Objective:To analyze the effect of Xuezhikang on the markers of the serum lipid levels of cholesterol synthesis and absorption in early menopausal women with hypercholesterolemia,and preliminarily explore its lipid-lowering mechanism.Methods:A total of 90 early menopausal women with hypercholesterolemia were enrolled from December,2014 to May,2016 from Beijing Anzhen Hospital,Capital Medical University,who were randomly allocated to receive Xuezhikang(1200 mg/d,orally)or atorvastatin(10 mg/d,orally)according to a random number table.Serum levels of some related biomarkers,including cholesterol synthesis markers(squalene,dihydrocholesterol,dehydrocholesterol,and lathosterol),and absorption markers(campesterol,stigmasterol,and sitosterol)as well as safety indices were obtained at baseline and after 8 weeks of the intervention.Results:Eight weeks after treatment,both Xuezhikang and atorvastatin significantly reduced the levels of total cholesterol,triglycerides,low density cholesterol compared to baseline(all P＜0.01).Xuezhikang significantly reduced the levels of squalene,dehydrocholesterol and lathosterol compared to baseline(all P＜0.01),but atorvastatin only significantly reduced the level of squalene(P＜0.01),compared to baseline.All cholesterol absorption markers showed no significant differences before and after treatment(P＞0.05),however,a more obvious downward trend was shown in the Xuezhikang group.In addition,all the safety indices showed no significant differences between the two groups.Although the creatinekinase level in the Xuezhikang group was significantly higher,it remained within the safe range.Conclusions:Xuezhikang may have more comprehensive effects on the markers of cholesterol synthesis and metabolism in early menopausal women with hypercholesterolemia through ergosterol and flavonoids in its“natural polypill.”