Cholesterol

A cyclic hydrocarbon alcohol commonly classified as a lipid because it is insoluble in water but soluble in a number of organic solvents. It is the major sterol in all vertebrate cells and the most common sterol of eukaryotes. In vertebrates, the highest concentration of cholesterol is in the myelin sheath that surrounds nerves and in the plasma membrane that surrounds all cells.

Cholesterol can exist either in the free (unesterified) form (see structure below) or in the esterified form, in which a fatty acid is

bound to the hydroxyl group of cholesterol by an ester bond. The free form is found in membranes. Cholesteryl esters are normally found in lipid droplets either within the cells of steroidogenic tissues, where it can be converted to free cholesterol and then to steroid hormones, or in the middle of spherical lipid-protein complexes, called lipoproteins, that are found in blood.

Cholesterol, together with phospholipids and proteins, is important in the maintenance of normal cellular membrane fluidity. At physiological temperatures, the cholesterol molecule interacts with the fatty acids of the membrane phospholipids and causes increased packing of the lipid molecules and hence a reduction of membrane fluidity. Thus, all vertebrate cells require cholesterol in their membranes in order for the cell to function normally. Cholesterol is also important as a precursor for a number of other essential compounds, including steroid hormones, bile acids, and vitamin D.

Cellular cholesterol is obtained both from the diet, following its absorption in the intestine, and from synthesis within all cells of the body. Foods that are particularly high in cholesterol include eggs, red meat, and organs such as liver and brain. About 40–50% of the dietary cholesterol is absorbed from the intestine per day. In contrast, plant sterols are very poorly absorbed. Cholesterol synthesis occurs in all vertebrate cells but is highest in the liver, intestine, and skin, and in the brain at the time of myelination.

Cholesterol and cholesteryl esters are essentially insoluble in water. In order to transport these compounds around the body in the blood, the liver and intestine produce various lipid-protein complexes, called lipoproteins, which serve to solubilize them. Lipoproteins are large, complex mixtures of cholesterol, cholesteryl esters, phospholipids, triglycerides (fats), and various proteins. The major lipoproteins include chylomicrons, very low density lipoprotein (VLDL), low-density lipoprotein, and high-density lipoprotein (HDL).

Total plasma cholesterol levels of less than 200 mg/100 ml are considered desirable. Values of 200–239 or greater than 239 mg per 100 ml are considered, respectively, borderline high or high risk values, indicating the potential for a heart attack. High levels of low-density lipoprotein in the plasma are associated with increased risk of atherosclerosis, ("hardening of the arteries"), which involves deposition of cholesterol and other lipids in the artery wall. Diets low in cholesterol and saturated fats often result in a reduction in total plasma and LDL cholesterol levels. Such changes in blood cholesterol levels are thought to be beneficial and to reduce the incidence of heart attacks.