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

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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.


Plasma and RBCM phytosterol levels were, respectively, on average 56 μmol/L and 83 μmol/g per protein in patients after TPN, 13 μmol/L and 15 μmol/g per protein in patients before TPN, and 9 μmol/L and 13 μmoL/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, γ-glutamyltransferase, or alanine transaminase.


Plasma and RBCM phytosterols increase significantly in newborns after a short period of TPN. Higher phytosterol 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.

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