LAUSR

Abstract Background&Aims The presence of phytosterols in vegetal lipid emulsions has been associated with alterations of liver function tests (LFT). Serum levels of phytosterols are under strict genetic control. T-allele carriers in rs41360247 and C allele in rs4245791 of ABCG8 genes are associated with higher phytosterolemia. The objective of this study was to determine the association between these SNPs and LFT alterations in an adult hospitalized population treated with PN. Material and methods This is a substudy of a previous clinical trial (EudraCT Number: 2014-003597-17). It included adult hospitalized patients with at least 7 days of PN with 0.8 g/kg/day of an olive/soybean lipid emulsion (LE) that were randomized 1:1 to olive/soybean or 100% fish oil at a dose of 0.4 g/kg/day for 7 days. Plasma phytosterols and its fractions, rs41360247 and rs4245791 of ABCG8 genes and LFT were determined. ANOVA variance analyses were performed to determine the association between the SNPs and LFT values, and ​​total phytosterol values ​​and their fractions. Simple linear regressions were performed to analyse LFT variations and the different interactions of the SNPs studied with phytosterols and their fractions. The synergic variable plasma phytosterol and its fractions x SNP allow study of the interaction of the SNPs with phytosterols with a regression. Results 19 patients were included. In the multivariate model, total phytosterols, sitosterol and lanosterol were positively associated with gamma-glutamyl transferase (GGT) increases. Significant increases of GGT with stigmasterol were associated with T allele of rs41360247, while campesterol showed only a tendency to increase that was not significant. Alkaline phosphatase (AP) increases were associated with T-rs41360247 independently of the presence of phytosterols. With stigmasterol, C-allele carriers of rs4245791 showed a tendency to increase, and also for sitosterol and lanosterol though independently of the SNP analysed. Alanine aminotransaminase (ALT) increases were associated positively with total phytosterol and sitostanol, while 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 PN is conditional.