Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6229ER Maastricht, The Netherlands.
Department of Pediatrics, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6229ER Maastricht, The Netherlands.
Nutrients. 2019 Jan 8;11(1):120. doi: 10.3390/nu11010120.
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).
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.
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%.
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.
非胆固醇甾醇是肠道胆固醇吸收（胆甾烷醇）和内源性胆固醇合成（羊毛固醇）的有效标志物。本研究旨在评估暴露于两种不同静脉内脂肪乳剂的儿童的胆固醇合成和吸收标志物，这两种脂肪乳剂在其肠外营养（PN）中迅速改变血清植物甾醇浓度。
使用来自两项不同研究的血清样本：（1）9 例患有与肠衰竭相关肝病（IFALD）的 PN 依赖型儿童，其富含植物甾醇的大豆基脂质（SO）被富含植物甾醇的鱼基脂质（FO）所替代；（2）5 例出生后即开始使用 SO 的新生儿。在第一项研究中，在基线（开始使用 FO 之前）和使用 FO 3 个月和 6 个月时采集样本。在第二项研究中，在出生后 1 周和 3 周时采集样本。
在第一项研究中，转换为 FO 后 6 个月，菜油固醇降低了 7 倍，谷甾醇降低了 12 倍，豆甾醇降低了 15 倍。血清胆固醇浓度没有变化，但胆固醇标准化羊毛固醇增加了（3 倍），胆固醇标准化胆甾烷醇减少了（2 倍）。在第二项研究中，使用 SO 3 周后，谷甾醇和菜油固醇浓度增加了 4-5 倍。与此同时，胆固醇标准化羊毛固醇增加了 69%，胆固醇标准化胆甾烷醇减少了 29%。
根据这些发现，我们得出结论，血清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会影响肠道胆固醇的吸收。
