liver it undergoes a variety of oxidation steps which increase its polarity and permit its direct transit through the aqueous fluids of the body. The parent sterol molecule lacks this facility and must therefore be solubilized by interaction with a number of amphipathic agents. In plasma it exists in association with phospholipid and certain proteins to form the lipid—protein complexes that we call lipoproteins. In bile, on the other hand, bile salts and phospholipid act as its emulsifying agents, leading to the production of micellar aggregates. These two transport systems are subject to interdependent regulation in the liver (Shepherd and Packard, 1987). Disturbances of either lead to pathological sequelae which result in deposition of the sterol in unusual sites like the gallbladder and the intima of artery walls. Such deposits are highly resistant to mobilization and further accretion leads to the macroscopic lesions which we recognize as gallstones and atherosclerotic plaques.

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  1. J. Shepherd
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  2. C. J. Packard
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© 1992 Springer Science+Business Media Dordrecht

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Shepherd, J., Packard, C.J. (1992). Atherosclerosis in perspective: the pathophysiology of human cholesterol metabolism. In: Human Nutrition. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-4495-5_3

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  • DOI: https://doi.org/10.1007/978-1-4899-4495-5_3

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-412-40310-1

  • Online ISBN: 978-1-4899-4495-5

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