Nikkilä K, Riikonen S, Lindfors M, Miettinen T A
Jorvi Hospital, Espoo, Finland.
J Lipid Res. 1996 Dec;37(12):2687-95.
Mechanisms of hyperlipidemia were studied by measurement of serum lipid concentrations and the ratios of cholesterol precursors (squalene, delta 8-cholestenol, desmosterol, and lathosterol), plant sterols (campesterol and sitosterol), and cholestanol (a 5 alpha-derivative of cholesterol) to cholesterol in nonpregnant women, and normal and cholestatic pregnancies near term, and a few days and 6 weeks after delivery. The ratios of the precursors are known to reflect cholesterol synthesis, those of plant sterols and cholestanol the absorption efficiency and biliary sterol secretion of cholesterol. In normal pregnancy, increased serum cholesterol was associated with up to 2-fold increases in squalene, desmosterol, and lathosterol proportions, and the values remained elevated, especially for desmosterol, during the lactation period. These findings suggest that pregnancy and lactation are associated with increased cholesterol synthesis. The proportions of plant sterols were slightly lower, but that of cholestanol was 2-fold that of the nonpregnant women. In contrast to the latter group, the cholestanol proportions were not related to those of plant sterols or the campesterol/sitosterol ratio. The values, especially of cholestanol, became normal during lactation. In cholestatic pregnancy the changes were basically similar, but the serum values of delta 8-cholestenol increased more, and those of squalene, desmosterol and lathosterol less markedly, and the mean cholestanol proportion was 40% higher and the campesterol/sitosterol ratio 15% lower than in the normal pregnancy. Cholestanol was positively related to serum bilirubin and bile acids in cholestatic pregnancy, yet only one-third of the cholestatic pregnant women exhibited cholestanol values higher than in the healthy pregnant women.
通过测量非孕妇、足月正常妊娠和胆汁淤积性妊娠妇女以及产后几天和6周的血清脂质浓度，以及胆固醇前体（角鲨烯、δ8-胆甾烯醇、羊毛甾醇和粪甾醇）、植物甾醇（菜油甾醇和谷甾醇）和胆甾烷醇（胆固醇的5α-衍生物）与胆固醇的比率，研究了高脂血症的机制。已知前体的比率反映胆固醇合成，植物甾醇和胆甾烷醇的比率反映胆固醇的吸收效率和胆汁甾醇分泌。在正常妊娠中，血清胆固醇升高与角鲨烯、羊毛甾醇和粪甾醇比例增加高达2倍有关，并且这些值在哺乳期仍保持升高，尤其是羊毛甾醇。这些发现表明妊娠和哺乳与胆固醇合成增加有关。植物甾醇的比例略低，但胆甾烷醇的比例是非孕妇的2倍。与后一组不同，胆甾烷醇的比例与植物甾醇的比例或菜油甾醇/谷甾醇比率无关。这些值，尤其是胆甾烷醇的值，在哺乳期恢复正常。在胆汁淤积性妊娠中，变化基本相似，但δ8-胆甾烯醇的血清值升高更多，角鲨烯、羊毛甾醇和粪甾醇的血清值升高不明显，胆甾烷醇的平均比例比正常妊娠高40%，菜油甾醇/谷甾醇比率比正常妊娠低15%。在胆汁淤积性妊娠中，胆甾烷醇与血清胆红素和胆汁酸呈正相关，但只有三分之一的胆汁淤积性孕妇的胆甾烷醇值高于健康孕妇。
