Division of Neurology, Department of Paediatrics, Hospital for Sick Children, Toronto, ON, Canada.
Department of Radiology and Biomedical Imaging, University of Washington, Seattle, WA, USA.
Pediatr Res. 2019 Feb;85(3):299-304. doi: 10.1038/s41390-018-0260-0. Epub 2018 Dec 20.
To assess whether postnatal plasma cholesterol levels are associated with microstructural and macrostructural regional brain development in preterm newborns.
Sixty preterm newborns (born 24-32 weeks gestational age) were assessed using MRI studies soon after birth and again at term-equivalent age. Blood samples were obtained within 7 days of each MRI scan to analyze for plasma cholesterol and lathosterol (a marker of endogenous cholesterol synthesis) levels. Outcomes were assessed at 3 years using the Bayley Scales of Infant Development, Third Edition.
Early plasma lathosterol levels were associated with increased axial and radial diffusivities and increased volume of the subcortical white matter. Early plasma cholesterol levels were associated with increased volume of the cerebellum. Early plasma lathosterol levels were associated with a 2-point decrease in motor scores at 3 years.
Higher early endogenous cholesterol synthesis is associated with worse microstructural measures and larger volumes in the subcortical white matter that may signify regional edema and worse motor outcomes. Higher early cholesterol is associated with improved cerebellar volumes. Further work is needed to better understand how the balance of cholesterol supply and endogenous synthesis impacts preterm brain development, especially if these may be modifiable factors to improve outcomes.
评估早产儿产后血浆胆固醇水平与脑微结构和脑宏观结构区域发育之间的关系。
对 60 名早产儿（胎龄 24-32 周）进行 MRI 检查，分别在出生后和足月时进行。在每次 MRI 扫描后 7 天内采集血样，以分析血浆胆固醇和羊毛固醇（内源性胆固醇合成的标志物）水平。在 3 岁时使用贝利婴幼儿发展量表第三版评估结果。
早期血浆羊毛固醇水平与轴突和放射状扩散增加以及皮质下白质体积增加有关。早期血浆胆固醇水平与小脑体积增加有关。早期血浆羊毛固醇水平与 3 岁时运动评分降低 2 分有关。
较高的早期内源性胆固醇合成与微结构测量较差和皮质下白质体积较大有关，这可能表明存在区域性水肿和运动结局较差。较高的早期胆固醇与改善的小脑体积有关。需要进一步研究以更好地了解胆固醇供应和内源性合成的平衡如何影响早产儿的大脑发育，特别是如果这些因素是可以改变的，以改善结局。
