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Llop Talaveron JM, Suárez-Lledó Grande A, Leiva Badosa E, Bas Minguet J, Climent Martí J, Poyatos Cantón E, Badia Tahull MB. Inflammatory processes involved in the alteration of liver function biomarkers in adult hospitalized patients treated with parenteral nutrition. Front Nutr 2023; 10:1034481. [PMID: 36776600 PMCID: PMC9911521 DOI: 10.3389/fnut.2023.1034481] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 01/12/2023] [Indexed: 01/28/2023] Open
Abstract
Introduction Liver damage has been associated with the accumulation of phytosterols (PS) in patients treated with parenteral nutrition (PN). We aimed to study the association of inflammatory markers with liver function biomarker (LFB) alterations in patients treated with PN containing PS. Materials and methods Prospective observational study. Simple linear and stepwise multiple linear regression tests and interactions were performed. Results Nineteen patients were included. In the multivariable model, determinations based on LFBs as dependent and phytosterols (and their fractions) as independent variables showed an association between increases in gamma-glutamyltransferase (GGT) and lanosterol (p < 0.001), stigmasterol (p < 0.001), interleukin-10 (IL-10) × total phytosterols (Phyt) (p < 0.009), tumor necrosis factor-α (TNF-α) × Phyt (p < 0.002), IL-10 × sitosterol (p < 0.002), TNF-α × sitosterol (p < 0.001), IL-10 × campesterol (p < 0.033), IL-10 (p < 0.006 and p < 0.015), TNF-α (p < 0.048 and p < 0.027). Increases in alanine aminotransferase (ALT) were associated with Phyt (p < 0.006), lanosterol (p < 0.016), C-reactive protein (CRP) × campesterol (p < 0.001), interleukin-6 (IL-6) × stigmasterol (p < 0.030), CRP (p < 0.08), and IL-6 (p < 0.042). Alkaline phosphatase (AP) increases were associated with CRP (p < 0.002). Discussion Inflammation in the presence of plasmatic PS seems to have a synergistic effect in impairing liver function, mainly altering GGT but also ALT.
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Affiliation(s)
| | - Ana Suárez-Lledó Grande
- Department of Pharmacy, Bellvitge University Hospital, Barcelona, Spain,*Correspondence: Ana Suárez-Lledó Grande,
| | | | - Jordi Bas Minguet
- Immunology Laboratory, Bellvitge University Hospital, University of Barcelona-IDIBELL, Barcelona, Spain
| | | | - Elisabet Poyatos Cantón
- Immunology Laboratory, Bellvitge University Hospital, University of Barcelona-IDIBELL, Barcelona, Spain
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Lv WJ, Huang JY, Lin J, Ma YM, He SQ, Zhang YW, Wang TZ, Cheng K, Xiong Y, Sun FG, Pan ZC, Sun JB, Mao W, Guo SN. Phytosterols Alleviate Hyperlipidemia by Regulating Gut Microbiota and Cholesterol Metabolism in Mice. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2023; 2023:6409385. [PMID: 37151603 PMCID: PMC10156461 DOI: 10.1155/2023/6409385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/29/2022] [Accepted: 02/17/2023] [Indexed: 05/09/2023]
Abstract
Phytosterols (PS) have been shown to regulate cholesterol metabolism and alleviate hyperlipidemia (HLP), but the mechanism is still unclear. In this study, we investigated the mechanism by which PS regulates cholesterol metabolism in high-fat diet (HFD) mice. The results showed that PS treatment reduced the accumulation of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) in the serum of HFD mice, while increasing the serum levels of high-density lipoprotein cholesterol (HDL-C). Compared with HFD mice, PS not only increased the antioxidant activity of the liver but also regulated the mRNA expression levels of enzymes and receptors related to cholesterol metabolism. The hypolipidemic effect of PS was abolished by antibiotic (Abx) intervention and reproduced by fecal transplantation (FMT) intervention. The results of 16S rRNA sequencing analysis showed that PS modulated the gut microbiota of mice. PS reduced the relative abundance of Lactobacillus and other bile salt hydrolase- (BSH-) producing gut microbiota in HFD mice, which are potentially related to cholesterol metabolism. These findings partially explain the mechanisms by which PS regulates cholesterol metabolism. This implies that regulation of the gut microbiota would be a potential target for the treatment of HLP.
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Affiliation(s)
- Wei-Jie Lv
- College of Veterinary Medicine, South China Agricultural University, State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangzhou, China
| | - Jie-Yi Huang
- College of Veterinary Medicine, South China Agricultural University, State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangzhou, China
| | - Jin Lin
- College of Veterinary Medicine, South China Agricultural University, State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangzhou, China
| | - Yi-Mu Ma
- College of Veterinary Medicine, South China Agricultural University, State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangzhou, China
| | - Shi-Qi He
- College of Veterinary Medicine, South China Agricultural University, State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangzhou, China
| | - Ying-Wen Zhang
- College of Veterinary Medicine, South China Agricultural University, State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangzhou, China
| | - Tian-Ze Wang
- College of Veterinary Medicine, South China Agricultural University, State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangzhou, China
| | - Ke Cheng
- College of Veterinary Medicine, South China Agricultural University, State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangzhou, China
| | - Ying Xiong
- College of Veterinary Medicine, South China Agricultural University, State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangzhou, China
| | - Feng-Gang Sun
- College of Veterinary Medicine, South China Agricultural University, State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangzhou, China
| | - Zhong-Chao Pan
- College of Veterinary Medicine, South China Agricultural University, State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangzhou, China
| | - Jing-Bo Sun
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangzhou, China
| | - Wei Mao
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangzhou, China
| | - Shi-Ning Guo
- College of Veterinary Medicine, South China Agricultural University, State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangzhou, China
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Llop-Talaveron J, Leiva-Badosa E, Alia-Ramos P, Rigo-Bonnin R, Virgili-Casas N, Farran-Teixidor L, Miró-Martín M, Garrido-Sanchez L, Suárez-Lledó A, Badía-Tahull MB. Genetic factors associated with alterations in liver function test results in adult hospitalized patients treated with parenteral nutrition: A substudy of a clinical trial. Nutrition 2021; 93:111507. [PMID: 34785440 DOI: 10.1016/j.nut.2021.111507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 09/25/2021] [Accepted: 09/26/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The presence of phytosterols in vegetable-based lipid emulsions has been associated with alterations in the results of liver function tests (LFTs). Serum levels of phytosterols are under strict genetic control. T-allele carriers in rs41360247 and C-allele carriers in rs4245791 of ABCG8genes are associated with higher phytosterolemia. The objective of this study was to determine the association between these single-nucleotide polymorphisms (SNPs) and LFT result alterations in an adult hospitalized population treated with parenteral nutrition. METHODS This is a substudy of a previous clinical trial (EudraCT 2014-003597-17). It included adult hospitalized patients who had received at least 7 d of parenteral nutrition with 0.8 g/kg/d of an olive/soybean lipid emulsion, randomized 1:1 to receive the same olive/soybean emulsion or 100% fish oil at a dose of 0.4 g/kg/d for 7 d. Plasma phytosterols and their fractions, rs41360247 and rs4245791 of ABCG8 genes, and LFT were determined. Analyses of variance were performed to determine the association between the SNPs and LFT values, as well as total phytosterol values and their fractions. Simple linear regressions were performed to analyze LFT variations and the different interactions of the SNPs studied with phytosterols and their fractions. Interactions of the synergic variable plasma phytosterol and its fractions with SNPs allow us to study the interaction of the SNPs with phytosterols with a regression. RESULTS We included 19 participants. In the multivariate model, total phytosterols, sitosterol, and lanosterol were positively associated with increases in γ-glutamyltransferase. Significant increases with stigmasterol were associated with the T allele of rs41360247, whereas campesterol showed only a tendency to increase that was not significant. Increases in alkaline phosphatase were associated with T-rs41360247 independent of the presence of phytosterols. With stigmasterol, C-allele carriers of rs4245791 showed a tendency to increase, and also for sitosterol and lanosterol, although independent of the SNP analyzed. Increases in alanine aminotransferase were positively associated with total phytosterol and sitostanol, whereas lanosterol and stigmasterol were associated with the presence of the T allele of rs41360247. CONCLUSIONS With both SNPs rs41360247 and rs4245791, the alteration in parameters of liver function in adult patients with short-term parenteral nutrition is conditional.
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Affiliation(s)
- Josep Llop-Talaveron
- Pharmacy Department, Hospital Universitari Bellvitge, IDIBELL, Universitat Barcelona, L'Hospitalet de Llobregat, Spain
| | - Elisabet Leiva-Badosa
- Pharmacy Department, Hospital Universitari Bellvitge, IDIBELL, Universitat Barcelona, L'Hospitalet de Llobregat, Spain.
| | - Pedro Alia-Ramos
- Clinical Laboratory Department, Hospital Universitari Bellvitge, IDIBELL, Universitat Barcelona, L'Hospitalet de Llobregat, Spain
| | - Raül Rigo-Bonnin
- Clinical Laboratory Department, Hospital Universitari Bellvitge, IDIBELL, Universitat Barcelona, L'Hospitalet de Llobregat, Spain
| | - Núria Virgili-Casas
- Endocrinology Department, Hospital Universitari Bellvitge, IDIBELL, Universitat Barcelona, L'Hospitalet de Llobregat, Spain
| | - Leandre Farran-Teixidor
- Surgery Department, Hospital Universitari Bellvitge, IDIBELL, Universitat Barcelona, L'Hospitalet de Llobregat, Spain
| | - Mónica Miró-Martín
- Surgery Department, Hospital Universitari Bellvitge, IDIBELL, Universitat Barcelona, L'Hospitalet de Llobregat, Spain
| | - Leticia Garrido-Sanchez
- Pharmacy Department, Hospital Universitari Bellvitge, IDIBELL, Universitat Barcelona, L'Hospitalet de Llobregat, Spain
| | - Ana Suárez-Lledó
- Pharmacy Department, Hospital Universitari Bellvitge, IDIBELL, Universitat Barcelona, L'Hospitalet de Llobregat, Spain
| | - Maria B Badía-Tahull
- Pharmacy Department, Hospital Universitari Bellvitge, IDIBELL, Universitat Barcelona, L'Hospitalet de Llobregat, Spain
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Fish Oil Enriched Intravenous Lipid Emulsions Reduce Triglyceride Levels in Non-Critically Ill Patients with TPN and Type 2 Diabetes. A Post-Hoc Analysis of the INSUPAR Study. Nutrients 2020; 12:nu12061566. [PMID: 32471262 PMCID: PMC7352525 DOI: 10.3390/nu12061566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 05/20/2020] [Accepted: 05/25/2020] [Indexed: 01/04/2023] Open
Abstract
There are no studies that have specifically assessed the role of intravenous lipid emulsions (ILE) enriched with fish oil in people with diabetes receiving total parenteral nutrition (TPN). The objective of this study was to assess the metabolic control (glycemic and lipid) and in-hospital complications that occurred in non-critically ill inpatients with TPN and type 2 diabetes with regard to the use of fish oil emulsions compared with other ILEs. We performed a post-hoc analysis of the Insulin in Parenteral Nutrition (INSUPAR) trial that included patients who started with TPN for any cause and that would predictably continue with TPN for at least five days. The study included 161 patients who started with TPN for any cause. There were 80 patients (49.7%) on fish oil enriched ILEs and 81 patients (50.3%) on other ILEs. We found significant decreases in triglyceride levels in the fish oil group compared to the other patients. We did not find any differences in glucose metabolic control: mean capillary glucose, glycemic variability, and insulin dose, except in the number of mild hypoglycemic events that was significantly higher in the fish oil group. We did not observe any differences in other metabolic, liver or infectious complications, in-hospital length of stay or mortality.
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