The Role of Cholesterol in Assessing the Condition of the Surgical Patients

Ralitsa P. Stavrova-Hristova 1
  • 1 Department of Anesthesiology and Intensive Care, UMHAT “G. Stranski”, , Pleven


Cholesterol is a white, waxy substance that always takes part in building each cell in the human body. The role of cholesterol in the normal functioning of the human body has been known for a long time, however, it is mainly due to its elevated levels and the health risk of it. It is less well known that low serum cholesterol levels are associated with serious health problems. When it comes to intensive care unit (ICU) patients, hypocholesterolemia may indicate infectious complications, impaired hepatic synthesis, significant bodily injury. Surgical patients are judged for operative trauma and perioperative stress, as well as for the resuscitation process.

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  • 1. Cholesterol. MedlinePlus. [cited 2019 Jul 27]. Available from:

  • 2. Cholesterol. Wikipedia, The Free Encyclopedia. [cited 2019 Jul 27]. Available from:

  • 3. Cholesterin. Wikipedia, The Free Encyclopedia. [cited 2019 Jul 26]. Available from:

  • 4. Ma H. Cholesterol and human health. Nat Sci. 2004;2(4):17-21.

  • 5. Cholesterol metabolism [Internet]. [cited 2019 Jul 26]. Available from:

  • 6. Šmahelová A, Hyšpler R, Haas T. Relation of cholesterol metabolism and non-cholesterol sterols to insulin resistance. Physiol Res. 2007;56(6):749-55.

  • 7. Severin ES, ed. [Biochemistry]. Moscow: GEOTAR –MED; 2004. Russian

  • 8. Omoigui S. The Interleukin-6 inflammation pathway from cholesterol to aging - Role of statins, bisphosphonates and plant polyphenols in aging and age-related diseases. Immun Ageing. 2007;4:1-22.

  • 9. Argirova T, ed. [Lectures on medical biochemistry]. Sofia: Medical University - Sofia; 2010. Bulgarian

  • 10. Moss D. Pressure Vessel Design Manual. 3rd ed. Oxford: Elsevier; 2004.

  • 11. Yeagle P, editor. Biology of cholesterol. CRC Press: Boca Raton, FL; 1988.

  • 12. Orth M, Bellosta S. Cholesterol: Its Regulation and Role in Central Nervous System Disorders. Cholesterol. 2012;2012:1-19.

  • 13. Voet D, Voet JG. Biochemistry. 4th ed. John Wiley & Sons; 2010.

  • 14. Feingold KR, Wiley MH, MacRae G, Siperstein MD. The effect of decreased plasma cholesterol concentration on circulatinga mevalonate metabolism in rats. J Lipid Res. 1981;22(6):990-7.

  • 15. Shin DJ, Osborne TF. Thyroid Hormone Regulation and Cholesterol Metabolism Are Connected through Sterol Regulatory Element- binding Protein-2 (SREBP-2). J Biol Chem. 2003;278(36):34114-8.

  • 16. Vicente SJV, Sampaio GR, Ferrari CKB, Torres EAFS. Oxidation of Cholesterol in Foods and Its Importance for Human Health. Food Rev Int. 2012;28(1):47-70.

  • 17. Tabas I. Cholesterol in health and disease. J Clin Invest [Internet]. 2002;110(5):583-90.

  • 18. Porter JA, Young KE, Beachy PA. Cholesterol modification of hedgehog signaling proteins in animal development. Science. 1996;274(5285):255-9.

  • 19. Maxfield FR, Tabas I. Role of cholesterol and lipid organization in disease. Nature. 2005;438(7068):612–21.

  • 20. Suter PM. Checkliste Ernährung. 3rd ed. Georg Thieme Verlag; 2008.

  • 21. Vyroubal P, Chiarla C, Giovannini I, Hyspler R, Ticha A, Hrnciarikova D, et al. Hypocholesterolemia in clinically serious conditions--review. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2008;152(2):181-9.

  • 22. Yamano S, Shimizu K, Ogura H, Hirose T, Hamasaki T, Shimazu T, et al. Low total cholesterol and high total bilirubin are associated with prognosis in patients with prolonged sepsis. J Crit Care. 2016;31(1):36-40.

  • 23. Sun X, Oberlander D, Huang J, Weissman C. Fluid resuscitation, nutritional support, and cholesterol in critically ill postsurgical patients. J Clin Anesth. 1998;10(4):302-8.

  • 24. Aufenanger J, Walter H, Kattermann R. Untersuchungen zum Lipid-und Lipoproteinstoffwechsel beim Menschen nach operativen Eingriffen. Langenbecks Arch Chir, 1993;378(1):41-8

  • 25. Eriksen N, Benditt EP. Trauma, high density lipoproteins, and serum amyloid protein A. Clin Chim Acta. 1984;140(2):139-49.

  • 26. Goodman DS, Noble RP, Dell RB. Three-pool model of the long-term turnover of plasma cholesterol in man. J Lipid Res. 1973;14(2):178-88.

  • 27. Lindh A, Lindholm M, Holmquist L, Carlson LA. Time course for the changes of serum lipoproteins and apolipoprotein T concentrations after major surgical trauma in man. J Parenter Enter Nutr. 1986;10(3):265-73.

  • 28. Gui D, Spada PL, Gaetano A De, Pacelli F. Hypocholesterolemia and risk of death in the critically ill surgical patient. Intensive Care Med. 1996;22(8):790-4.

  • 29. Memiş D, Gursoy O, Tasdogan M, Süt N, Kurt I, M, et al. High C-reactive protein and low cholesterol levels are prognostic markers of survival in severe sepsis. J Clin Anesth. 2007;19(3):186-91.

  • 30. Giovannini I, Boldrini G, Chiarla C, Giuliante F, Vellone M, Nuzzo G. Pathophysiologic correlates of hypocholesterolemia in critically ill surgical patients. Intensive Care Med. 1999;25(7):748-51.

  • 31. Marques MB, Langouche L. Endocrine, metabolic, and morphologic alterations of adipose tissue during critical illness. Crit Care Med. 2013;41(1):317-25.

  • 32. Lee SH, Lee JY, Hong TH, Kim BO, Lee YJ, Lee JG. Severe persistent hypocholesterolemia after emergency gastrointestinal surgery predicts in- hospital mortality in critically ill patients with diffuse peritonitis. PLoS One. 2018;13(7):1-15.

  • 33. Giovannini, I., Chiarla, C., Greco, F., Boldrini, G., & Nuzzo, G. Characterization of biochemical and clinical correlates of hypocholesterolemia after hepatectomy. Clin chem. 2003;49(2):317-9.

  • 34. Dunham CM, Fealk MH, Sever WE. Following severe injury, hypocholesterolemia improves with convalescence but persists with organ failure or onset of infection. Crit Care. 2003;7(6):R145-53.

  • 35. Bakalar B, Hyspler R, Pachl J, Zadak Z. Changes in cholesterol and its precursors during the first days after maJor trauma. Wien Klin Wochenschr. 2003;115(21–22):775-9.

  • 36. Oster P, Muchowski H, Heuck CC, Schlierf G. The prognostic significance of hypocholesterolemia in hospitalized patientsDie prognostische Signifikanz einer Hypocholesterinämie bei stationären Patienten. Klin Wochenschr. 1981;59(15):857-60.

  • 37. Stavrova R, Radeva-Dafinova N, Radev V, Marinchev N, Getov I. Changes in serum cholesterol levels in patients with combined trauma. Anesteziologiâ i intenzivno lecenie. 2009;3

  • 38. Stavrova R, Radeva-Dafinova N, Getov I, Bogdanov S, Maneva N, Radev V, et al. Dynamics in serum cholesterol and cortisol levels in trauma patients, National Congress of Anesthesiology and Intensive Care with international participation, Sofia, October 1-4, 2009


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