Modifying Serum Plant Sterol Concentrations: Effects on Markers for Whole Body Cholesterol Metabolism in Children Receiving Parenteral Nutrition and Intravenous Lipids
Modifying Serum Plant Sterol Concentrations: Effects on Markers for Whole Body Cholesterol Metabolism in Children Receiving Parenteral Nutrition and Intravenous Lipids
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DOI：
10.3390/nu11010120
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发表时间：
2019-01-01
期刊：
影响因子：
5.9
通讯作者：
Mensink, Ronald P.
中科院分区：
文献类型：
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作者：
Plat, Jogchum;Baumgartner, Sabine;Mensink, Ronald P.
背景资料：非胆固醇甾醇是肠道胆固醇吸收分数（胆甾烷醇）和内源性胆固醇合成（脂甾醇）的有效标志物。本研究的目的是评价暴露于两种不同静脉注射脂肪乳剂（作为肠外营养（PN）的一部分，可快速改变血清植物甾醇浓度）的儿童的胆固醇合成和吸收标志物。研究方法：使用了来自两项不同研究的血清样本：（1）9名患有肠衰竭相关性肝病（IFALD）的PN依赖儿童，其大豆为基础的富含植物甾醇的脂质（SO）被替换为鱼类为基础的植物甾醇贫乏（FO）脂质;（2）5名出生后开具SO处方的新生儿。在第一项研究中，在基线（开始FO前）和FO 3个月和6个月后采集样本。在研究2中，在1周龄和3周龄时收集样品。结果如下：在研究1中，在转换为FO后6个月，观察到菜油甾醇减少7倍，谷甾醇减少12倍，豆甾醇减少15倍。血清胆固醇浓度没有变化，但胆固醇标准化的胆甾醇增加（3倍）和胆固醇标准化的胆甾烷醇减少（2倍）。在研究2中，SO 3周后，谷甾醇和菜油甾醇浓度增加4-5倍。与此同时，胆固醇标准化的胆甾醇增加了69%，胆固醇标准化的胆固醇减少了29%。结论：基于这些发现，我们得出结论，血清中植物甾醇浓度的变化可能对内源性胆固醇合成有直接影响，但这需要在未来的研究中得到证实。此外，我们推测，这种改变的合成随后影响肠道胆固醇吸收。
Background: Non-cholesterol sterols are validated markers for fractional intestinal cholesterol absorption (cholestanol) and endogenous cholesterol synthesis (lathosterol). This study's objective was to evaluate markers for cholesterol synthesis and absorption in children exposed to two different intravenous lipid emulsions that rapidly change serum plant sterol concentrations as part of their parenteral nutrition (PN). Methods: Serum samples from two different studies were used: (1) nine PN-dependent children with intestinal failure associated liver disease (IFALD) whose soy-based, plant sterol-rich lipid (SO) was replaced with a fish-based, plant sterol-poor (FO) lipid; and (2) five neonates prescribed SO after birth. In the first study, samples were collected at baseline (prior to FO initiation) and after 3 and 6 months of FO. In study 2, samples were collected at 1 and 3 weeks of age. Results: In study 1, a 7-fold reduction in campesterol, a 12-fold reduction in sitosterol, and a 15-fold reduction in stigmasterol was observed 6 months after switching to FO. Serum cholesterol concentrations did not change, but cholesterol-standardized lathosterol increased (3-fold) and cholesterol-standardized cholestanol decreased (2-fold). In study 2, after 3 weeks of SO, sitosterol and campesterol concentrations increased 4-5 fold. At the same time, cholesterol-standardized lathosterol increased 69% and cholesterol-standardized cholestanol decreased by 29%. Conclusion: Based on these finding we conclude that changes in serum plant sterol concentrations might have direct effects on endogenous cholesterol synthesis, although this needs to be confirmed in future studies. Moreover, we speculate that this changed synthesis subsequently affects intestinal cholesterol absorption.