[The role of cholesterol and intermediary metabolites of its synthesis in intensive care and parenteral nutrition].

Hypocholesterolaemia is a frequent and typical phenomenon of many acute situations such as injury, severe infection associated with sepsis and septic shock, catabolic situations after serious operations, in myocardial infarction and neoplastic diseases. This phenomenon cannot be explained only by malnutrition or energy deficiency although they may participate in the development of hypocholesterolaemia. In the development of the mentioned acute conditions participates according to our opinion also impaired synthesis of cholesterol as well as of intermediary metabolites of its biosynthesis (isoprene, squalene, lanosterol, and lathosterol). Evidence was provided that deprivation of these metabolites is frequent, very marked and statistically significant. Some precursors of cholesterol biosynthesis are extremely important for normal processes in the cell and as mediators (isoprene, farnesyl diphosphate, squalene). Their deficiency is a serious disorder which must be diagnosed in time. It is important to define the patients and conditions where a serious deficiency of these metabolites develops regularly and to seek ways how to treat deprivation of the mentioned metabolites.