Cholesterol catabolism in patients with acute myelogenous leukemia and hypocholesterolemia: suppressed levels of a circulating marker for bile acid synthesis

Hypocholesterolemia is a frequent finding in patients with acute myelogenou s leukemia (AML) and in other types of malignancies. Since bile acids are m ajor excretion products of cholesterol, the hepatic degradation of choleste rol to bile acids was investigated in AML patients by analyzing a circulati ng marker for bile acid synthesis. In addition, plasma levels of a marker f or cholesterol synthesis were determined. The plasma levels of 7 alpha -hyd roxy-4-cholesten-3-one, reflecting bile acid production, were markedly lowe r in patients with AML than in healthy controls. The median levels were 3.3 and 18.5 ng/ml (P < 0.0001) in the AML patients (n = 29) and the healthy s ubjects (n = 16), respectively. The plasma levels of 7-dehydrocholesterol, reflecting hepatic cholesterol synthesis, were similar for the AML patients and the controls. The results show that the conversion of cholesterol to b ile acids was suppressed in AML patients, a phenomenon that may result in a decreased intestinal absorption of cholesterol and subsequent hypocholeste rolemia. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.