Effect of parenteral serum plant sterols on liver enzymes and cholesterol metabolism in a patient with short bowel syndrome

Autor: Laura Huikko, Kirsi Kontra, Markku J. Nissinen, Vieno Piironen, Maarit Hallikainen, Tatu A. Miettinen, Helena Gylling
Rok vydání: 2008
Předmět:
Short Bowel Syndrome
medicine.medical_specialty
Fat Emulsions
Intravenous
Parenteral Nutrition
Chromatography
Gas
Adolescent
030309 nutrition & dietetics
Campesterol
Medicine (miscellaneous)
Nutritional Status
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Cholestasis
Liver enzyme
Internal medicine
medicine
Humans
Plant Oils
Infusions
Intravenous
Olive Oil
0303 health sciences
Nutrition and Dietetics
Stigmasterol
Dose-Response Relationship
Drug
business.industry
Phytosterols
Short bowel syndrome
medicine.disease
Lipids
3. Good health
Dose–response relationship
Endocrinology
Parenteral nutrition
Cholesterol
Nutrition Assessment
chemistry
Liver
lipids (amino acids
peptides
and proteins)
030211 gastroenterology & hepatology
Female
business
Plant sterols
Follow-Up Studies
Zdroj: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition. 23(4)
ISSN: 0884-5336
Popis: Hepatobiliary complications are common during parenteral nutrition. Lipid moiety in commercially available solutions contains plant sterols. It is not known whether plant sterols in parenteral nutrition interfere with hepatic function in adults. We detected how different amounts of plant sterols in parenteral nutrition solution affected serum plant sterol concentrations and liver enzymes during a 1.5-year follow-up in a patient with short bowel syndrome. Serum lipid, plant sterol, and liver enzyme levels were measured regularly during the transition from Intralipid (100% soy-based intravenous fat emulsion) to ClinOleic (an olive oil-based intravenous fat emulsion with 80% olive oil, 20% soy oil and lower plant sterols); the lipid supply was also gradually increased from 20 to 35 g/d. Plant sterols in parenteral nutrition solution and serum were measured with gas-liquid chromatography. During infusion of soy-based intravenous fat emulsion (30 g/d, total plant sterols 87 mg/d), the concentrations of sitosterol, campesterol, and stigmasterol were 4361, 1387, and 378 microg/dL, respectively, and serum liver enzyme values were >or= 2.5 times above upper limit of normal. After changing to olive oil-based intravenous fat emulsion (20-35 g/d, plant sterols 37-65 mg/d), concentrations decreased to 2148 to 2251 microg/dL for sitosterol, 569-297 microg/dL for campesterol, and 95-55 microg/dL for stigmasterol. Concomitantly, liver enzyme values decreased to 1.4 to 1.8 times above upper limit of normal at the end of follow-up. The nutrition status of the patient improved. The amount of plant sterols in lipid emulsion affects serum liver enzyme levels more than the amount of lipid.
Databáze: OpenAIRE
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