Normal Plasma Cholesterol in an 88-Year-Old Man Who Eats 25 Eggs a Day

Abstract

DIETARY cholesterol increases the plasma level of total and low-density lipoprotein (LDL) cholesterol and accelerates the development of atherosclerosis and its complications, but individual responses to a given change in the dietary cholesterol level vary widely.^{1 2 3 4 5 6 7} Such responses are reproducible to some extent, suggesting genetic as well as physiologic determinants.^{8 , 9} Several genetic determinants have been identified in nonhuman primates.^{10 11 12 13} The homeostatic and regulatory mechanisms that maintain a relatively constant level of plasma cholesterol despite changes in dietary cholesterol intake include alterations in the efficiency of intestinal absorption and in the rates of cholesterol biosynthesis, LDL-receptor activity, secretion of cholesterol into bile, and hepatic conversion of cholesterol into bile acids, the chief metabolic product of cholesterol.^{5 , 7 , 14 , 15}