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Phytosterol Esterification is Markedly Decreased in Preterm Infants Receiving Routine Parenteral Nutrition
Authors:Sara Savini  Alessio Correani  Daniele Pupillo  Rita D’Ascenzo  Chiara Biagetti  Adriana Pompilio  Manuela Simonato  Giovanna Verlato  Paola Cogo  Marina Taus  Albano Nicolai  Virgilio Paolo Carnielli
Affiliation:1. , Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy;2. Pediatric Research Institute “Città della Speranza”, Padua, Italy;3. , Department of Women's and Children's Health, University of Padua, Padua, Italy;4. , Division of Pediatrics, Department of Clinical and Experimental Medical Sciences, University of Udine, Udine, Italy;5. , Department of Dietetics and Clinical Nutrition, Azienda Ospedaliero‐Universitaria Ospedali Riuniti, Ancona, Italy;6. , Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Azienda Ospedaliero‐Universitaria Ospedali Riuniti, Ancona, Italy
Abstract:Several studies reported the association between total plasma phytosterol concentrations and the parenteral nutrition‐associated cholestasis (PNAC). To date, no data are available on phytosterol esterification in animals and in humans during parenteral nutrition (PN). We measured free and esterified sterols (cholesterol, campesterol, stigmasterol, and sitosterol) plasma concentrations during PN in 16 preterm infants (500–1249 g of birth weight; Preterm‐PN), in 11 term infants (Term‐PN) and in 12 adults (Adult‐PN). Gas chromatography–mass spectrometry was used for measurements. Plasma concentrations of free cholesterol (Free‐CHO), free phytosterols (Free‐PHY) and esterified phytosterols (Ester‐PHY) were not different among the three PN groups. Esterified cholesterol (Ester‐CHO) was statistically lower in Preterm‐PN than Adult‐PN. Preterm‐PN had significantly higher Free‐CHO/Ester‐CHO and Free‐PHY/Ester‐PHY ratios than Adult‐PN (Free‐CHO/Ester‐CHO: 1.1 ± 0.7 vs. 0.6 ± 0.2; Free‐PHY/Ester‐PHY: 4.1 ± 2.6 vs. 1.3 ± 0.8; *P < 0.05). Free‐CHO/Ester‐CHO and Free‐PHY/Ester‐PHY ratios of Term‐PN (Free‐CHO/Ester‐CHO: 1.1 ± 0.4; Free‐PHY/Ester‐PHY: 2.9 ± 1.7) were not different from either Preterm‐PN or from Adult‐PN. Plasma Free‐CHO/Ester‐CHO and Free‐PHY/Ester‐PHY were unchanged after 24 h on fat‐free PN both in Preterm‐PN and in Adult‐PN. Free‐PHY/Ester‐PHY did not correlate with phytosterol intake in Preterm‐PN. Free‐PHY/Ester‐PHY of Preterm‐PN was positively correlated with the Free‐CHO/Ester‐CHO and negatively correlated with gestational age and birth weight. In conclusion, PHY were esterified to a lesser extent than CHO in all study groups; the esterification was markedly decreased in Preterm‐PN compared to Adult‐PN. The clinical consequences of these findings warrant further investigations.
Keywords:Gas chromatography–mass spectrometry  Parenteral nutrition  Plant sterols  Preterm infants  Sterol metabolism
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