Document Detail

The role of phytosterols in the pathogenesis of liver complications of pediatric parenteral nutrition.
MedLine Citation:
PMID:  9437703     Owner:  NLM     Status:  MEDLINE    
Long-term parenteral nutrition of infants who have had major gut resections is associated with a high incidence of cholestatic liver disease. Affected infants have high plasma concentrations of phytosterols--compounds that resemble cholesterol but have an alkylated side chain. The phytosterols that accumulate in patients receiving parenteral nutrition are derived from the soya oil and/or soya lecithin used to make the intravenous lipid emulsion. There is a striking association between phytosterolemia and cholestatic liver disease. This has led us to put forward the hypothesis that phytosterols can cause cholestasis in susceptible infants. Experiments using neonatal piglets indicate that phytosterols (given without any of the other components of parenteral nutrition) can indeed reduce bile flow. We suggest that increasing the content of phytosterols in cell membranes may interfere with the function of important transport proteins involved in the secretion of bile. Other factors that might contribute to cholestasis (such as inhibition of cholesterol 7 alpha-hydroxylase) are discussed.
P T Clayton; P Whitfield; K Iyer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Nutrition (Burbank, Los Angeles County, Calif.)     Volume:  14     ISSN:  0899-9007     ISO Abbreviation:  Nutrition     Publication Date:  1998 Jan 
Date Detail:
Created Date:  1998-02-20     Completed Date:  1998-02-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8802712     Medline TA:  Nutrition     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  158-64     Citation Subset:  IM    
Biochemistry Unit, Institute of Child Health, London, United Kingdom.
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MeSH Terms
Bile / physiology
Cell Membrane / metabolism
Child, Preschool
Fat Emulsions, Intravenous
Liver Diseases / etiology*
Parenteral Nutrition / adverse effects*
Phytosterols / administration & dosage,  adverse effects,  metabolism*
Reg. No./Substance:
0/Fat Emulsions, Intravenous; 0/Phytosterols

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