Inflammatory processes involved in the alteration of liver function biomarkers in adult hospitalized patients treated with parenteral nutrition

Josep M Llop Talaveron; Ana Suárez-Lledó Grande; Elisabet Leiva Badosa; Jordi Bas Minguet; Joan Climent Martí; Elisabet Poyatos Cantón; María B Badia Tahull

doi:10.3389/fnut.2023.1034481

Inflammatory processes involved in the alteration of liver function biomarkers in adult hospitalized patients treated with parenteral nutrition

Front Nutr. 2023 Jan 27:10:1034481. doi: 10.3389/fnut.2023.1034481. eCollection 2023.

Authors

Josep M Llop Talaveron¹, Ana Suárez-Lledó Grande¹, Elisabet Leiva Badosa¹, Jordi Bas Minguet², Joan Climent Martí³, Elisabet Poyatos Cantón², María B Badia Tahull¹

Affiliations

¹ Department of Pharmacy, Bellvitge University Hospital, Barcelona, Spain.
² Immunology Laboratory, Bellvitge University Hospital, University of Barcelona-IDIBELL, Barcelona, Spain.
³ Immunology Laboratory, Germans Trias i Pujol Hospital, Barcelona, Spain.

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.

Keywords: fish oil lipid emulsion; inflammation; liver function biomarkers; parenteral nutrition; phytosterols.