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Phytosterol Esterification is Markedly Decreased in Preterm Infants Receiving Routine Parenteral Nutrition

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Lipids

Abstract

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.

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Abbreviations

ACAT:

Acyl-CoA cholesterol acyltransferase

Adult-PN:

Adults on PN

CAMP:

Campesterol

CHO:

Cholesterol

Ester:

Esterified

IV:

Intravenous

LCAT:

Lecithin cholesterol acyltransferase

LE:

Lipid emulsion

NICU:

Neonatal intensive care unit

PHY:

Phytosterols

PN:

Parenteral nutrition

PNAC:

Parenteral nutrition-associated cholestasis

Preterm-PN:

Preterm infants on PN

SITO:

Sitosterol

SO:

Soybean oil

STIGM:

Stigmasterol

Term-PN:

Term infants on PN

Δ:

Difference

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Acknowledgments

The authors are grateful to the infants’ parents, to the NICU staff and to the adults of the Department of Dietetics and Clinical Nutrition. There are no conflicts of interest to declare. There were 12 authors who contributed to the work. We report below the contribution of each author: VPC was responsible for the design of the study; SS, AC, DP, MS and AP contributed to data collection and analysis; RD, GV, CB, MT and AN contributed to subject recruitment and data collection; PEC was in charge of the statistical analysis. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Salesi Children’s Hospital, Ancona, Italy

    Sara Savini, Alessio Correani, Daniele Pupillo, Rita D’Ascenzo, Chiara Biagetti, Adriana Pompilio & Virgilio Paolo Carnielli

  2. Pediatric Research Institute “Città della Speranza”, Padua, Italy

    Manuela Simonato

  3. Department of Women’s and Children’s Health, University of Padua, Padua, Italy

    Giovanna Verlato

  4. Division of Pediatrics, Department of Clinical and Experimental Medical Sciences, University of Udine, Udine, Italy

    Paola Cogo

  5. Department of Dietetics and Clinical Nutrition, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy

    Marina Taus & Albano Nicolai

  6. Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Azienda Ospedaliero-Universitaria Ospedali Riuniti, Corridoni street 11, 60123, Ancona, Italy

    Virgilio Paolo Carnielli

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  1. Sara Savini
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Correspondence to Virgilio Paolo Carnielli.

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Savini, S., Correani, A., Pupillo, D. et al. Phytosterol Esterification is Markedly Decreased in Preterm Infants Receiving Routine Parenteral Nutrition. Lipids 51, 1353–1361 (2016). https://doi.org/10.1007/s11745-016-4197-y

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  • DOI: https://doi.org/10.1007/s11745-016-4197-y

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