Cholesterol and non-cardiovascular disease: basic science.

Cholesterol metabolism is of fundamental biological importance. This review examines the role of cholesterol metabolism in relation to non-cardiovascular disease (non-CVD). Particular attention is paid to the question of whether or not low levels of cholesterol may have harmful effects on cell function or lead to pathological processes. Many in vitro phenomena have been demonstrated at levels of cholesterol which are very low in comparison to physiological conditions. Nevertheless, low cholesterol is more favourable than high cholesterol for most aspects of cell function. There is no evidence that any catastrophic cellular response or pathological process occurs due to exposure of organisms to low cholesterol. On the other hand, the inflammatory process is a powerful and consistent cause of decreased cholesterol levels. This, together with other confounding factors, appears to explain a major component of the association between low cholesterol levels and non-CVD.