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Cholesterol

Drugs and Chemicals · NLM MeSH · updated 2026-10-31 · version 1

Citations verified against PubMedNot yet clinician-reviewed9 referencesApproximately 3 min read

The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils.

Table of Contents

1. Definition2. Research landscape3. Reading the evidence4. Open-access studies5. Key reviews6. References7. About this article

Definition and research guide

This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.

Content available: 3 complete abstracts (618 words), 9 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.

Definition

The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils.

Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.

Also known as: Epicholesterol.

Where it fits in the MeSH classification

Broader topics
Cholestenes; Sterols
Narrower topics
19-Iodocholesterol; Azacosterol; Cholesterol Esters; Oxysterols; Cholestanol; Cholesterol, Dietary; Cholesterol, HDL; Cholesterol, LDL; Cholesterol, VLDL; Dehydrocholesterols
See also
Hypercholesterolemia; Embolism, Cholesterol

Research landscape

PubMed indexes 185,226 records tagged with the MeSH heading “Cholesterol” (counts retrieved 2026-10-31). 25,085 of them (13.5%) were published from 2020 onward, and the busiest period so far is through 1999 with 80,892 records.

Reviews account for 16,487 records (8.9%) and meta-analyses for 1,902. Randomized controlled trials number 9,919 (5.4%) as a share of all records on the topic.

PubMed records by publication periodthrough 1999: 80,892 records; 2000-2009: 37,443 records; 2010-2019: 41,806 records; 2020 onward: 25,085 records80,892through 199937,4432000-200941,8062010-201925,0852020 onward
Records in PubMed indexed with this heading, by publication period. Real counts from NCBI E-utilities; the final period covers only part of the current year. Volume reflects how much has been published, not how strong the evidence is.
Show the data
PeriodRecords
through 199980,892
2000-200937,443
2010-201941,806
2020 onward25,085
Share of records by publication typeReviews: 8.9 percent; Meta-analyses: 1.0 percent; Randomized controlled trials: 5.4 percentReviews8.9% (16,487)Meta-analyses1.0% (1,902)Randomized controlled trials5.4% (9,919)
Share of all PubMed records on this heading that carry each publication type. Types overlap with other records, so the shares do not sum to 100%.
Publication-type chart data
Publication types among 185,226 PubMed records
TypeRecordsShare
Reviews16,4878.9%
Meta-analyses1,9021.0%
Randomized controlled trials9,9195.4%

Method: PubMed query "Cholesterol"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-31.

Reading the evidence in drugs and chemicals

Studies of a chemical or drug can answer very different questions: what it is and how it behaves in cells and animals, how the body handles it, and whether it changes outcomes in people. Laboratory and animal findings often do not carry over to patients, and observational studies of exposures are confounded by who uses a substance and why. Nothing on this page is a recommendation to use, avoid, start or stop any substance or medicine; talk to a qualified clinician or pharmacist about your own situation. Check the dose, the species, the comparison group and whether a patient-relevant outcome was measured.

Evidence from open-access studies

These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.

Study comparison — selected abstracts, not a systematic review
Study / authorsYearSource label / designEurope PMC citationsLicence / source
Lipoprotein(a) and residual cardiovascular risks in Japanese patients with coronary artery disease who achieve guideline-recommended low-density lipoprotein cholesterol goals
Kataoka Y, Ray KK, Nicholls SJ, Katasako-Yabumoto A, Kitahara S, Hosoda H, et al.
2026Research article
Design not recorded in structured metadata
3cc by
PMID 42177636 · DOI · PMC13696080
SARS-CoV-2 ORF3a blocks lysosomal cholesterol egress by disrupting VPS39-regulated NPC2 trafficking and BMP metabolism
Goodson BA, Montenegro Vazquez V, Doyle A, Kolaczkowski OM, Liu R, Jia J, et al.
2026Research article
Design not recorded in structured metadata
3cc by
PMID 42287635 · DOI · PMC13378056
Predictive value of the combined cholesterol, high-density lipoprotein, glucose and frailty indices for cardiometabolic multimorbidity incidence: evidence from a national prospective cohort study
Fan H, Jiang G, Cheng J, Chen H
2026Research article
Design not recorded in structured metadata
3cc by
PMID 42144600 · DOI · PMC13348554

Lipoprotein(a) and residual cardiovascular risks in Japanese patients with coronary artery disease who achieve guideline-recommended low-density lipoprotein cholesterol goals [1]

Research article Kataoka Y, Ray KK, Nicholls SJ, Katasako-Yabumoto A, Kitahara S, Hosoda H, et al. · · 2026 · cited 3 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Background and aimsCurrent guidance recommends better LDL-C control in patients with elevated Lp(a) as Lp(a) lowering therapies are unavailable.
Closing excerpt
The Lp(a) threshold amongst Japanese patients with CAD at risk of recurrent events appears lower than in Caucasian populations which merits further evaluation.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (139 words)

Background and aimsCurrent guidance recommends better LDL-C control in patients with elevated Lp(a) as Lp(a) lowering therapies are unavailable. Whether risks attributable to Lp(a) are mitigated in patients with CAD who achieved LDL-C MethodsMulticentre retrospective observational study analysed 1581 Japanese patients with CAD [Lp(a)-JAPAN: jRCT1050260016]. Risk of MACE (cardiac-caused death + nonfatal MI + coronary revascularization in non-culprit segments) was compared according to Lp(a) levels (ResultsDuring the 5.1-year observation amongst patients with LDL-C ≥55mg/dL (n=1069), MACE occurred in 21.3% with risk of MACE increasing with Lp(a) levels (3.9, 7.9, and 11.0 events per 100 person-years for ConclusionsWhilst lower achieved LDL-C attenuates in part the risk from Lp(a), elevated Lp(a) levels still associate with worse cardiovascular outcomes. The Lp(a) threshold amongst Japanese patients with CAD at risk of recurrent events appears lower than in Caucasian populations which merits further evaluation.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 42177636 · DOI · PMC13696080

SARS-CoV-2 ORF3a blocks lysosomal cholesterol egress by disrupting VPS39-regulated NPC2 trafficking and BMP metabolism [2]

Research article Goodson BA, Montenegro Vazquez V, Doyle A, Kolaczkowski OM, Liu R, Jia J, et al. · · 2026 · cited 3 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Cholesterol homeostasis depends on lysosomes liberating cholesterol from degraded lipids.
Closing excerpt
These findings identify dual functions of VPS39-regulating retromer trafficking and BMP biosynthesis-and also reveal how ORF3a blocks lysosomal cholesterol egress.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (145 words)

Cholesterol homeostasis depends on lysosomes liberating cholesterol from degraded lipids. We show that SARS-CoV-2 blocks lysosomal cholesterol egress through the viral protein ORF3a. ORF3a binds the HOPS subunit VPS39 via the W193 and Y184 residues. Disrupting this interface restores cholesterol trafficking. Mechanistically, the ORF3a-VPS39 interaction exerts dual effects. First, it traps the retromer complex on endolysosomes, preventing endosome-to-Golgi recycling and mislocalizing the cholesterol transporter NPC2. Retromer deletion reproduced these defects, whereas the ORF3a W193A mutant restored retromer trafficking. Second, ORF3a-VPS39 interaction reduces bis(monoacylglycerol)phosphates (BMPs), lysosomal lipids required for cholesterol egress, by disrupting the transfer of their precursor, phosphatidylglycerols, from mitochondria. Lipidomics revealed increased mitochondrial and decreased lysosomal phosphatidylglycerol metabolites. Disturbing autophagy or mitochondrion-derived vesicles did not alter BMP levels, whereas ORF3a reduced mitochondrion-lysosome membrane contacts. These findings identify dual functions of VPS39-regulating retromer trafficking and BMP biosynthesis-and also reveal how ORF3a blocks lysosomal cholesterol egress.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 42287635 · DOI · PMC13378056

Predictive value of the combined cholesterol, high-density lipoprotein, glucose and frailty indices for cardiometabolic multimorbidity incidence: evidence from a national prospective cohort study [3]

Research article Fan H, Jiang G, Cheng J, Chen H · · 2026 · cited 3 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
BackgroundThe cholesterol, high-density lipoprotein, and glucose (CHG) is a surrogate of insulin resistance, while frailty reflects cumulative physiological decline, yet their combined utility for cardiometabolic multimorbidity (CMM) is underexplored.
Closing excerpt
As an accessible tool integrating routine metabolic and physiologic reserve measures, CHG-FI offers a practical alternative approach for risk stratification.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (334 words)

BackgroundThe cholesterol, high-density lipoprotein, and glucose (CHG) is a surrogate of insulin resistance, while frailty reflects cumulative physiological decline, yet their combined utility for cardiometabolic multimorbidity (CMM) is underexplored. We evaluated a combined CHG-frailty index (CHG-FI) for incident heart disease, stroke, diabetes, and CMM.MethodsWe conducted a retrospective cohort study of 6812 Chinese adults aged ≥ 45 years enrolled in the 2011-2020 waves of the China Health and Retirement Longitudinal Study (CHARLS). Participants with baseline lipid and fasting glucose measurements were included and followed prospectively for incident heart disease, stroke, diabetes, and cardiometabolic multimorbidity (≥ 2 conditions). FI was calculated using the cumulative deficit approach, and CHG was incorporated according to established procedures. Multivariable Cox regression estimated associations; CHG-FI interaction was assessed on multiplicative and additive scales. Incremental predictive utility of CHG, FI, TYG‑FI, and CHG‑FI was compared using receiver operating characteristic (ROC) curves, net reclassification improvement (NRI), and decision curve analysis (DCA). Stratified and sensitivity analyses evaluated robustness.ResultsOver a median follow‑up of 9.0 years, we observed 1,304 heart disease events, 554 strokes, 932 diabetes cases, and 467 CMM cases. Each 1-unit increase in CHG-FI was associated with higher risk: heart disease (HR 1.34, 95% CI 1.23-1.45), stroke (HR 1.85, 95% CI 1.65-2.06), diabetes (HR 1.29, 95% CI 1.17-1.42), and CMM (HR 1.79, 95% CI 1.58-2.04). Associations showed dose-response patterns and nonlinearity. The multiplicative interaction between CHG and FI for CMM was 0.54 (95% CI 0.35-0.83), reflecting a "risk saturation" or ceiling effect. Despite this, the combined CHG -FI index offered superior predictive performance for CMM relative to individual components: AUC 0.652 (95% CI 0.627-0.678), with significant improvement in reclassification (NRI 0.329, 95% CI 0.236-0.423) and discrimination (IDI 0.011, 95% CI 0.008-0.015). CHG -FI and TyG -FI showed broadly comparable performance across outcomes.ConclusionThe combined CHG-frailty index was significantly associated with incident cardiometabolic multimorbidity and its individual components, demonstrating predictive performance comparable to established combined indices. As an accessible tool integrating routine metabolic and physiologic reserve measures, CHG-FI offers a practical alternative approach for risk stratification.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 42144600 · DOI · PMC13348554

Key reviews and meta-analyses

The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.

  • Research article Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins [4]
    Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, et al. · Lancet · 2005 · cited 4,835 times (Europe PMC)
  • Research article Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials [5]
    Cholesterol Treatment Trialists’ (CTT) Collaboration, Baigent C, Blackwell L, Emberson J, Holland LE, Reith C, et al. · Lancet · 2010 · cited 4,773 times (Europe PMC)
  • Research article The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials [6]
    Cholesterol Treatment Trialists' (CTT) Collaborators, Mihaylova B, Emberson J, Blackwell L, Keech A, Simes J, et al. · Lancet · 2012 · cited 2,090 times (Europe PMC)
  • Research article Plasma HDL cholesterol and risk of myocardial infarction: a mendelian randomisation study [7]
    Voight BF, Peloso GM, Orho-Melander M, Frikke-Schmidt R, Barbalic M, Jensen MK, et al. · Lancet · 2012 · cited 1,798 times (Europe PMC)
  • Research article Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths [8]
    Prospective Studies Collaboration, Lewington S, Whitlock G, Clarke R, Sherliker P, Emberson J, et al. · Lancet · 2007 · cited 1,619 times (Europe PMC)
  • Research article Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis [9]
    Law MR, Wald NJ, Rudnicka AR · BMJ · 2003 · cited 1,145 times (Europe PMC)

References

  1. Kataoka Y, Ray KK, Nicholls SJ, Katasako-Yabumoto A, Kitahara S, Hosoda H, et al.. Lipoprotein(a) and residual cardiovascular risks in Japanese patients with coronary artery disease who achieve guideline-recommended low-density lipoprotein cholesterol goals. . 2026. PMID 42177636 · DOI · PMC13696080
  2. Goodson BA, Montenegro Vazquez V, Doyle A, Kolaczkowski OM, Liu R, Jia J, et al.. SARS-CoV-2 ORF3a blocks lysosomal cholesterol egress by disrupting VPS39-regulated NPC2 trafficking and BMP metabolism. . 2026. PMID 42287635 · DOI · PMC13378056
  3. Fan H, Jiang G, Cheng J, Chen H. Predictive value of the combined cholesterol, high-density lipoprotein, glucose and frailty indices for cardiometabolic multimorbidity incidence: evidence from a national prospective cohort study. . 2026. PMID 42144600 · DOI · PMC13348554
  4. Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, et al.. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005. PMID 16214597 · DOI
  5. Cholesterol Treatment Trialists’ (CTT) Collaboration, Baigent C, Blackwell L, Emberson J, Holland LE, Reith C, et al.. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010. PMID 21067804 · DOI · PMC2988224
  6. Cholesterol Treatment Trialists' (CTT) Collaborators, Mihaylova B, Emberson J, Blackwell L, Keech A, Simes J, et al.. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet. 2012. PMID 22607822 · DOI · PMC3437972
  7. Voight BF, Peloso GM, Orho-Melander M, Frikke-Schmidt R, Barbalic M, Jensen MK, et al.. Plasma HDL cholesterol and risk of myocardial infarction: a mendelian randomisation study. Lancet. 2012. PMID 22607825 · DOI · PMC3419820
  8. Prospective Studies Collaboration, Lewington S, Whitlock G, Clarke R, Sherliker P, Emberson J, et al.. Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths. Lancet. 2007. PMID 18061058 · DOI
  9. Law MR, Wald NJ, Rudnicka AR. Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis. BMJ. 2003. PMID 12829554 · DOI

About this article

Sources
NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
Verification
Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
Review state
automated source verified; no human expert review has been recorded yet.
Version
1, last updated 2026-10-31.

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At a glance

185,226
PubMed records on this heading
14%
published since 2020
16,487
review articles
9,919
randomized trials
9
verified references below

Counts come from PubMed on 2026-10-31; they show how much has been written, not how strong the evidence is.

Related topics See all →

  • Cholesterol EstersDrugs and Chemicals
  • HDL CholesterolDrugs and Chemicals
  • LDL CholesterolDrugs and Chemicals
  • LanosterolDrugs and Chemicals
  • CalcitriolDrugs and Chemicals

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