title: Kinetics of phytosterol metabolism in neonates receiving parenteral nutrition.
abstract: BACKGROUND
  Phytosterols in soybean oil (SO) lipids likely contribute to parenteral nutrition-associated liver disease (PNALD) in infants. No characterization of phytosterol metabolism has been done in infants receiving SO lipids.
  
  
  METHODS
  In a prospective cohort study, 45 neonates (36 SO lipid vs. 9 control) underwent serial blood sample measurements of sitosterol, campesterol, and stigmasterol. Mathematical modeling was used to determine pharmacokinetic parameters of phytosterol metabolism and phytosterol exposure.
  
  
  RESULTS
  Compared to controls, SO lipid-exposed infants had significantly higher levels of sitosterol and campesterol (P < 0.01). During SO lipid infusion, sitosterol and campesterol reached half of steady-state plasma levels within 1.5 and 0.8 d, respectively. Steady-state level was highest for sitosterol (1.68 mg/dl), followed by campesterol (0.98 mg/dl), and lowest for stigmasterol (0.01 mg/dl). Infants born < 28 wk gestational age had higher sitosterol steady-state levels (P = 0.03) and higher area under the curve for sitosterol (P = 0.03) during the first 5 d of SO lipid (AUC5) than infants born ≥ 28 wk gestational age.
  
  
  CONCLUSIONS
  Phytosterols in SO lipid accumulate rapidly in neonates. Very preterm infants receiving SO lipid have higher sitosterol exposure, and may have poorly developed mechanisms of eliminating phytosterols that may contribute to their vulnerability to PNALD.
authors.affiliation: Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: T Hang
authors.initials: TH
authors.lastname: Nghiem-Rao
authors.affiliation: Bioinformatics and Systems Biology, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Ilker
authors.initials: I
authors.lastname: Tunc
authors.affiliation: Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Alisha M
authors.initials: AM
authors.lastname: Mavis
authors.affiliation: Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Yumei
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Department of Clinical Nutrition, Children's Hospital of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Polzin
authors.affiliation: Department of Pharmacy, Children's Hospital of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Mary F
authors.initials: MF
authors.lastname: Firary
authors.affiliation: Bioinformatics and Systems Biology, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Xujing
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Pippa M
authors.initials: PM
authors.lastname: Simpson
authors.affiliation: 1] Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin [2] Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin.
authors.forename: Shailendra B
authors.identifier: 0000000300465513
authors.initials: SB
authors.lastname: Patel
mesh_terms: D005260:Female; D006207:Half-Life; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010288:Parenteral Nutrition; D010840:Phytosterols / Q000493:pharmacokinetics*; D011446:Prospective Studies
chemical_list: D010840:Phytosterols