Vuoristo M, Tilvis R, Miettinen T A
Second Department of Medicine, University of Helsinki, Finland.
Clin Chim Acta. 1988 May 31;174(2):213-24. doi: 10.1016/0009-8981(88)90388-9.
The concentrations of the plant sterols, campesterol and beta-sitosterol in serum, normally correlate with the efficiency of cholesterol absorption, whereas the concentration of lathosterol, a cholesterol precursor sterol, closely parallels changes in cholesterol synthesis. In this study we explored whether the plant sterol concentrations in serum in coeliac disease are determined by cholesterol absorption and whether they alone or with the serum lathosterol concentration, could be used for screening the activity of coeliac disease. In six patients the plant sterol concentrations in serum were significantly lower than in 17 control subjects, the reduction being more marked for campesterol than for beta-sitosterol: the serum lathosterol concentration was significantly higher than in the control subjects. The opposite changes in serum plant sterols and lathosterol were recorded in patients on a gluten-free diet. The plant sterol concentrations in serum (nmol/mg of cholesterol) were positively correlated with each other, and with the percentage absorption of cholesterol and with xylose absorption; they were negatively correlated with faecal fat, but not with faecal plant sterols. Thus, the low plant sterol concentrations in serum in coeliac disease were attributable to their impaired absorption, which in turn was closely associated with the absorption of cholesterol. The serum campesterol concentration clearly distinguished the untreated patients from the controls, whereas the use of serum beta-sitosterol, and the serum ratios of lathosterol/plant sterol resulted in some overlapping with the controls. It is suggested that the plant sterols in serum might be worth of determining when screening patients for coeliac disease and especially when testing their adherence to the gluten-free diet.
血清中植物甾醇、菜油甾醇和β-谷甾醇的浓度通常与胆固醇吸收效率相关，而胆甾烯醇（一种胆固醇前体甾醇）的浓度则与胆固醇合成的变化密切平行。在本研究中，我们探讨了乳糜泻患者血清中植物甾醇浓度是否由胆固醇吸收决定，以及它们单独或与血清胆甾烯醇浓度一起是否可用于筛查乳糜泻的活动。在6名患者中，血清植物甾醇浓度显著低于17名对照受试者，菜油甾醇的降低比β-谷甾醇更明显：血清胆甾烯醇浓度显著高于对照受试者。在采用无麸质饮食的患者中，血清植物甾醇和胆甾烯醇出现了相反的变化。血清中植物甾醇浓度（nmol/毫克胆固醇）相互之间呈正相关，与胆固醇吸收百分比和木糖吸收呈正相关；它们与粪便脂肪呈负相关，但与粪便植物甾醇无关。因此，乳糜泻患者血清中植物甾醇浓度低归因于其吸收受损，而这又与胆固醇吸收密切相关。血清菜油甾醇浓度能清楚地区分未治疗患者和对照，而血清β-谷甾醇以及胆甾烯醇/植物甾醇的血清比值则导致与对照有一些重叠。建议在筛查乳糜泻患者时，尤其是检测他们对无麸质饮食的依从性时，测定血清中的植物甾醇可能是有价值的。
