Findings of a study of obese and nonobese subjects indicate that body weight regulates cholesterol metabolism in patients with type 2 diabetes.
Cholesterol absorption efficiency is lower and cholesterol synthesis is higher in obese patients.
Simonen and colleagues of the University of Helsinki, Finland, studied cholesterol metabolism in 22 obese (mean body mass index, 33.4 kg/m2) and 20 nonobese (mean body mass index, 24.1 kg/ m2) patients with type 2 diabetes. Age, blood glucose levels, and dietary intake of calories, cholesterol, fat, and plant sterols were similar in the two groups.
Although serum cholesterol levels were similar in the two groups, bile acid
synthesis, fecal neutral sterol excretion, and cholesterol synthesis were higher in the obese patients than in the nonobese patients. On the other hand, sitosterol and cholesterol ratios were significantly lower in the obese than in the non-obese group, suggesting low cholesterol absorption in obese patients.