Hypocholesterolemia: a blessing or a problem?

Abstract

We are all accustomed to face serum cholesterol as a potential threat for our health and so wish and try to have its levels as low as possible. So, in clinical practice we are rather indifferent or even satisfied when we find very low serum cholesterol levels -what we can call “hypocholesterolemia- in a certain individual. Is this practice right or it should be reevaluated? Since cholesterol is an important component of all cell membranes and its concentrations affect membrane permeability and fluidity it is highly probable that very low levels of it may disturb some cell functions and participate in the pathogenesis of diseases. Let’s start with a definition of the term, although this is not generally accepted. It can be described as a serum total cholesterol level under the fifth percentile of a general population adjusted for sex and age.1 In a less complicated manner it can be defined as less than 115 mg/dl.  In a study of 7,000 healthy blood donors, a percentage of 7,8% were found to meet the criteria for hypocholesterolemia. Hypocholesterolemia may be congenital or acquired. Congenital conditions are either combined with low LDL- (low density lipoprotein) or low HDL- (high density lipoprotein) cholesterol levels.