Document Detail


Cholesterol metabolism in pediatric short bowel syndrome after weaning off parenteral nutrition.
MedLine Citation:
PMID:  20538532     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Small intestine essentially regulates cholesterol homeostasis. AIMS: To evaluate cholesterol metabolism in short bowel syndrome (SBS). METHODS: Cholesterol precursors (e.g., cholestenol, desmosterol and lathosterol) and plant sterols (campesterol and sitosterol), respective markers of cholesterol synthesis and absorption, were determined in SBS patients (n=12) an average of 31 months after weaning off parenteral nutrition and in age-matched controls (n=80). RESULTS: Among patients, serum cholesterol precursor sterol to cholesterol ratios were 2-10 times higher (P<0.0001 for each). Those without any remaining ileum had 1.2-2.8 times higher precursor sterol to cholesterol ratios than those with an ileal remnant (P<0.05 for each). Serum cholesterol concentration, campesterol/cholesterol and campesterol/sitosterol were 34-39% lower (P<0.05 for each) in relation to controls. Bile acid absorption was markedly impaired (2.4 (0.2-3.2)%). Plant sterol ratios reflected the absolute length of remaining jejunum (r=0.625-0.663), and precursor sterol ratios inversely that of ileum (r=-0.589 to 0.750, P<0.05 for all). CONCLUSION: After weaning off parenteral nutrition, patients with pediatric onset SBS continue to have marked intestinal malabsorption of bile acids and moderate cholesterol malabsorption resulting in decreased serum cholesterol despite a marked compensatory increase in cholesterol synthesis.
Authors:
Mikko P Pakarinen; Annika Kurvinen; Helena Gylling; Tatu A Miettinen; Maria Pesonen; Markku Kallio; Antti I Koivusalo; Markku J Nissinen
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-06-09
Journal Detail:
Title:  Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver     Volume:  42     ISSN:  1878-3562     ISO Abbreviation:  Dig Liver Dis     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-12     Completed Date:  2010-10-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100958385     Medline TA:  Dig Liver Dis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  554-9     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Section of Pediatric Surgery, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland. mikko.pakarinen@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Bile Acids and Salts / metabolism
Child
Child, Preschool
Cholesterol / biosynthesis,  blood*
Desmosterol / blood
Humans
Intestinal Absorption
Intestine, Small / metabolism,  pathology,  physiopathology
Malabsorption Syndromes / metabolism,  physiopathology,  therapy
Parenteral Nutrition
Phytosterols / blood
Short Bowel Syndrome / metabolism*,  pathology,  physiopathology,  therapy
Sterols / blood
Time Factors
Chemical
Reg. No./Substance:
0/Bile Acids and Salts; 0/Phytosterols; 0/Sterols; 313-04-2/Desmosterol; 57-88-5/Cholesterol; 80-99-9/lathosterol

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