Related Experiment Video
Updated: Feb 4, 2026
In Silico Clinical Trials for Cardiovascular Disease
Published on: May 27, 2022
Cholesterol is Inefficiently Converted to Cholesteryl Esters in the Blood of Cardiovascular Disease Patients
Mathias J Gerl1, Winchil L C Vaz2, Neuza Domingues2
1Lipotype GmbH, Tatzberg 47, 01307, Dresden, Germany.
Insights
Cardiovascular disease (CVD) patients show impaired cholesterol conversion, indicated by lower lysophosphatidylcholine and cholesteryl ester to cholesterol ratios. A novel cholesterol homeostasis quotient (Q') may aid in rapid CVD diagnosis.
Area of Science:
- Biochemistry
- Clinical Chemistry
- Cardiovascular Medicine
Background:
- Cholesterol homeostasis is crucial for preventing cardiovascular diseases (CVD).
- Dysregulation in cholesterol metabolism is a hallmark of conditions like acute coronary syndrome (ACS), ischemic stroke (IS), and stable angina pectoris (SAP).
- Understanding lipid profiles in CVD patients can reveal underlying metabolic disruptions.
Purpose of the Study:
- To investigate lipidomic differences in blood plasma between CVD patients and a control group.
- To identify specific lipid alterations associated with ACS, IS, and SAP.
- To evaluate the potential of a novel cholesterol homeostasis quotient (Q ') as a diagnostic marker for CVD.
Main Methods:
- Shotgun lipidomic analysis of 203 lipids across 13 classes in blood plasma.
- Comparison of lipid profiles from CVD cohorts (ACS, IS, SAP) and an age-matched control cohort.
- Calculation and analysis of a non-equilibrium reaction quotient (Q ') for global cholesterol homeostasis.
Main Results:
- Strong correlations observed between cholesteryl esters (CE) and phosphatidylcholines (PC) with shared fatty acids.
- Lower concentrations of lysophosphatidylcholine (LPC) and CE/Cholesterol ratios in CVD cohorts compared to controls.
- Significantly lower Q ' values in ACS, IS, and SAP cohorts (approx. one-third less than controls), indicating disrupted cholesterol homeostasis.
Conclusions:
- CVD is associated with deficient conversion of cholesterol to cholesteryl esters in blood plasma.
- The Q ' quotient reflects global cholesterol homeostasis and shows potential as a rapid predictive/diagnostic measure for CVD.
- Lipidomic profiling offers insights into metabolic irregularities underlying cardiovascular conditions.
Abstract:
Shotgun lipidomic analysis of 203 lipids in 13 lipid classes performed on blood plasma of donors who had just suffered an acute coronary syndrome (ACS, n = 74), or an ischemic stroke (IS, n = 21), or who suffer from stable angina pectoris (SAP, n = 78), and an age-matched control cohort (n = 52), showed some of the highest inter-lipid class correlations between cholesteryl esters (CE) and phosphatidylcholines (PC) sharing a common fatty acid. The concentration of lysophospatidylcholine (LPC) and ratios of concentrations of CE to free cholesterol (Chol) were also lower in the CVD cohorts than in the control cohort, indicating a deficient conversion of Chol to CE in the blood plasma in the CVD subjects. A non-equilibrium reaction quotient, Q', describing the global homeostasis of cholesterol as manifested in the blood plasma was shown to have a value in the CVD cohorts (Q'ACS = 0.217 ± 0.084; Q'IS = 0.201 ± 0.084; Q'SAP = 0.220 ± 0.071) that was about one third less than in the control cohort (Q'Control = 0.320 ± 0.095, p < 1 × 10-4), suggesting its potential use as a rapid predictive/diagnostic measure of CVD-related irregularities in cholesterol homeostasis.
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