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Cholesterol metabolism in active Crohn's disease

Cholesterin-Stoffwechsel bei aktivem Morbus Crohn

Zusammenfassung

Erniedrigte Cholesterin-Spiegel gelten als typisches Merkmal einer schweren Erkrankung und sind mit einer schlechten Prognose vergesellschaftet. Der Morbus Crohn ist eine entzündliche Erkrankung, die mit verschiedenen Störungen des Stoffwechsels einhergeht. In den vergangenen Dekaden haben verschiedene klinische Studien einen Zusammenhang zwischen dem Lipidstoffwechsel und der systemischen Entzündung etabliert. In unserer Studie haben wir nicht nur das Cholesterin-Profil (Cholesterin, LDL und HDL Cholesterin) im Plasma bestimmt, sondern auch Veränderungen im Cholesterin-Absorptions- beziehungsweise -Synthese-Prozess durch Bestimmung der Konzentrationen der Nicht-Cholesterin-Sterole im Serum untersucht. Die Plasmakonzentrationen des Gesamtcholesterins, des LDL- und HDL-Cholesterins sowie der Nicht-Cholesterin-Sterole (Squalene, Lathosterol, Campesterol, Sitosterol) wurden bei 24 Patienten mit aktivem Morbus Crohn in einer Zeitspanne von 28 Tagen erhoben. Die Plasmakonzentrationen des Gesamtcholesterins (p < 0,001) und des LDL-, und HDL-Cholesterins (p < 0,05) waren signifikant niedriger als die bei Kontrollpersonen erhobenen Werte. Im Vergleich zur Kontrolle hatten die Patienten mit aktivem Morbus Crohn signifikant niedrigere Plasmaspiegel von Lathosterol (p < 0,001) mit gleichzeitig nicht signifikant erhöhten Konzentrationen von Squalene. Die Campesterol-Plasmakonzentrationen waren signifikant (p < 0,001) erniedrigt. Sitosterol auch – aber nicht signifikant. Die aktive Phase des Morbus Crohn ist durch Veränderungen des Lipidstoffwechsels – vor allem von Cholesterin – gekennzeichnet. Unsere Ergebnisse zeigen Plasmakonzentrationen der Nicht-Cholesterin-Sterole außerhalb der Norm und sprechen dafür, dass die Cholesterin-Synthese und -Absorption beim aktiven Morbus Crohn verändert ist.

Summary

Hypocholesterolemia has been investigated as a typical feature of critical illness and is connected with poor prognosis. Crohn's disease is an inflammatory process and is associated with several metabolic disturbances. In recent decades clinical studies have established a link between lipid metabolism and systemic inflammation. In our study we examined the serum profile of cholesterol (total cholesterol, LDL- and HDL-cholesterol) and changes in the cholesterol absorption/synthesis process by determination of plasma non-cholesterol sterol (squalene, lathosterol, campesterol, sitosterol) concentrations. Serum concentrations of total cholesterol, LDL- and HDL-cholesterol and non-cholesterol sterols were evaluated in 24 patients with active Crohn's disease during a period of 28 days. We detected lower serum levels of total cholesterol (P < 0.001), LDL- and HDL-cholesterol (P < 0.05) in the patients with active Crohn's disease than in the control group. In addition, the patients had significantly lower plasma levels of lathosterol (P < 0.001) and higher concentrations of squalene, although without significant differences. A significant decrease of campesterol plasma levels (P < 0.001) was detected, but lower plasma concentrations of sitosterol were without statistical significance. The active phase of Crohn's disease is characterized by altered metabolism of lipids, mainly of cholesterol. Our results show abnormalities in plasma concentrations of non-cholesterol sterols and provide evidence that the process of cholesterol synthesis and absorption is altered in active Crohn's disease.

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Correspondence to Vladimír Hrabovský.

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Hrabovský, V., Zadák, Z., Bláha, V. et al. Cholesterol metabolism in active Crohn's disease. Wien Klin Wochenschr 121, 270 (2009). https://doi.org/10.1007/s00508-009-1150-6

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Keywords

  • Crohn's disease
  • Lipids
  • Cholesterol
  • Hypocholesterolemia
  • Non-cholesterol sterols