1. Introduction
The global rise in obesity has heightened health concerns, evidenced by a significant increase in prevalence. Alongside the surge in obesity rates, associated complications, mortality rates, and healthcare costs have also escalated [
1]. Notable complications include impaired glucose tolerance, reduced insulin sensitivity, and dyslipidemia, all of which pose considerable risks for cardiovascular diseases [
2]. Dietary cholesterol can accumulate in plasma and tissues such as the liver [
3]. Elevated plasma cholesterol is linked to diseases such as hypercholesterolemia and atherosclerosis, and can lead to hepatic lipid accumulation [
3,
4]. Dietary cholesterol may influence overall cholesterol metabolism, affecting plasma cholesterol levels through mechanisms like intestinal absorption, synthesis, fecal excretion, lipoprotein receptor numbers, and lipoprotein metabolic rates [
5]. Obesity significantly disrupts cholesterol homeostasis by increasing cholesterol synthesis and altering lipoprotein metabolism. Studies have shown that obesity enhances the activity of HMG-CoA reductase, the key enzyme in cholesterol biosynthesis, leading to elevated cholesterol levels [
6]. Additionally, obesity impairs the clearance of low-density lipoprotein (LDL) from the bloodstream, contributing to higher circulating LDL levels and an increased risk of atherosclerosis [
7]. These disruptions in cholesterol metabolism underscore the critical link between obesity and dyslipidemia [
8].
In the bloodstream, only 20–30% of cholesterol is absorbed from food, with the majority synthesized by the liver. Cholesterol, existing as free cholesterol or combined with long-chain fatty acids, travels in plasma lipoproteins and can be excreted via bile as cholesterol or bile salts. Cholesterol is transported within lipoproteins, which have a protein layer that makes cholesterol hydrophilic for travel through the bloodstream. Very-low-density lipoproteins (VLDLs) and LDL contribute to arterial plaque buildup, increasing heart disease risk. VLDL primarily transports triglycerides, while LDL mainly carries cholesterol. High-density lipoproteins (HDLs) return excess cholesterol from blood vessels to the liver for breakdown or use, reducing cardiovascular disease risk [
9]. Moreover, a positive correlation between plasma phospholipid and cholesterol levels has been reported [
10]. In obese children, plasma leptin levels are higher and correlate with body mass index, body fat percentage, and plasma levels of total cholesterol, triglycerides, and LDL-C [
11]. Activity of cholesteryl ester transfer protein (CETP), which transfers cholesterol esters and phospholipids from HDL to LDL and VLDL, correlates with total plasma cholesterol and LDL-C levels [
12]. Evidence suggests that consuming a diet high in cholesterol may lead to changes in lipid peroxidation and the activities of antioxidant enzymes [
13]. Glutathione, in its reduced (GSH) and oxidized (GSSG) states, protects cells from lipid peroxidation in membranes. Glutathione peroxidase (GSH-Px) uses GSH to neutralize lipid peroxides, converting GSH to GSSG and preventing oxidative damage. GSH-Px and catalase activities increase in the livers of animals on high-cholesterol diets as a defense against lipid peroxidation [
14]. Lipid peroxidation, initiated by free radicals attacking fatty acids, can be monitored through malondialdehyde (MDA) levels, indicating oxidative damage within biological systems. Additionally, hepatic cholesterol levels impact glucagon sensitivity, relevant to the development of non-alcoholic fatty liver disease, which is linked to both increased liver cholesterol and glucagon resistance [
15].
Excessive dietary cholesterol intake has been linked to metabolic disorders such as cardiovascular disease and non-alcoholic fatty liver disease (NAFLD) [
16,
17]. Understanding the impact of dietary cholesterol on growth parameters, plasma lipid profiles, and lipid metabolism is essential for developing effective health strategies. Laboratory animals, including rats, mice, rabbits, and pigs, serve as valuable models for studying the effects of dietary cholesterol. These models help elucidate the physiological and biochemical responses to different cholesterol levels in the diet [
18]. Each model provides unique insights due to their distinct metabolic and physiological characteristics, offering a comprehensive understanding of cholesterol’s impact across species. Growth parameters such as body weight, organ weight, and feed efficiency are crucial indicators of overall health and development. Studies have shown that dietary cholesterol can affect these parameters in a dose-dependent manner [
19,
20,
21]. The plasma lipid profile, including total cholesterol, LDL, HDL, and triglycerides, is a key marker of cardiovascular health. Higher dietary cholesterol intake typically elevates total cholesterol and LDL levels, increasing cardiovascular risk. Monitoring plasma lipid profiles in response to dietary interventions is crucial [
22]. Lipid metabolism involves complex processes of lipid synthesis, transport, and degradation, with the liver playing a central role in regulating cholesterol homeostasis and lipid storage. Dietary cholesterol influences liver metabolism by modulating enzyme activities involved in cholesterol synthesis and degradation. Excessive intake can lead to fatty liver, characterized by lipid accumulation in hepatic cells, a precursor to severe liver diseases such as steatohepatitis and cirrhosis [
3]. Oxidative stress, caused by an imbalance between reactive oxygen species production and antioxidant defenses, is critical in metabolic disorders’ pathogenesis. Dietary cholesterol has been associated with increased oxidative stress, exacerbating liver damage and cardiovascular dysfunction. Investigating antioxidant potential in response to dietary cholesterol is essential for mitigating these harmful effects. Animal studies highlight antioxidants’ role in counteracting oxidative stress induced by high cholesterol diets [
23]. By utilizing various animal models, scientists can better understand cholesterol’s dose-dependent effects and develop effective dietary strategies to promote health and prevent disease. These findings have significant implications for human nutrition and public health policies.
Syrian hamsters are widely used in lipoprotein metabolism studies [
24]. Unlike rats and mice, hamsters exhibit a distinctive atherogenic lipoprotein profile with a significant proportion of non-HDL lipoproteins, possess CETP, engage in receptor-mediated LDL uptake via the LDL receptor, synthesize apolipoprotein (apo) B-100 in the liver, and produce apo B-48 in the intestines [
20,
25]. Notably, hamsters develop hypercholesterolemia and hypertriglyceridemia when fed a cholesterol-rich diet [
26,
27]. They are also prone to obesity and insulin resistance on high-fat, high-carbohydrate diets [
28]. These traits make hamsters ideal models for evaluating drugs affecting weight, hypertriglyceridemia, and hypercholesterolemia. So far, there is limited research on how different dietary cholesterol levels impact cholesterol metabolism and antioxidant enzyme activity of hamsters. It remains unclear which cholesterol dosage best mimics human lipid metabolism and the underlying mechanisms involved. Although numerous studies have used high-cholesterol diets to induce hyperlipidemia in hamsters, we have not found any scientific findings from a single study confirming that a single variable, namely “specific cholesterol diet dosage”, triggers specific symptoms of hyperlipidemia or obesity in hamsters. Moreover, it lacks credibility to speculate on the impact of different dietary cholesterol levels based on data obtained from different studies. This study aimed to explore how different levels of dietary cholesterol affect lipid metabolism in hamsters and evaluate their impact on obesity, lipidemia, lipid accumulation, and lipid metabolism enzymes. The optimal cholesterol dosage for dietary supplementation in hamster models was determined, providing recommendations for future research on obese or hyperlipidemic animal models.
4. Discussion
So far, we have found limited studies investigating the impact of cholesterol diet dosage on plasma lipid profile or obesity. However, the experimental design of these studies involved multiple variables, such as the interactions between cholesterol diet and saturated fatty acids, (
n-3) polyunsaturated fatty acids, fat, and fructose [
19,
20,
21]. Therefore, it was unclear whether specific dosages of cholesterol diets can induce particular symptoms in hamsters. This study is the first to show that varying specific dosages of cholesterol diets can independently induce specific symptoms in hamsters, such as elevated LDL-C, VLDL-C, and hepatic lipid accumulation, without any additional treatment. These results are crucial for future studies using hamster models to evaluate the effects of drugs or natural substances on hyperlipidemia, as they provide important information on the appropriate cholesterol dosage in the diet. This can help reduce the number of experimental groups and animals used, adhering to the 3Rs principle in further animal experiments.
Upon administering varied cholesterol levels, it was noted that at a 1% cholesterol diet, hamsters exhibited a significant reduction in body weight compared to those fed a 0% cholesterol diet. Notably, food intake remained consistent across all diets, suggesting that the observed weight change was not linked to consumption levels. The decrease in body weight could potentially result from the supplementation of 1% cholesterol, which may induce fatty liver, consequently disrupting cholesterol metabolism. Subsequently, heightened lipase activity could facilitate fat breakdown, leading to elevated levels of fatty acids in the plasma and liver. Consequently, adipose tissue reduction ensues, culminating in weight loss. Excessive cholesterol intake also yielded observable declines in weights of adipose, heart, and kidney tissues, alongside an increased liver-to-body weight ratio. Concordantly, a prior study has corroborated cholesterol accumulation in plasma and liver tissues following dietary cholesterol supplementation [
3].
In normal conditions, intestinal cholesterol absorption typically reaches around 55% [
32]. However, as dietary cholesterol intake increases, absorption rates decline, affecting HMG-CoA reductase activity within enterocytes [
33]. While postprandial plasma cholesterol concentrations generally remain stable, prolonged excessive cholesterol intake can disrupt both plasma and hepatic cholesterol levels [
34]. In this study, elevating dietary cholesterol in hamsters correlated with increased plasma total cholesterol and triglyceride levels, consistent with prior findings indicating that dietary cholesterol supplementation raises plasma cholesterol and triglyceride concentrations [
35]. Additionally, plasma phospholipid concentrations rose alongside dietary cholesterol supplementation [
10]. HDL-C concentration increased with cholesterol supplementation up to 0.5%, while LDL-C and VLDL-C concentrations rose steadily. VLDL-triglyceride content initially increased with dietary cholesterol, peaking before decreasing at 1%, likely due to cholesterol accumulation in the liver replacing triglycerides in lipoprotein composition. Cholesterol supplementation can either stimulate or inhibit HDL secretion, with our experiment noting an increase in HDL-C concentration. However, the HDL-C/LDL-C ratio declined with rising cholesterol supplementation, implying an increased risk of cardiovascular disease. Excessive cholesterol intake elevated HDL-C, VLDL-C, and LDL-C concentrations to facilitate cholesterol transport back to the liver for metabolism or synthesis. Notably, dietary cholesterol supplementation significantly inhibited LDL receptor activity, impairing LDL cholesterol metabolism and elevating plasma LDL levels [
36]. Moreover, fecal cholesterol excretion increased with higher cholesterol intake, leading to higher excretion of acidic and neutral sterols [
37]. Concordantly, there was an observed increasing trend in bile acid excretion in hamsters with higher cholesterol intake in this study. Higher cholesterol intake leads to increased bile acid excretion to maintain cholesterol balance in the body [
38].
It has been showcased that both high-fat and low-fat diets supplemented with cholesterol exhibited lower plasma TBARS concentrations compared to their non-supplemented counterparts, with particularly lower levels observed in that of the low-fat diet [
39]. Cholesterol is known as a potential free radical scavenger, positing its antioxidant properties [
40]. Conversely, Gokkusu et al. found higher plasma TBARS concentrations in rats on a high-cholesterol diet, indicating cholesterol may exacerbate oxygen free radical production, potentially fostering arteriosclerosis [
41]. In this study, we observed lower plasma TBARS concentrations in cholesterol-supplemented groups compared to the control group when cholesterol reached or exceeded 0.5%, hinting at potential antioxidant functions in hamster plasma. As dietary cholesterol supplementation increased, observable changes emerged in the liver, suggestive of hepatomegaly or fatty liver development. While no significant difference in AST concentrations was noted among groups, ALT levels rose with escalating cholesterol supplementation, often indicative of liver dysfunction, potentially linked to fatty liver progression [
42]. Hepatic cholesterol accumulation and triglyceride content also increased with dietary cholesterol supplementation, likely stemming from an imbalance between cholesterol intake and hepatic metabolism. It has been proposed that elevated hepatic triglyceride levels could result from increased triglyceride synthesis and reduced VLDL secretion, while hepatic TBARS content decreased with increasing cholesterol supplementation, suggesting that cholesterol addition may mitigate hepatic MDA formation [
35,
39]. Furthermore, GSH, an antioxidant, decreased with cholesterol supplementation, possibly due to cholesterol’s antioxidant properties reducing GSH demand. While no significant differences were noted in kidney TBARS among groups, heart TBARS levels increased with cholesterol supplementation. In the current study, leptin levels decreased with escalating cholesterol supplementation, potentially linked to decreased adipose tissue mass. Remarkably, following cholesterol supplementation, plasma CETP concentrations increased, correlating positively with LDL-C levels. CETP activity likely rises with LDL-C concentration, facilitating cholesterol ester transport in HDL.
Using the ATPIII guidelines as a reference, cholesterol addition below 0.13% maintained ideal plasma cholesterol lower than 200 mg/dL, and that below 0.38% keep plasma LDL-C lower than 100 mg/dL. To induce hypercholesterolemia in animal models for research, several considerations arise, e.g., elevating LDL-C concentration, increasing VLDL-C concentration, inducing hypercholesterolemia with fatty liver, and inducing hypercholesterolemia without excessive cholesterol accumulation in the liver and abnormal VLDL-C excretion. Based on the results of this study, to raise LDL-C, cholesterol can be added up to 0.97%. However, severe cholesterol accumulation in the liver and disrupted VLDL secretion may occur, possibly due to the near-saturation of liver cholesterol leading to elevated cholesterol content in VLDL. This may result from decreased LDL receptor numbers in the liver, perpetuating elevated LDL-C levels [
43]. For elevating VLDL-C concentration without causing secretion abnormalities, cholesterol addition should consider the rate of VLDL-C secretion. A critical point emerged when cholesterol addition reached 0.43%, where hepatic cholesterol accumulation approached a high level while maintaining normal VLDL-C secretion. Consequently, the LDL-C concentration can reach 120 mg/dL, within the normal range according to ATPIII standards. The recommended cholesterol addition to induce hypercholesterolemia without causing abnormalities in liver function and lipoprotein secretion is 0.43%. However, considering the ATPIII LDL-C standard of 190 mg/dL may lead to liver dysfunction and fatty liver formation, adding cholesterol up to 0.97% is necessary to specifically study LDL-C changes.