Gm. Barker et al., ANALYSIS OF FECAL NEUTRAL STEROLS IN PATIENTS WITH FAMILIAL ADENOMATOUS POLYPOSIS BY GAS-CHROMATOGRAPHY MASS-SPECTROMETRY, International journal of colorectal disease, 8(4), 1993, pp. 188-192
Previous studies have suggested that patients with familial adenomatou
s polyposis (FAP) have increased faecal excretion of cholesterol but a
reduction in cholesterol metabolites. It was consequently proposed th
at the degree of faecal cholesterol degradation could be used as a mea
ns of diagnosis. Developments in the extraction and analysis of faecal
neutral sterols as well as the accurate means of diagnosing FAP by DN
A analysis and indirect ophthalmoscopy has necessitated a re-examinati
on of this proposal. Faecal neutral sterols were analysed in 10 patien
ts with untreated FAP following a complete 5-day stool collection and
compared with 9 healthy control subjects (including 4 siblings) closel
y matched for age and sex. The median [25 and 75, percentiles] stool w
et weights were similar between the FAP (97.5 [69, 192] g.24 h(-1)) an
d the control (116 [61.5, 137] g.24 h(-1)) groups. Faecal cholesterol
concentration was similar in the two groups (FAP=2.3 [1.4, 4.2]; contr
ol=3.5 [1.0, 6.0] mu mol .g(-1) dry wt) as was the concentration of to
tal neutral sterols not including plant sterols (FAP=17.2 [13.4, 21.0]
; control=18.2 [7.4, 21.6] mu mol.g(-1) dry wt). There were no signifi
cant differences in the proportions of cholesterol metabolised between
the FAP (82.3 [74.2, 93.5]%) and control(72.1 [5.7, 81.3]%) groups. T
his study does not support the notion that faecal neutral sterol metab
olism is uniquely different in patients with FAP.