Serum cholesterol precursors and phytosterol levels indicate increased cholesterol output and biosynthesis as independent predictive risk factors of gallstones

Aims: In enterocytes and hepatocytes sterols transport is mediated by NPC1L1 and ABCG5/8. Whereas serum levels of phytosterol represent surrogate markers for intestinal cholesterol absorption, cholesterol precursors reflect de novo cholesterol synthesis. Here, we compare serum and biliary sterol levels in patients with gallstone disease (GSD) and stone-free controls to determine differences in cholesterol transport and biosynthesis between both groups. Methods: We studied 112 German patients with GSD and 152 controls as well as two distinct Chilean ethnic groups: Hispanics (100 GSD and 100 controls) and Amerindi…