Familial Hypercholesterolemia may offer a slight protective advantage in cases of infection and diabetes.

“in fact FH maybe slightly protective in the case of an infection and in the case of diabetes and one argument for that via diabetes one's a little hard to explain the infection one FH has stuck around for a long time so there may have been a time when having the ability to mount an incredible immune response would have proved to have a survival advantage right and if you have four times the cholesterol of somebody else that's one moment in when that could come at a huge advantage right which gets back to the immunological response sugar”