Restorative proctocolectomy for ulcerative colitis: impact on lipid metabolism and adipose tissue and serum fatty acids.
The aim of this prospective study was to evaluate the changes of the metabolism of circulating and storage lipids in patients with ulcerative colitis after restorative proctocolectomy. Fifteen consecutive patients and 15 sex- and age-matched healthy controls were enrolled. Disease activity, diet, inflammatory parameters, plasma lipoprotein concentrations, and fatty acids (FA) of serum phospholipids and of the subcutaneous adipose tissue were assessed at colectomy and at ileostomy closure. In ulcerative colitis patients, total cholesterol and docosahexaenoic acid were lower than in healthy subjects (p < 0.01 and p < 0.05). The median interval between colectomy and ileostomy closure was 6 (range 2-9) months. During that interval, the inflammatory parameters improved, high-density lipoproteins (HDL) cholesterol increased (p < 0.01), and low-density (LDL) cholesterol decreased (p = 0.01). At ileostomy closure, serum arachidonic acid levels were increased (p = 0.04), whereas serum oleic acid level was decreased (p = 0.02). In this interval, no significant alteration, either in serum n-3 FA precursors or in the FA of subcutaneous adipose tissue, was observed. The increase of serum arachidonic acid after colectomy might suggest a lower utilization for inflammatory process. The reduction of LDL cholesterol is an index of malabsorption probably due to the accelerated transit and to the exclusion of the terminal ileum caused by the covering ileostomy.
Scarpa
Marco
M
Clinica Chirurgica I, Dipartimento di Scienze Chirurgiche e Gastroenterologiche, Policlinico Universitario, University of Padova, Padova, Italy. marcoscarpa73@yahoo.it
Romanato
Giovanna
G
Manzato
Enzo
E
Ruffolo
Cesare
C
Marin
Raffaella
R
Basato
Silvia
S
Zambon
Sabina
S
Filosa
Teresa
T
Zanoni
Silvia
S
Pilon
Fabio
F
Polese
Lino
L
Sturniolo
Giacomo C
GC
D'Amico
Davide F
DF
Angriman
Imerio
I
D000328:Adult; D000368:Aged; D016718:Arachidonic Acid / Q000097:blood; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003093:Colitis, Ulcerative / Q000097:blood / Q000378:metabolism* / Q000601:surgery*; D015525:Fatty Acids, Omega-3 / Q000097:blood / Q000378:metabolism; D005260:Female; D006801:Humans; D007081:Ileostomy; D008297:Male; D008875:Middle Aged; D019301:Oleic Acid / Q000097:blood; D016737:Proctocolectomy, Restorative; D011446:Prospective Studies; D050151:Subcutaneous Fat / Q000378:metabolism*
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D015525:Fatty Acids, Omega-3; D016718:Arachidonic Acid; D019301:Oleic Acid; D002784:Cholesterol