Phytosterol Esterification is Markedly Decreased in Preterm Infants Receiving Routine Parenteral Nutrition.
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.
Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy.
Sara
S
Savini
Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy.
Alessio
A
Correani
Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy.
Daniele
D
Pupillo
Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy.
Rita
R
D'Ascenzo
Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy.
Chiara
C
Biagetti
Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy.
Adriana
A
Pompilio
Pediatric Research Institute "Città della Speranza", Padua, Italy.
Manuela
M
Simonato
Department of Women's and Children's Health, University of Padua, Padua, Italy.
Giovanna
G
Verlato
Division of Pediatrics, Department of Clinical and Experimental Medical Sciences, University of Udine, Udine, Italy.
Paola
P
Cogo
Department of Dietetics and Clinical Nutrition, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy.
Marina
M
Taus
Department of Dietetics and Clinical Nutrition, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy.
Albano
A
Nicolai
Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy. v.carnielli@univpm.it.|Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Azienda Ospedaliero-Universitaria Ospedali Riuniti, Corridoni street 11, 60123, Ancona, Italy. v.carnielli@univpm.it.
Virgilio Paolo
VP
Carnielli
D000328:Adult; D002779:Cholestasis / Q000378:metabolism*; D002784:Cholesterol / Q000032:analysis / Q000097:blood; D004951:Esterification; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D008297:Male; D010288:Parenteral Nutrition / Q000009:adverse effects / Q000379:methods*; D010840:Phytosterols / Q000032:analysis* / Q000097:blood
D010840:Phytosterols; D002784:Cholesterol
Gas chromatography–mass spectrometry; Parenteral nutrition; Plant sterols; Preterm infants; Sterol metabolism
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