Hypocholesterolemia

Abstract

Hypocholesterolemia is defined as total cholesterol (TC) and low density cholesterol (LDL-C) levels below the 5(th) percentile of the general population adjusted for age, gender and race. Hypocholesterolemia may be attributed to inherited disorders or several secondary causes. Inherited forms of hypocholesterolemia consist of a group of rare diseases. The best studied are familial hypobetalipoproteinemia (FHBL) and abetalipoproteinemia (ABL). Clinical diagnosis rests on lipid levels and the pattern of inheritance after secondary causes are excluded. Patients with primary hypobetalipoproteinemias may manifest a variety of symptoms and signs affecting several organs (steatorrhea, neurological and ophalmological symptoms, non-alcoholic fatty liver disease) or be asymptomatic. Understanding hypocholesterolemia and the underlying molecular basis is of crucial importance since this may provide new insights in the treatment of hypercholesterolemia and cardiovascular disease.

Impact of antiretroviral therapy on serum lipoprotein levels and dyslipidemias: A systematic review and meta-analysis

“…Overall, exposure to ART was associated with significant increases in serum cholesterol and triglyceride levels among HIV-infected patients. While it can be argued that an increase in serum lipoprotein levels may indicate a return to health rather than an ongoing atherogenic process [66], the inclusion of dyslipidemias as study outcomes addresses this argument: ART was also associated with increased risks of hypercholesterolemia and hypertriglyceridemia. Moreover, even small increases in serum cholesterol and triglyceride levels could have a considerable impact on the incidence of dyslipidemia.…”

Characteristics of Subjects with Very Low Serum Low-Density Lipoprotein Cholesterol and the Risk for Intracerebral Hemorrhage

“…The causes of primary hypocholesterolemia include certain disorders resulting from genetic mutations in the pathways of cholesterol absorption, biosynthesis, or metabolism; for example, abetalipoproteinemia, hypobetalipoproteinemia, Tangier disease, chylomicron retention disease, and inherited disorders of cholesterol biosynthesis [18]. The causes of secondary hypocholesterolemia comprise anemia, hyperthyroidism, malignancy, chronic hepatitis B or C infection, other liver diseases, critical illness, serious stress, malabsorption or malnutrition, acute or chronic infection, chronic inflammation, and use of some drugs [18].…”

“…The causes of secondary hypocholesterolemia comprise anemia, hyperthyroidism, malignancy, chronic hepatitis B or C infection, other liver diseases, critical illness, serious stress, malabsorption or malnutrition, acute or chronic infection, chronic inflammation, and use of some drugs [18]. Although direct causal relationships have not been clarified, hypocholesterolemia can result in adverse events such as increased mortality, ICH, cancer, infection, adrenal failure, and mental disorders [18,22-25]. Therefore, with the practice of intensive lipid-lowering therapy and the tendency toward increased indications for statins, optimal cholesterol levels and the clinical importance of hypocholesterolemia should be considered [17,26,27].…”

“…The 5th percentile for TC for males in the United States is 131 to 154 mg/dL, and the 5th percentile for LDL-C in Western countries is about 90 mg/dL [18]. Although hypocholesterolemia is not uncommon, it is frequently overlooked.…”

Potential neurochemical links between cholesterol and suicidal behavior

“…It is important to mention, at this time, that the low cholesterol referred to throughout this text does not necessarily constitute hypocholesterolemia, which is defined as total cholesterol and low density protein/ cholesterol levels of below the 5th percentile of the general population, when adjusted for age, gender and race (Moutzouri et al, 2011). The 5th percentile of total cholesterol for adult men in USA ranges from 3.39 to 3.98 mmol/L and the 5th percentile of cholesterol in low density protein is approximately 2.33 nmol/L.…”