Koivisto P V, Miettinen T A
Second Department of Medicine, University of Helsinki, Finland.
Scand J Clin Lab Invest. 1988 Oct;48(6):501-7. doi: 10.3109/00365518809085764.
To evaluate the value of plasma cholesterol precursor sterols in the detection of bile acid malabsorption we measured these sterols in 14 familial hypercholesterolaemia patients, seven with and seven without an ileal exclusion. In the operated subjects bile acid malabsorption had induced a 4.8-fold increase in cholesterol synthesis, accompanied by a 1.9-5.1-fold increase in the plasma content of the eight cholesterol precursor sterols studied. There was no overlap between the two groups in any of these sterols, when total and free sterols were considered, and only three of the esterified sterols overlapped. The tri- and dimethyl sterols were mostly unesterified, monomethyl sterols modestly esterified and the demethylated sterols, especially desmosterol, were mainly esterified. The plasma lathosterol content segregated most clearly the patients with bile acid malabsorption from the controls. The lowest lathosterol value of the operated patients was 2.5-fold higher than the highest value of the control patients. Because lathosterol is the most abundant of the plasma cholesterol precursor sterols and is relatively easy to quantitate, it is suggested that plasma lathosterol measurement can be used in the detection of bile acid malabsorption.
为评估血浆胆固醇前体甾醇在胆汁酸吸收不良检测中的价值，我们对14名家族性高胆固醇血症患者的这些甾醇进行了测量，其中7名患者进行了回肠切除术，7名未进行。在接受手术的患者中，胆汁酸吸收不良使胆固醇合成增加了4.8倍，同时所研究的8种胆固醇前体甾醇的血浆含量增加了1.9 - 5.1倍。当考虑总甾醇和游离甾醇时，两组在任何一种这些甾醇上均无重叠，仅三种酯化甾醇有重叠。三甲基和二甲基甾醇大多未酯化，单甲基甾醇适度酯化，而去甲基甾醇，尤其是羊毛甾醇，主要为酯化形式。血浆羊毛甾醇含量最清楚地将胆汁酸吸收不良患者与对照组区分开来。接受手术患者的最低羊毛甾醇值比对照患者的最高值高2.5倍。由于羊毛甾醇是血浆胆固醇前体甾醇中含量最丰富且相对易于定量的，因此建议血浆羊毛甾醇测量可用于胆汁酸吸收不良的检测。
