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  Dr. Jorge Gutiérrez | Internal Medicine


It is a lipid steroid found in body tissues and in blood plasma of vertebrates.

sociedad ecuatoriana de aterosclerosis y endotelio

The human being comes through two channels:


  • Exogenous 25%: foods that contain cholesterol are; meat egg yolk, milk, butter, cheeses, meats, etc.
  • Endogenous 75%: by biosynthesis of smooth endoplasmic reticulum of cells and liver.

A person of normal weight, about 70 kilos, produces 9 to 13mg / kg that amounts to 630 to 900 mg / dl.


4 steps outlined in cholesterol biosynthesis:


  1. Acetil-Coenzima A, is converted by a series of biochemical reactions to mevalonate.
  2. Mevalonate, is converted into squalene by a series of biochemical reactions.
  3. Squalene, becomes Lanosterol
  4. Lanosterol, becomes about 20 successive stages CHOLESTEROL.

Humans can not metabolize cholesterol CO2 and H2O, thus making it removes fatty acids and bile salts, bile through.

Genetics also has to do with increased production and / or prevent adequate absorption, for high cholesterol they are not getting.

Cholesterol by its insolubility to be transported in the blood to where it is needed, binds to lipoproteins, which are high density (HDL) and low density (LDL).


Have given cholesterol bad reputation, but the body needs for the structure of cell membranes, the precursor of vitamin D, sex hormones, steroids, bile acids and bile salts.


The problem of circulating cholesterol is related to atherosclerosis and ischemic consequences of heart, brain, eyes, kidneys, etc., known to all, but this is due more to high circulating lipoproteins LDL and decreasing HDL, for this reason the term is more dyslipoproteinemias Hyperlipidemias or Hyperlipoproteinemias, for all these changes.


The significance is not only the quantity but the quality or class of particles and small dense there that are more atherogenic LDL within it.


Normal blood values ​​currently considered:

  • Total cholesterol to                                  200mg/ dl.
  • LDL                                                              130mg/dl.
  1. Diabetes                                                      -100mg/dl.
  2. Coronary heart disease with up to         70 mg/dl.
  • HDL men                                                    40 o más mg/dl.
  • HDL women                                               50 o más mg/dl.

Cholesterol is connected and accompanied by other factors, such as diabetes, hypertension, snuff, etc., in atherosclerosis. That is a process where endothelial cells, monocytes, macrophages and smooth muscle cells are involved, considering all this mechanism as endothelial dysfunction.


This would be the first step in the disease process of atherosclerosis, noting that some arterial vascular beds are more sensitive than others.


For atherosclerosis it is constant in the aorta and more common in the abdominal portion and the iliac arteries than in the carotid; more severe in the coronary arteries, greater than 3cm common carotid, and lower limb.

sociedad ecuatoriana de aterosclerosis y endotelio
Ecuadorian society of atherosclerosis and endothelium

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