title: Half-life of plasma phytosterols in very low birth weight preterm infants on routine parenteral nutrition with vegetable oil-based lipid emulsions.
abstract: Phytosterols in vegetable oil (VO)-based lipid emulsions (LE) likely contribute to parenteral nutrition-associated cholestasis (PNAC) in preterm infants. No characterization of plasma phytosterol half-lives has been done in very low birth weight (VLBW) preterm infants receiving parenteral nutrition (PN) with LE.
  
  
  
  In a prospective cohort study, 45 VLBW preterm infants who received PN underwent serial blood sample measurements of sitosterol (SITO), campesterol (CAMP), and stigmasterol (STIGM). Plasma phytosterol half-lives were calculated from the phytosterol concentrations-decay curves by using a single-compartment model.
  
  
  
  After the stop of the intravenous LE, study infants had significantly lower plasma total CAMP, STIGM and SITO concentrations. The decay of plasma phytosterol concentrations was monoexponential. Half-life of plasma total CAMP, STIGM and SITO was 13.5 ± 6.9, 10.3 ± 4.5 and 10.3 ± 4.0 days, respectively. Plasma phytosterol half-lives did not correlate with gestational age, birth weight, cumulative phytosterol intakes and plasma conjugated bilirubin.
  
  
  
  VLBW preterm infants on PN with LE had rather long plasma phytosterol half-lives similar to hypercholesterolemic adults and phytosterolemic homozygotes patients. We speculate that the accumulation of phytosterols could contribute to their vulnerability to PNAC.
  
  
  
  The Ethics Committee of Marche-Italy (DG/469); www.clinicaltrials.gov (identification number NCT02758834).
authors.affiliation: Division of Neonatology, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Pupillo
authors.affiliation: Division of Neonatology, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy. Electronic address: a.correani@pm.univpm.it.
authors.forename: Alessio
authors.initials: A
authors.lastname: Correani
authors.affiliation: Division of Neonatology, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Biagetti
authors.affiliation: Division of Neonatology, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: D'Ascenzo
authors.affiliation: Pediatric Research Institute "Città della Speranza", Padua, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Simonato
authors.affiliation: Department of Women's and Children's Health, University of Padua, Padua, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Verlato
authors.affiliation: Department of Experimental and Clinical Medicine, University of Udine, Udine, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Cogo
authors.affiliation: Department of Biomolecular Sciences, University of Urbino "Carlo Bo", Urbino, Italy.
authors.forename: Marco B L
authors.initials: MBL
authors.lastname: Rocchi
authors.affiliation: Division of Neonatology, Polytechnic University of Marche and Salesi Children's Hospital, Ancona, Italy.
authors.forename: Virgilio P
authors.initials: VP
authors.lastname: Carnielli
mesh_terms: D001724:Birth Weight; D015331:Cohort Studies; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000097:blood / Q000378:metabolism; D008297:Male; D010289:Parenteral Nutrition, Total / Q000379:methods*; D010840:Phytosterols / Q000097:blood / Q000378:metabolism / Q000493:pharmacokinetics; D010938:Plant Oils / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D011446:Prospective Studies
chemical_list: D005217:Fat Emulsions, Intravenous; D010840:Phytosterols; D010938:Plant Oils
keywords: Parenteral nutrition; Plant sterols; Preterm infants; Sterol metabolism