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J Pediatr Gastroenterol Nutr. 2008 Nov;47(5):645-51. doi: 10.1097/MPG.0b013e318170956a.

Sterol profiling in red blood cell membranes and plasma of newborns receiving total parenteral nutrition.

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  • 1Department of Biochemistry and Medical Biotechnology, University Federico II, Italy.

Abstract

BACKGROUND AND OBJECTIVES:

Total parenteral nutrition (TPN) is a lifesaving therapy in children with intestinal failure, frequently complicated by liver dysfunction. Plant sterols (phytosterols) of lipid emulsions have been supposed to contribute to cholestasis in TPN-treated children. The present study aimed to evaluate the plasma and red blood cell membrane (RBCM) phytosterol levels in newborns after a short period of TPN.

PATIENTS AND METHODS:

Phytosterols, cholesterol, and other sterol levels were quantified by gas chromatography-mass spectrometry in 15 healthy control infants, 22 patients after TPN, and 11 patients before TPN. Sterols of lipid emulsions were quantified.

RESULTS:

Plasma and RBCM phytosterol levels were, respectively, on average 56 micromol/L and 83 micromol/g per protein in patients after TPN, 13 micromol/L and 15 micromol/g per protein in patients before TPN, and 9 micromol/L and 13 micromoL/g per protein in control infants (P < 0.05 for differences). The days of TPN and the total amount of infused lipids correlated significantly with RBCM phytosterol (P < 0.05); correlations for plasma were positive but not significant. No correlation was observed with plasma bilirubin, gamma-glutamyltransferase, or alanine transaminase.

CONCLUSIONS:

Plasma and RBCM phytosterols increase significantly in newborns after a short period of TPN. Higher phytosterol levels were observed in some patients that could have been due to their individual variability in phytosterol metabolism and/or clearance. A greater accumulation of phytosterols in membranes may induce TPN-related cholestasis.

PMID:
18955867
DOI:
10.1097/MPG.0b013e318170956a
[PubMed - indexed for MEDLINE]
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