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Short-term effects of parenteral nutrition of cholestatic infants with lipid emulsions based on medium-chain and long-chain triacylglycerols.
Nutrition. 2007 Feb; 23(2):121-6.N

Abstract

OBJECTIVE

Infants with chronic cholestasis may require parenteral nutrition with lipid emulsions to provide energy and essential fatty acids but the optimal strategy is controversial.

METHODS

We studied the effects of parenteral lipid emulsions with long-chain triacylglycerols (LCTs) or a mixture of LCTs and medium-chain triacylglycerols (MCTs/LCTs) on serum bilirubin and lipid metabolism in cholestatic infants who received these 20% emulsions in alternating order for 3 d each, together with a glucose and amino acid infusion.

RESULTS

Of 11 recruited infants, two dropped out because enteral feeding could be established. In nine infants (2-8 mo of age, mean age 4.2 mo) who completed the study, serum bilirubin decreased from baseline to 6 h after the end of LCT infusion (from 8.5 +/- 2.0 to 7.8 +/- 1.8 mg/dL, mean +/- SEM, P < 0.05) and MCT/LCT infusion (7.9 +/- 6.5 to 7.1 +/- 6.5 mg/dL, P < 0.05). Cholesterol, triacylglycerol, and phospholipid concentrations in plasma and in chylomicrons, very low-density lipoprotein, low-density lipoprotein, and high-density lipoprotein were not changed by either emulsion. Total polyunsaturated fatty acid contents in high-density lipoprotein phospholipids increased during LCT infusion (from 29.8 +/- 0.9 to 35.9 +/- 1.4% wt/wt, P < 0.05) and MCT/LCT infusion (from 30.4 +/- 1.0 to 33.0 +/- 0.7%, P < 0.05). The long-chain polyunsaturated fatty acid docosahexaenoic acid increased only with the LCT infusion. Because docosahexaenoic acid availability during infancy is important for early visual and cognitive development, the use of soybean oil-based lipid emulsions may be preferable for infants with severe progressive cholestasis.

CONCLUSION

The MCT/LCT and LCT emulsions showed a good metabolic tolerance in infants with chronic cholestasis but had a differential effect on high-density lipoprotein phospholipid contents of arachidonic and docosahexaenoic acids.

Authors+Show Affiliations

Division of Gastroenterology, Hepatology and Immunology, The Children's Memorial Health Institute, Warsaw, Poland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17234505

Citation

Socha, Piotr, et al. "Short-term Effects of Parenteral Nutrition of Cholestatic Infants With Lipid Emulsions Based On Medium-chain and Long-chain Triacylglycerols." Nutrition (Burbank, Los Angeles County, Calif.), vol. 23, no. 2, 2007, pp. 121-6.
Socha P, Koletzko B, Demmelmair H, et al. Short-term effects of parenteral nutrition of cholestatic infants with lipid emulsions based on medium-chain and long-chain triacylglycerols. Nutrition. 2007;23(2):121-6.
Socha, P., Koletzko, B., Demmelmair, H., Jankowska, I., Stajniak, A., Bednarska-Makaruk, M., & Socha, J. (2007). Short-term effects of parenteral nutrition of cholestatic infants with lipid emulsions based on medium-chain and long-chain triacylglycerols. Nutrition (Burbank, Los Angeles County, Calif.), 23(2), 121-6.
Socha P, et al. Short-term Effects of Parenteral Nutrition of Cholestatic Infants With Lipid Emulsions Based On Medium-chain and Long-chain Triacylglycerols. Nutrition. 2007;23(2):121-6. PubMed PMID: 17234505.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Short-term effects of parenteral nutrition of cholestatic infants with lipid emulsions based on medium-chain and long-chain triacylglycerols. AU - Socha,Piotr, AU - Koletzko,Berthold, AU - Demmelmair,Hans, AU - Jankowska,Irena, AU - Stajniak,Anna, AU - Bednarska-Makaruk,Malgorzata, AU - Socha,Jerzy, PY - 2005/12/27/received PY - 2006/10/13/revised PY - 2006/10/24/accepted PY - 2007/1/20/pubmed PY - 2007/4/18/medline PY - 2007/1/20/entrez SP - 121 EP - 6 JF - Nutrition (Burbank, Los Angeles County, Calif.) JO - Nutrition VL - 23 IS - 2 N2 - OBJECTIVE: Infants with chronic cholestasis may require parenteral nutrition with lipid emulsions to provide energy and essential fatty acids but the optimal strategy is controversial. METHODS: We studied the effects of parenteral lipid emulsions with long-chain triacylglycerols (LCTs) or a mixture of LCTs and medium-chain triacylglycerols (MCTs/LCTs) on serum bilirubin and lipid metabolism in cholestatic infants who received these 20% emulsions in alternating order for 3 d each, together with a glucose and amino acid infusion. RESULTS: Of 11 recruited infants, two dropped out because enteral feeding could be established. In nine infants (2-8 mo of age, mean age 4.2 mo) who completed the study, serum bilirubin decreased from baseline to 6 h after the end of LCT infusion (from 8.5 +/- 2.0 to 7.8 +/- 1.8 mg/dL, mean +/- SEM, P < 0.05) and MCT/LCT infusion (7.9 +/- 6.5 to 7.1 +/- 6.5 mg/dL, P < 0.05). Cholesterol, triacylglycerol, and phospholipid concentrations in plasma and in chylomicrons, very low-density lipoprotein, low-density lipoprotein, and high-density lipoprotein were not changed by either emulsion. Total polyunsaturated fatty acid contents in high-density lipoprotein phospholipids increased during LCT infusion (from 29.8 +/- 0.9 to 35.9 +/- 1.4% wt/wt, P < 0.05) and MCT/LCT infusion (from 30.4 +/- 1.0 to 33.0 +/- 0.7%, P < 0.05). The long-chain polyunsaturated fatty acid docosahexaenoic acid increased only with the LCT infusion. Because docosahexaenoic acid availability during infancy is important for early visual and cognitive development, the use of soybean oil-based lipid emulsions may be preferable for infants with severe progressive cholestasis. CONCLUSION: The MCT/LCT and LCT emulsions showed a good metabolic tolerance in infants with chronic cholestasis but had a differential effect on high-density lipoprotein phospholipid contents of arachidonic and docosahexaenoic acids. SN - 0899-9007 UR - https://www.unboundmedicine.com/medline/citation/17234505/Short_term_effects_of_parenteral_nutrition_of_cholestatic_infants_with_lipid_emulsions_based_on_medium_chain_and_long_chain_triacylglycerols_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0899-9007(06)00395-9 DB - PRIME DP - Unbound Medicine ER -