Sterols

Now Providing the Most Comprehensive
Assessment of Cholesterol Balance

Our scientists have developed and validated a new, more precise and robust method for the
Boston Heart Cholesterol BalanceTM test. The new process captures the complete cholesterol production pathway and all of the major absorption markers. This additional information provides a more complete assessment of CVD risk and helps better guide your treatment options to most effectively manage your patients to their LDL-C goals.

Developed and patented by Dr. Thomas Dayspring, one of the most requested educators in the US, the Sterols Algorithm is designed to guide physicians in respect to Sterols and Phytosterolemia. Also known as sitosterolemia or xenosterolemia, which is a “rare” autosomal recessively inherited lipid metabolic disorder; while this condition appears to be relatively rare, more than likely it is significantly underdiagnosed and many patients are probably misdiagnosed with hyperlipidemia.
Boston Heart Cholesterol Balance Test*

100% of production pathway:
Lathosterol and desmosterol

All major markers of absorption:
Beta-sitosterol,campesterol and cholestanol

Additional Information:
We will now report very high
absolute values of all five sterols
consistent with uncommon disease
states including desmosterolosis,
phytosterolemia and
cerebrotendinous xanthomatosis.
These can be associated with
premature heart disease and
neurological disease as well as in
some cases with tendon
xanthomas.

Clinical significance

By measuring all major non-cholesterol sterols in plasma we can provide a much more complete
assessment of cardiovascular disease risk and better recommendations to assist clinicians with patient
treatment. If a patient’s LDL cholesterol levels are not at goal, the cholesterol production and
absorption markers can indicate which cholesterol pathway needs to be addressed with therapy.

Generally:

  • Patients with elevated cholesterol production values can be treated with a statin, which inhibits cholesterol production.
  • Patients with elevated cholesterol absorption values can be treated with ezetimibe or thecombination of a statin and ezetimibe
Total Serum Cholesterol – A Result of Production, Absorption and Clearance

Body cells and the liver produce 75% of circulating cholesterol, while dietary intake of plant sterols contributes 25%. Most (80%) of in vivo cholesterol production goes through a major production pathway, measured by the precursor lathosterol, while the remaining (20%) goes through desmosterol.

Enhanced test report with Cholesterol Balance Score

Ordering information

There are no changes to the current ordering process or specimen requirements for the enhanced

Cholesterol Balance Test.

References

  1. Matthan NR, Restighini N, Robertson M, Ford I, Shepherd J, Packard C, Buckley BM, Jukema JW, Lichtenstein AH, Schaefer EJ. Cholesterol absorption and synthesis in individuals with and without CHD events during pravastatin therapy:insights from the PROSPER Trial. J Lipid Res. 2009;51:202-209.
  2. van Himbergen TM, Matthan NR, Resteghini NA, Otokozawa S, Ai M, Stein EA,Jones PH, Schaefer EJ. Comparison of the effects of maximal dose atorvastatin and rosuvastatin therapy on cholesterol synthesis and absorption markers.J Lipid Res. 2009; 50:730-739.
  3. Assmann G, Kannenberg F, Ramey DR, Musliner TA, Gutkin SW, Veltri EP. Effectsof ezetimibe, simvastatin, atorvastatin, and ezetimibe-statin therapies on noncholesterolsterols in patients with primary hypercholesterolemia. Curr Med ResOpin. 2008;24:249-259.
  4. Sudhop T, Lutjohann D, Kodal A, Igel M, Tribble DL, Shah S, Perevozskaya I, vonBergmann K. Inhibition of intestinal cholesterol absorption by ezetimibe inhumans. Circulation. 2002;106:1943-1948.
  5. Cholesterol Treatment Trialists’ (CTT) Collaboration, Baigent C, Blackwell L,Emberson J, Holland LE, Reith C, Bhala N, Peto R, Barnes EH, Keech A, Simes J,Collins R. Efficacy and safety of more intensive lowering of LDL cholesterol: ameta-analysis of data from 170,000 participants in 26 randomised trials. Lancet.   2010;376:1670-1681.