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Nutrients 2012, 4(8), 904-921; doi:10.3390/nu4080904

Steroidal Compounds in Commercial Parenteral Lipid Emulsions

1 Methodist Research Institute, Indiana University Health, Indianapolis, IN 46202, USA 2 Baxter Healthcare Corporation, Deerfield, IL 60015, USA 3 Baxter SAS, Maurepas-Cedex 78311, France 4 Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
* Author to whom correspondence should be addressed.
Received: 14 June 2012 / Revised: 1 August 2012 / Accepted: 1 August 2012 / Published: 13 August 2012
(This article belongs to the Special Issue Dietary Lipids: Sources, Function and Metabolism)
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Parenteral nutrition lipid emulsions made from various plant oils contain steroidal compounds, called phytosterols. During parenteral administration of lipid emulsions, phytosterols can reach levels in the blood that are many fold higher than during enteral administration. The elevated phytosterol levels have been associated with the development of liver dysfunction and the rare development of liver failure. There is limited information available in the literature related to phytosterol concentrations in lipid emulsions. The objective of the current study was to validate an assay for steroidal compounds found in lipid emulsions and to compare their concentrations in the most commonly used parenteral nutrition lipid emulsions: Liposyn® II, Liposyn® III, Lipofundin® MCT, Lipofundin® N, Structolipid®, Intralipid®, Ivelip® and ClinOleic®. Our data demonstrates that concentrations of the various steroidal compounds varied greatly between the eight lipid emulsions, with the olive oil-based lipid emulsion containing the lowest levels of phytosterols and cholesterol, and the highest concentration of squalene. The clinical impression of greater incidences of liver dysfunction with soybean versus MCT/LCT and olive/soy lipid emulsions may be reflective of the levels of phytosterols in these emulsions. This information may help guide future studies and clinical care of patients with lipid emulsion-associated liver dysfunction.
Keywords: lipid emulsions; gas chromatography; cholesterol; squalene; phytosterols; sterols lipid emulsions; gas chromatography; cholesterol; squalene; phytosterols; sterols
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Xu, Z.; Harvey, K.A.; Pavlina, T.; Dutot, G.; Hise, M.; Zaloga, G.P.; Siddiqui, R.A. Steroidal Compounds in Commercial Parenteral Lipid Emulsions. Nutrients 2012, 4, 904-921.

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