Influence of dietary cholesterol on vitamin d metabolism in formula-fed preterm neonates.
OBJECTIVE
Supplementation of preterm formulas with cholesterol could help to mimic the fat composition of human milk. However, this could possibly influence vitamin D 25-hydroxylation because this reaction is catalyzed in part by the mitochondrial cytochrome P-450, the enzyme responsible for the 27-hydroxylation of cholesterol. The purpose of this study was to verify whether the addition of cholesterol to preterm formulas could interfere with vitamin D metabolism in preterm neonates.


METHODS
In a prospective study, 30 preterm neonates were randomly assigned to a low (< 0.03 g/L), medium (0.15 g/L), or high (0.30 g/L) cholesterol-content preterm formula until theoretical term (i.e., 40 weeks post-conceptional age). Anthropometric data and serum hydroxy-vitamin D and 1,25 dihydroxy-vitamin D concentrations were measured at study entry and theoretical term. In a subgroup of 14 subjects, serum cholesterol and lymphocyte 3-hydroxy-3-methylglutaryl coenzyme A reductase mRNA were also assessed.


RESULTS
(median [25, 75 centiles]): At theoretical term, there were no significant differences in serum hydroxy-vitamin D concentrations among the three groups, even after adjustment for confounding variables (65 [50, 78] nmol/L, 79 [59, 86] nmol/L, and 67 [43, 103] nmol/L, respectively, = 0.65) or 1,25 dihydroxy-vitamin D ( = 0.88). Furthermore, there were no significant differences in 3-hydroxy-3-methylglutaryl coenzyme A reductase mRNA copy numbers.


CONCLUSIONS
In preterm neonates fed formulas with a cholesterol content similar to or higher than that of human milk, we did not observe deleterious effects on vitamin D metabolism. However, long-term effects of cholesterol supplementation require further studies.
Department of Neonatology, Human Nutrition Research Center, Hospital E. Herriot, Lyon, France. jc-picaud@chu-montpellier.fr
Jean-Charles
JC
Picaud
Philippe
P
Boucher
Alexandre
A
Lapillonne
Magali
M
Berthouze
Edgar
E
Delvin
Günther
G
Boehm
Oliver
O
Claris
Sophie
S
Laborie
Bernadette
B
Reygrobellet
Helene
H
Lapillonne
Francis H
FH
Glorieux
Bernard L
BL
Salle
D001903:Bottle Feeding; D002784:Cholesterol / Q000097:blood; D002791:Cholesterol, Dietary / Q000008:administration & dosage* / Q000009:adverse effects / Q000378:metabolism; D006801:Humans; D006903:Hydroxymethylglutaryl CoA Reductases / Q000235:genetics; D007225:Infant Food; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature / Q000378:metabolism*; D008895:Milk, Human / Q000737:chemistry; D011446:Prospective Studies; D012333:RNA, Messenger / Q000097:blood; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood / Q000378:metabolism*
D002791:Cholesterol, Dietary; D012333:RNA, Messenger; D014807:Vitamin D; C097949:1,25-dihydroxyvitamin D; D002784:Cholesterol; C104450:25-hydroxyvitamin D; D006903:Hydroxymethylglutaryl CoA Reductases