Skip to main content
SpringerLink
Log in

Absorption, excretion, and distribution of plant sterols after proximal gut resection and autotransplantation of porcine ileum

  • Published:
Lipids

Abstract

Contribution of different gut segments to plant sterol absorption, adaptation of plant sterol absorption after partial small bowel resection, and effects of gut transplantation (necessitates extrinsic autonomic denervation and lymphatic disruption) on plant sterol biodynamics are unclear. We studied the consequences of massive proximal small bowel resection and autotransplantation of the remaining ileum on the adaptive absorption and biodynamics of plant sterols. Dietary, fecal, biliary, hepatic and plasma plant sterols, fecal elimination and absorption of cholesterol, small bowel morphology, and intestinal transit were determined before (n=5) and at 4, 8, and 14 wk after resection of the proximal 75% of the jejunoileum (n=15) and autotransplantation of the remaining ileum (n=15) or transection (n=5). Proximal gut resection significantly reduced cholesterol absorption efficiency; percentage absorption and biliary secretion of plant sterols; plasma, biliary and hepatic campesterol-to-cholesterol proportions; and sitosterol proportions in plasma and bile. Autotransplantation of the remaining ileum further significantly decreased cholesterol absorption efficiency; percentage absorption and biliary secretion of campesterol; campesterol proportions in plasma, bile and liver; and plasma proportions of sitosterol while increasing fecal excretion of neutral and acidic steroids. Plasma proportions of the two plant sterols, but absorption of just campesterol, were gradually improved with increasing cholesterol absorption and villus height after proximal gut resection; the same result was observed to a lesser degree after ileal autotransplantation. In addition, significant positive correlations were found between percentage cholesterol and campesterol absorption and the plasma plant sterol proportions in both proximal resection groups, between campesterol absorption and ileal villus height in the resection group, and between campesterol absorption and intestinal transit time in the autotransplantation group. In conclusion, plasma campesterol and sitosterol closely reflect absorption of cholesterol and plant sterols from intact and autotransplanted ileum during adaptation to proximal gut resection. A loss of proximal gut absorptive surface impairs cholesterol and campesterol absorption more than sitosterol absorption, the later being apparently less dependent on available jejunal villus surface area.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Heinemann, T., Axtman, G., and Von Bergman, K. (1993) Comparison of Intestinal Absorption of Cholesterol with Different Plant Sterols in Man, Eur. J. Clin. Invest. 23, 827–831.

    Article  PubMed  CAS  Google Scholar 

  2. Bhattacharyya, A.K. (1981) Uptake and Esterification of Plant Sterols by Rat Small Intestine, Am. J. Physiol. 240, G50-G55.

    PubMed  CAS  Google Scholar 

  3. Ikeda, K., Tanaka, K., Sugano, M., Vahouny, G.V., and Gallo, L.L. (1988) Discrimination of Cholesterol and Sitosterol Absorption in Rats, J. Lipid Res. 29, 1583–1591.

    PubMed  CAS  Google Scholar 

  4. Salen, G., Ahrens, E.H., and Grundy, S.M. (1970) Metabolism of β-Sitosterol in Man, J. Clin. Invest. 49, 952–967.

    PubMed  CAS  Google Scholar 

  5. Tavani, D.M., Nes, W.R., and Billheimer, J.T. (1982) The Sterol Substrate Specificity of Acyl CoA: Cholesterol Acyltransferase from Rat Liver, J. Lipid Res. 23, 774–781.

    PubMed  CAS  Google Scholar 

  6. Tilvis, R.S., and Miettinen, T.A. (1986) Serum Plant Sterols and Their Relation to Cholesterol Absorption, Am. J. Clin. Nutr. 43, 92–97.

    PubMed  CAS  Google Scholar 

  7. Miettinen, T.A., Tilvis, R.S., and Kesäniemi, A. (1990) Serum Plant Sterols and Cholesterol Precursors Reflect Cholesterol Absorption and Synthesis in Volunteers of a Randomly Selected Male Population, Am. J. Epidemiol. 131, 20–31.

    PubMed  CAS  Google Scholar 

  8. Vuoristo, M., Tilvis, R., and Miettinen, T.A. (1988) Serum Plant Sterols and Lathosterol Related to Cholesterol Absorption in Coeliac Disease, Clin. Chim. Acta 174, 213–224.

    Article  PubMed  CAS  Google Scholar 

  9. Färkkilä, M.A., Tilvis, R.S., and Miettinen, T.A. (1988) Regulation of Plasma Plant Sterol Levels in Patients with Gut Resections, Scand. J. Clin. Lab. Invest. 48, 715–722.

    PubMed  Google Scholar 

  10. Borgström, B. (1960) Studies on Intestinal Cholesterol Absorption in the Human, J. Clin. Invest. 39, 809–815.

    PubMed  Google Scholar 

  11. Sylvén, C., and Nordström, C. (1970) The Site of Absorption of Cholesterol and Sitosterol the Rat Small Intestine, Scand. J. Gastroenterol. 5, 57–63.

    PubMed  Google Scholar 

  12. Williamson, R.C., and Chir, M. (1978) Intestinal Adaptation. Structural, Functional and Cytokinetic Changes, New Engl. J. Med. 298, 1393–1402.

    Article  PubMed  CAS  Google Scholar 

  13. Thompson, J.S., Rose, S.G., Spanta, A.D., and Quigley, E.M. (1992) The Long-term Effects of Jejunoileal Autotransplantation on Intestinal Function, Surgery 111, 62–68.

    PubMed  CAS  Google Scholar 

  14. Oishi, A.J., and Sarr, M.G. (1995) Intestinal Transplantation: Effects on Ileal Enteric Physiology, Surgery 117, 545–553.

    Article  PubMed  CAS  Google Scholar 

  15. Pakarinen, M.P., Miettinen, T.A., Kuusanmäki, P., and Halttunen, J. (1996) Cholesterol Absorption and Synthesis After Autotransplantation of Porcine Ileum, Surgery 120, 822–830.

    Article  PubMed  CAS  Google Scholar 

  16. Pakarinen, M., Kuusanmäki, P., and Halttunen, J. (1996) Ileal Nutritional Function After One-stage Orthotopic Ileum Transplantation in the Growing Pig: Reversal of Lethal Short Bowel Syndrome, J. Pediatr. Surg. 31, 686–694.

    Article  PubMed  CAS  Google Scholar 

  17. Crouse, J.R., and Grundy, S.M. (1978) Evaluation of a Continuous Isotope Feeding Method for Measurement of Cholesterol Absorption in Man, J. Lipid Res. 19, 967–971.

    PubMed  CAS  Google Scholar 

  18. Miettinen, T.A., Ahrens, E.H., and Grundy, S.M. (1965) Quantitative Isolation and Gas-Liquid Chromatographic Analysis of Total Dietary and Fecal Neutral Steroids, J. Lipid Res. 6, 411–424.

    PubMed  CAS  Google Scholar 

  19. Grundy, S.M., Ahrens, E.H., and Miettinen, T.A. (1965) Quantitative Isolation and Gas-Liquid Chromatographic Analysis of Total Fecal Bile Acids, J. Lipid Res. 6, 397–410.

    PubMed  CAS  Google Scholar 

  20. Miettinen, T.A. (1982) Gas-Liquid Chromatographic Determination of Fecal Neutral Sterols Using a Capillary Column, Clin. Chim. Acta 124, 245–248.

    Article  PubMed  CAS  Google Scholar 

  21. Bolin, D.W., King, R.P., and Klosterman, E.H. (1952) A Simplified Method for Determination of Chromic Oxide (Cr2O3) When Used as an Index Substance, Science 116, 634–635.

    Article  PubMed  CAS  Google Scholar 

  22. Miettinen, T.A. (1970) Detection of Changes in Human Cholesterol Metabolism, Ann. Clin. Res. 2, 300–320.

    PubMed  CAS  Google Scholar 

  23. Miettinen, T.A., and Koivisto, P. (1983) Non-cholesterol Sterols and Bile Acid Production in Hypercholesterolaemic Patients with Ileal Bypass, in Bile Acids and Cholesterol in Health and Disease (Paumgartner, G., Stiehl, A., and Gerok, W., eds.) pp. 183–187, MTP, Lancaster.

    Google Scholar 

  24. Miettinen, T.A. (1988) Cholesterol Metabolism During Ketoconazole Treatment in Man, J. Lipid Res. 29, 43–51.

    PubMed  CAS  Google Scholar 

  25. Miettinen, T.A. (1978) Hyperlipidemia, Bile Acid Metabolism and Gallstones, Ital. J. Gastroenterol. 10 Suppl. 1, 53–55.

    Google Scholar 

  26. Boberg, K.M., Lund, E., Ölund, J., and Björkhem, I. (1990) Formation of C21 Bile Acids from Plant Sterols in the Rat J. Biol. Chem. 265, 7967–7975.

    PubMed  CAS  Google Scholar 

  27. Grundy, S.M., and Mok, H.Y. (1977) Determination of Cholesterol Absorption in Man by Intestinal Perfusion, J. Lipid Res. 18, 263–271.

    PubMed  CAS  Google Scholar 

  28. Vahouny, G.V., Connor, W.E., Subramaniam, S., Lin, D.S., and Gallo, L.L. (1983) Comparative Lymphatic Absorption of Sitosterol, Stigmasterol, and Fucosterol and Differential Inhibition of Cholesterol Absorption, Am. J. Clin. Nutr. 37, 805–809.

    PubMed  CAS  Google Scholar 

  29. Pond, W.G. (1991) Of Pigs and People, in Swine Nutrition (Miller, E.R., Ullrey, D.E., and Lewis, A.J., eds.) pp. 3–23, Buttenworth-Heinemann, Boston.

    Google Scholar 

  30. Fidge, N. (1973) The Isolation and Properties of Pig Plasma Lipoproteins and Partial Characterisation of Their Apoproteins, Biochim. Biophys. Acta 295, 258–273.

    PubMed  CAS  Google Scholar 

  31. Huff, M., Telford, D.E., Woodcroft, K., and Strong, W.L. (1985) Mevinolin and Cholestyramine Inhibit the Direct Synthesis of Low Density Lipoprotein Apolipoprotein B in Miniature Pigs, J. Lipid Res. 26, 1175–1186.

    PubMed  CAS  Google Scholar 

  32. Marsh, A., Kim, D.N., Lee, K.T., Reiner, J.M., and Thomas, W.A. (1972) Cholesterol Turnover, Synthesis, and Retention in Hypercholesterolemic Growing Swine, J. Lipid Res. 13, 600–615.

    PubMed  CAS  Google Scholar 

  33. Pakarinen, M., Miettinen, T.A., Lauronen, J., Kuusanmäki, P., Raivio, P., Kivistö, T., and Halttunen, J. (1996) Adaptation of Cholesterol Absorption After Proximal Resection of Porcine Small Intestine, J. Lipid Res. 37, 1766–1775.

    PubMed  CAS  Google Scholar 

  34. Sigalet, D.L., Lees, G.M., Aherne, F., Van Aerde, J.E., Fedorak, R.N., Keelan, M., and Thomson, A.B. (1990) The Physiology of Adaptation to Small Bowel Resection in the Pig: An Integrated Study of Morphological and Functional Changes, J. Pediatr. Surg. 25, 650–657.

    Article  PubMed  CAS  Google Scholar 

  35. Armstrong, M.J., and Carey, M.C. (1987) Thermodynamic and Molecular Determinants of Sterol Solubilities in Bile Salt Micelles, J. Lipid Res. 28, 1144–1155.

    PubMed  CAS  Google Scholar 

  36. Pakarinen, M., Miettinen, T.A., Kuusanmäki, P., Vento, P., Kivistö, T., and Halttunen, J. (1997) Effect of Ileal Autotransplantation on Cholesterol, Bile Acids, and Biliary Lipids in Pigs with Proximal Small Bowel Resection, Hepatology 25, 1315–1322.

    Article  PubMed  CAS  Google Scholar 

  37. Miettinen, T.A., and Kesäniemi, Y.A. (1989) Cholesterol Absorption: Regulation of Cholesterol Synthesis and Elimination and Within-Population Variations of Serum Cholesterol Levels, Am. J. Clin. Nutr. 43, 629–635.

    Google Scholar 

  38. Boberg, K.M., Einarsson, K., and Björkhem, I. (1990) Apparent Lack of Conversion of Sitosterol into C24-Bile Acids in Humans, J. Lipid Res. 31, 1083–1088.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Second Department of Surgery, Helsinki University Central Hospital, Haartmaninkatu 4, FIN 00290, Helsinki, Finland

    M. P. Pakarinen, J. Halttunen & P. Kuusanmäki

  2. Second Department of Internal Medicine, Helsinki University Central Hospital, Haartmaninkatu 4, FIN 00290, Helsinki, Finland

    T. A. Miettinen

  3. Haartman Institute, Department of Pathology, University of Helsinki, Helsinki, Findland

    J. Lauronen

Authors
  1. M. P. Pakarinen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Halttunen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Kuusanmäki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Lauronen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. T. A. Miettinen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Halttunen.

About this article

Cite this article

Pakarinen, M.P., Halttunen, J., Kuusanmäki, P. et al. Absorption, excretion, and distribution of plant sterols after proximal gut resection and autotransplantation of porcine ileum. Lipids 33, 267–276 (1998). https://doi.org/10.1007/s11745-998-0205-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11745-998-0205-y

Keywords

Search

Navigation