The Spectrum of Plant and Animal Sterols in Different Oil‐Derived Intravenous Emulsions

Abstract

Intravenous lipid constituents have different effects on various biological processes. Some of these effects are protective, while others are potentially adverse. Phytosterols, in particular, seem to be implicated with parenteral nutrition-associated cholestasis. The aim of this study is to determine the amount of plant and animal sterols present in lipid formulations derived from different oil sources. To this end, animal (cholesterol) and plant (beta-sitosterol, campesterol, and stigmasterol) sterols in seven different commercially available intravenous lipid emulsions (ILEs) were quantified by capillary gas chromatography after performing a lipid extraction procedure. The two major constituents of the lipid emulsions were cholesterol (range 14-57% of total lipids) and beta-sitosterol (range 24-55%), followed by campesterol (range 8-18%) and stigmasterol (range 5-16%). The fish oil-derived formulation was an exception, as it contained only cholesterol. The mean values of the different sterols were statistically different across ILEs (P = 0.0000). A large percentage of pairwise comparisons were also statistically significant (P = 0.000), most notably for cholesterol and stigmasterol (14 out of 21 for both), followed by campesterol (12 out 21) and beta-sitosterol (11 out 21). In conclusion, most ILEs combined significant amounts of phytosterols and cholesterol. However, their phytosterols:cholesterol ratios were reversed compared to the normal human diet.

Fish oil containing intravenous lipid emulsions in parenteral nutrition-associated cholestatic liver disease

“…Intravenous lipid emulsions based on vegetable oils also contain significant amounts of the plant sterols b-sitosterol, campesterol, and stigmasterol [22]. Marked accumulation of these phytosterols was found in blood samples of children with PNAC [23], but it remained controversial whether these elevated levels were the cause or consequence of cholestasis [24].…”

Immunomodulatory and Physical Effects of Phospholipid Composition in Vaccine Adjuvant Emulsions

“…Perhaps the widest use of phospholipid emulsifiers is in the application of intravenous nutritional supplementation (5), such as in Intralipid®, a soybean oil/egg lecithin emulsion. However, there may be some disadvantages associated with egg lecithin (or egg PC) as an emulsifier, and advantages to substituting eggderived phospholipids with synthetic phospholipids.…”

Phytosterols and Lack of Occurrence of Cholestasis in Rats Nourished Parenterally or Orally

“…In a previous study (6), we found phytosterols to be considerably present in all the lipid emulsions analyzed so as to exceed the amount physiologically absorbed by the gut. In this study, we want to determine the plasma amount of phytosterols deriving from different oil sources in rats receiving parenteral nutrition, and compare it with those in rats on standard oral diet.…”

“…Information on the sterol contents of ILEs, however, is currently scant and one of our previous purpose was to identify animal and plant sterols contained in the most representative ILEs. To this end, we selected ILE formulations as being representative in terms of their main oil component (soy, olive oil, fish oil variably combined with mediumor long-chain fatty acids, and purified triglycerides) and we quantified their animal and vegetal sterol contents (6). The relative weight of each sterol, however, varied significantly across formulations, but cholesterol and beta-sitosterol were the most represented followed by campesterol and stigmasterol.…”