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Contrasting effects of sterols on metabolism
  1. Adrian David Marais1,2
  1. 1 Department of Pathology, University of Cape Town, Cape Town, South Africa
  2. 2 Department of Pathology, National Health Laboratory Service, Cape Town, South Africa
  1. Correspondence to Professor Adrian David Marais, Department of Pathology, University of Cape Town, Cape Town 7925, South Africa; david.marais{at}

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Phytosterolaemia,1 causing severe atherosclerosis,2 illustrates the stringent requirements for sterols in membranes and the impact of low-density lipoprotein (LDL) receptor on metabolism, but is not associated with malformations seen with sterol biosynthetic defects.

Membranes contain hopanoids3 in bacteria and a range of phytosterols in plants, mostly campesterol and beta-sitosterol. Animal cell membranes contain cholesterol. The rate-controlling step in sterol biosynthesis is the formation of mevalonic acid by hydroxymethylglutaryl coenzyme A reductase that can be inhibited by statins. During biosynthesis six isopentenyl units form a 30-carbon molecule. Demethylation, double-bond reduction and the creation of one final unsaturated bond deliver cholesterol. Phytosterols are synthesised similarly but retain methyl or ethyl moieties or double bonds. Cholesterol evolved …

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  • Handling editor Tahir S Pillay.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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