High cholesterol in exceptionally thin people may be associated with genetic factors, poor lifestyle, endogenous abnormalities of lipid metabolism, and secondary cholesterol elevation. High cholesterol in especially thin people may be related to familial hereditary hypercholesterolemia. Secondly, it may be related to poor lifestyle, often staying up late, excessive mental stress, smoking and drinking, often eating high-fat and high-calorie foods, and lack of exercise for a long period of time may lead to elevated cholesterol. Elevated cholesterol may be associated with abnormal lipid metabolism in the body, and abnormal endogenous lipid metabolism may also lead to high cholesterol in particularly thin people. Secondary conditions such as nephrotic syndrome may also lead to elevated cholesterol. When there is a significant elevation of cholesterol, it is important to seek prompt medical attention and rational treatment under the guidance of a doctor.