Parenteral plant sterols accumulate in the liver reflecting their increased serum levels and portal inflammation in children with intestinal failure

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Hukkinen , M , Mutanen , A , Nissinen , M , Merras-Salmio , L , Gylling , H & Pakarinen , M P 2017 , ' Parenteral plant sterols accumulate in the liver reflecting their increased serum levels and portal inflammation in children with intestinal failure ' , Journal of Parenteral and Enteral Nutrition , vol. 41 , no. 6 , pp. 1014-1022 . https://doi.org/10.1177/0148607116637855 , https://doi.org/10.1177/0148607116637855

Title: Parenteral plant sterols accumulate in the liver reflecting their increased serum levels and portal inflammation in children with intestinal failure
Author: Hukkinen, M; Mutanen, A; Nissinen, M; Merras-Salmio, L; Gylling, H; Pakarinen, M. P
Contributor: University of Helsinki, Children's Hospital
University of Helsinki, Gastroenterologian yksikkö
University of Helsinki, Faculty of Medicine
University of Helsinki, University Management
University of Helsinki, Children's Hospital
Date: 2017-08
Language: eng
Number of pages: 9
Belongs to series: Journal of Parenteral and Enteral Nutrition
ISSN: 0148-6071
URI: http://hdl.handle.net/10138/298083
Abstract: Background: Parenteral plant sterols (PSs) are considered hepatotoxic; however, liver PSs and their associations with liver injury in patients with intestinal failure (IF) have not been reported. Materials and Methods: We analyzed liver and serum PS (avenasterol, campesterol, sitosterol, and stigmasterol) concentrations and ratios to cholesterol and their associations with biochemical and histologic liver damage in children with IF during (n = 7) parenteral nutrition (PN) and after weaning off it (n = 9), including vegetable oil-based lipid emulsions. Results: Liver avenasterol, sitosterol, and total PS concentrations and cholesterol ratios were 2.4-fold to 5.6-fold higher in PN-dependent patients (P <.05). Parenteral PS delivery reflected liver avenasterol and sitosterol ratios to cholesterol (r = 0.83-0.89, P = .02-.04), while serum and liver total PS levels were positively interrelated (r = 0.98, P <.01). Any liver histopathology was equally common while portal inflammation more frequent (57 vs 0%, P = .02) in PN-dependent patients. All liver PS fractions correlated positively with histologic portal inflammation (r = 0.53-0.66, P <.05), and their total concentration was significantly (P = .01) higher among patients with versus without portal inflammation. In PN-dependent patients, liver fibrosis and any histopathology correlated with liver campesterol and stigmasterol levels (r = 0.79-0.87, P .03). Conclusion: Among children with IF, parenteral PSs accumulate in the liver, reflect their increased serum levels, and relate with biochemical liver injury, portal inflammation, and liver fibrosis, thus supporting their role in promoting liver damage.
Subject: intestinal failure-associated liver disease
parenteral nutrition
phytosterols
lipid emulsions
short bowel syndrome
NUTRITION-ASSOCIATED CHOLESTASIS
SHORT-BOWEL SYNDROME
GENERATION LIPID EMULSIONS
CHOLESTEROL-METABOLISM
DISEASE
INJURY
PHYTOSTEROLS
INFANTS
MECHANISMS
FIBROSIS
3123 Gynaecology and paediatrics
3121 General medicine, internal medicine and other clinical medicine
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