Koivisto P V, Miettinen T A
Second Department of Medicine, University of Helsinki, Finland.
Scand J Clin Lab Invest. 1988 Apr;48(2):193-8. doi: 10.3109/00365518809085412.
A plant sterol, sitosterol, was quantitated in very low density lipoproteins (VLDL), low density lipoproteins (LDL) and high density lipoproteins (HDL) and related to faecal steroids and cholesterol absorption in heterozygous familial hypercholesterolaemia patients with (n = 7) and without ileal bypass (n = 6). The latter had resulted in severe bile acid malabsorption but fractional cholesterol absorption was within low control limits. Serum total and LDL cholesterol and apoprotein B levels were reduced, whereas HDL cholesterol, apoprotein A-I, VLDL and HDL sitosterol concentrations were increased by the ileal exclusion, and the increase in LDL and serum total sitosterol levels was insignificant. In terms of mmol/mol of cholesterol or apoprotein B, however, the LDL and total sitosterol contents were higher in the subjects who had undergone operation. For an unknown reason the sitosterol content increased gradually within the lipoprotein particles from the lighter to the heavier lipoproteins, and the enrichment was similar in the two groups. Dietary sitosterol intake, indicated by faecal sitosterol excretion, was similar in the two groups. The contents of serum total and LDL sitosterol were positively correlated with the dietary sitosterol intake in both groups, and with the fractional cholesterol absorption only in the group not subject to operation. These associations were less consistent for sitosterol contents in other lipoproteins. We conclude that normally the serum sitosterol content reflects cholesterol absorption efficiency even in patients with familial hypercholesterolaemia, provided the dietary sitosterol intake is quite constant. In addition, for unknown reasons ileal exclusion leads to an increased lipoprotein sitosterol content.
对植物甾醇谷甾醇在极低密度脂蛋白（VLDL）、低密度脂蛋白（LDL）和高密度脂蛋白（HDL）中的含量进行了定量分析，并将其与杂合子家族性高胆固醇血症患者（有回肠旁路手术的n = 7例，无回肠旁路手术的n = 6例）的粪便类固醇及胆固醇吸收情况相关联。后者导致了严重的胆汁酸吸收不良，但胆固醇吸收分数仍在较低的控制范围内。回肠切除术使血清总胆固醇和低密度脂蛋白胆固醇以及载脂蛋白B水平降低，而高密度脂蛋白胆固醇、载脂蛋白A-I、极低密度脂蛋白和高密度脂蛋白谷甾醇浓度升高，低密度脂蛋白和血清总谷甾醇水平的升高不显著。然而，就每毫摩尔胆固醇或载脂蛋白B而言，接受手术的受试者的低密度脂蛋白和总谷甾醇含量更高。由于未知原因，谷甾醇含量在脂蛋白颗粒中从较轻的脂蛋白到较重的脂蛋白逐渐增加，且两组中的富集情况相似。两组中通过粪便谷甾醇排泄表明的膳食谷甾醇摄入量相似。两组中血清总谷甾醇和低密度脂蛋白谷甾醇含量均与膳食谷甾醇摄入量呈正相关，仅在未接受手术的组中与胆固醇吸收分数呈正相关。这些关联在其他脂蛋白中的谷甾醇含量方面不太一致。我们得出结论，正常情况下，即使在家族性高胆固醇血症患者中，只要膳食谷甾醇摄入量相当恒定，血清谷甾醇含量就能反映胆固醇吸收效率。此外，由于未知原因，回肠切除术会导致脂蛋白谷甾醇含量增加。
