Determination of Desmosterol, Campesterol, Cholestanol, and b-Sitosterol in plasma utilizing LC-MS/MS in Clinical Diagnostics

摘要

LC-MS/MS technology enables clinicians to rapidly and selectively determine plasma sterol and stanol concentrations. Sterol and stanol concentrations enable clinicians to better direct treatment for LDL cholesterol. When sterol concentrations were measured directly, as expected, the population % of hypersynthesizers and hyperabsorbers increased as LDL-cholesterol levels moved from Optimal to Intermediate to High risk. Unexpectedly, the opposite was observed when the sterols/stanol were measured in ratio to cholesterol; the population % of hypersynthesis and absorbers did not always increase as the LDL-cholesterol levels increased from Optimal to Intermediate to High risk. In all cases, associations were more strongly correlated with LDL risk when sterols were directly measured than when they were measured in ratio to cholesterol. This brings into question the validity of measuring the ratio of sterol/stanol to cholesterol and highlights the clinical utility of the absolute sterol/stanol values.