[The mechanism of reverse cholesterol transport and cholelithiasis in Northern ethnic groups].

ABSTRACT

The aim of the study was to investigate metabolic factors that protect the human organism from cholelithiasis and coronary artery disease (CAD). An epidemiological study was carried out to determine the prevalence of cholelithiasis and CAD in eight settlements of Yakutia and Evenkia. The subjects were 1154 Evens and Evenks, and 1591 Europoids. The parameters under study were the lipid composition and bile acid (BA) spectrum as well as the level of lipids, the spectrum of lipoproteins, neutral lipids, and phospholipids in the serum and blood plasma. Among Europoids, the prevalence of cholelithiasis was 8.8%, and the prevalence of CAD was 18.8%, while among Mongoloids they were 1.5% (p < 0.001) and 10.2% (p < 0.001), respectively. Serum levels of total cholesterol (CH) were significantly higher in Europoids than in Evens and Evenks, whereas CH, BA, and primary cholates prevailed in bile of Mongoloids. The levels of main LCHAT-reactive substrates evidence a significantly higher efficiency of CH esterification in Evens and Evenks vs. Europoids. Highly effective mechanism of CH return transport, an important component of which is active BA synthesis and transport of sterins into bile should be considered the leading factor that protects high latitude Mongoloids from cholelithiasis and CAD.