BChE breaks down ester type of neuromuscular blocking agents used in anesthesia . It may also play a role in lipid metabolism , and may be affected by dietary fat .
Similarly, diabetes mellitus has been shown to alter the levels of the
enzyme. BchE, which can affect cell membrane oxidative stress and
fluidity , is structurally homologous to lipase . The ratio of BChE to HDL cholesterol could be a marker of cardiovascular risk in the metabolic syndrome .
However recent studies have suggested BchE may not have a direct
pathophysiological role in the development of metabolic syndrome , but may be considered as secondary markers for this syndrome in obese individuals with the CHE2 C5- phenotype .
In consonance with earlier studies, level of butyrylcholinesterase was
related to changes in serum lipids; however there was a relationship to
serum triglycerides in a previous study  and to serum cholesterol in ours.
BChE activity could also be used to select the drug for treatment of hypertriglyceridaemia in type 2 diabetes mellitus . Similarly diabetes was one of the risk factors for coronary artery disease that independently correlated with BchE activity .
In the construction of evolutionary trees, the differences in Sus scrofa and Oryctolagus cuniculus was
the only variant in the two methods. The sequences being similar, such
an output is to be expected. Consistent with an earlier report , the genes of the following were close to each other: cow (Bos taurus M62410) and sheep (Ovis aries M62780), pig (Sus scrofa M62778) and dog (Canis familiaris M62411), rabbit (Oryctolagus cuniculus U04814) and house mouse (Mus musculus NM_009599).
Animal BchE gene structure was shown to be similar to the human gene .
The rate of evolution was reported to be rapid, but not more than other
proteins with well-known function. BchE evolution had a 2.2 unit
evolutionary period (ie, 2.2 million years for a 1% amino acid change) .
A broad based phylogenetic synthesis using combined and separate
analysis of published molecular and morphological source phylogenies
showed generally comparable tree structures : tiger, cat and horse together.
Despite the limitations in the study, it establishes proof of
concept that clinical and biochemical parameters can be linked to data
from nucleotide sequences; an evolutionary perspective may be obtained,
especially for proteins with poorly defined physiological functions.
In conclusion we (a) found a negative correlation between serum
total cholesterol and butyrylcholinesterase and between serum LDL
cholesterol in persons with type 2 diabetes (b) generated a
phylogenetic tree from 25 sequences of BchE using distance method (Fitch and Margoliash method) and maximum parsimony method.