Intestinal regulation of hepatic cholesterol synthesis: an hypothesis

The serum cholesterol level in man is predominantly dependent on the rate of endogenous synthesis. The liver is the main site of cholesterol synthesis and this activity is in turn intimately related to the ingestion of food. When no food is present in the intestine, as during periods of total parenteral nutrition, both normal individuals and patients with familiar hypercholesterolemia show a pronounced lowering of their serum cholesterol. The establishment of a portacaval shunt makes this a permanent change. This and other evidence lead us to postulate the existence of an intestinal factor capable of stimulating hepatic cholesterogenesis. The function of this factor would be to increase the synthesis of chol