Abstract 18611: Increased Absorption and Decreased Synthesis of Cholesterol in Cardiac Sarcoidosis
Introduction: Sarcoidosis is a multisystem inflammatory disease characterised by the formation of granulomas in many tissues. Some reports suggest that the disease is associated with altered lipoprotein cholesterol profiles, but there is no deeper knowledge of cholesterol metabolism in these patients.
Hypothesis: We tested the hypothesis that cholesterol metabolism is abnormal in cardiac sarcoidosis (CS).
Methods: The study population consisted of 39 patients with histologically verified CS (31 women and 8 men, mean age 53 years) and 124 healthy controls of similar age and gender. 31 of the CS patients were on immunosuppressive treatment. Serum lipids were determined and cholesterol metabolism was evaluated by measuring serum markers of cholesterol absorption (cholestanol, campesterol and sitosterol) and synthesis (desmosterol and lathosterol) as ratios to cholesterol with gas-liquid chromatography.
Results: CS was inactive in all patients based on clinical evaluation, cardiac ultrasound, and stable levels of serum TnT and proBNP. Serum total, LDL and HDL cholesterol concentrations (mean±SE) were 5.6±0.2, 3.3±0.1 and 1.5±0.1 mmol/l, respectively, and serum triglyceride averaged 1.7±0.7 mmol/l. These values did not differ from those of controls. Cholesterol absorption markers were higher in CS patients than in controls (eg. serum campesterol level 245±17 vs 190±17 102μmol/mmol of cholesterol, p<0.05). Cholesterol synthesis markers were lower in CS patients than in controls (eg. serum lathosterol level102±8 vs 195±17 102μmol/mmol of cholesterol, p<0.001). Concentrations of serum lipids and non-cholesterol sterols did not associate with the use of immunosuppressive drugs. Markers of cholesterol absorption and synthesis did not correlate with serum TnT levels, but there was a significant positive correlation between proBNP and cholesterol absorption markers (r=0.351, p<0.05).
Conclusions: We conclude that, in CS, cholesterol absorption is increased and its synthesis is decreased. The underlying mechanisms remain obscure and deserve further study. This is the first time that abnormal cholesterol metabolism has been described in CS.
Author Disclosures: P. Simonen: None. J. Lehtonen: None. H. Gylling: None. M. Kupari: None.
- © 2014 by American Heart Association, Inc.