Sterol Profiling in Red Blood Cell Membranes and Plasma of Newborns Receiving Total Parenteral Nutrition

Background and Objectives: Total parenteral nutrition (TPN) is a lifesaving therapy in children with intestinal failure. frequently complicated by liver dysfunction. Plant sterols (phytosterols) of lipid emulsions have been supposed to contribute to cholestasis in TPN-treated children. The present study aimed to evaluate the plasma and red blood cell membrane (RBCM) phytosterol levels in newborns after a short period of TPN. Patients and Methods: Phytosterols, cholesterol, and other Sterol levels were quantified by gas chromatography-mass spectrometry in 15 healthy, control infants. 22 patients after TPN, and 11 patients before TPN. Sterols of lipid emulsions Were quantified. Results: Plasma and RBCM phytosterol levels were. respectively. on average 56 mu mol/L and 83 mu mol/g per protein in patient, after TPN. 13 mu mol/L and 15 mu mol/g per protein in patients before TPN. and 9 mu mol/L and 13 mu mol/g per protein in control infants (P < 0.05 for differences). The days of TPN and the total amount of infused lipids correlated significantly with RBCM phytosterol (P < 0.05): correlations for plasma were positive but not significant. No correlation was observed with plasma bilirubin, gamma-glutamyltransferase, or alanine transaminase. Conclusions: Plasma and RBCM phytosterols increase significantly in newborns after a short period of TPN. Higher phylosterol levels were observed in some patients that could have been due to their individual variability in phytosterol metabolism and/or clearance. A greater accumulation of phytosterols in membranes may induce TPN-related cholestasis. JPGN 47:645-651, 2008.