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Lipid emulsions influence plasma phytosterols in infants receiving parenteral nutrition

A study in the most recent issue of the American Journal of Clinical Nutrition investigates the effect of 5 intravenous lipid emulsions on plasma phytosterols in preterm infants receiving parenteral nutrition.

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Elevated plasma phytosterol concentrations are an untoward effect of parenteral nutrition with vegetable oil–based lipid emulsions.

Phytosterols are elevated in neonatal cholestasis, but the relation remains controversial.

Dr Sara Savini and colleagues from Italy studied the effect of 5 lipid emulsions on plasma phytosterols in preterm infants.

The research team analyzed 144 consecutive admitted preterm infants.

Patients were randomly assigned to receive 1 of 5 different lipid emulsions, including S, MS, MSF, OS, or MOSF.

Phytosterols in the lipid emulsions and in plasma were measured by gas chromatography–mass spectrometry.

Patients in the S group had significantly higher total phytosterol intakes than did the other study groups.

On parental nutrition day 14, plasma phytosterol concentrations were highest in the S group
American Journal of Clinical Nutrition

The researchers found that on parental nutrition days 7 and 14, plasma phytosterol concentrations were highest in the S group, and lowest in the MOSF group.

Despite similar ß-sitosterol intakes between the MS and MSF groups, plasma concentrations were significantly lower in the MSF than in the MS group.

Only 3 patients developed cholestasis, including 1 in the MS, 1 in the MSF, and 1 in the MOSF group.

The researchers observed no cases of cholestasis in the S and OS groups.

Dr Savini's team concludes, "In uncomplicated preterm infants receiving routine parental nutrition, we found a correlation between phytosterol intake and plasma phytosterol concentrations."

However, cholestasis was rare and no difference in liver function at 6 weeks was observed."

Am J Clin Nutr  2013: 98(2): 312-318
23 August 2013

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