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Liver Disease, Systemic Inflammation, and Growth Using a Mixed Parenteral Lipid Emulsion, Containing Soybean Oil, Fish Oil, and Medium Chain Triglycerides, Compared With Soybean Oil in Parenteral Nutrition-Fed Neonatal Piglets.
JPEN J Parenter Enteral Nutr 2016; 40(7):973-81JJ

Abstract

BACKGROUND

The optimal parenteral lipid emulsion for neonates should reduce the risk of intestinal failure-associated liver disease and inflammation, while supporting growth and development. This could be best achieved by balanced content of ω-6 and ω-3 polyunsaturated fatty acids (PUFAs). Using a neonatal piglet model of parenteral nutrition (PN), we compared a 100% soy oil-based emulsion (ω-6:ω-3 PUFA: 7:1) with a mixed lipid emulsion comprising 30% soy oil, 30% medium-chain triglycerides, 25% olive oil, and 15% fish oil (ω-6:ω-3 PUFA: approximately 2.5:1) with regard to liver disease, inflammation, and fatty acid content in plasma and brain.

METHOD

Neonatal piglets, 3-6 days old, underwent jugular catheter insertion for isonitrogenous, isocaloric PN delivery over 14 days. The IL group (n = 8) was treated with Intralipid; the ML group (n = 10) was treated with the mixed lipid (SMOFlipid). Bile flow, liver chemistry, C-reactive protein (CRP), and PUFA content in plasma phospholipids and brain were compared.

RESULTS

Compared with the IL group, ML-treated piglets had increased bile flow (P = .008) and lower total bilirubin (P = .001) and CRP (P = .023) concentrations. The ω-6 long-chain PUFA content was lower in plasma and brain for the ML group. The key ω-3 long-chain PUFA for neonatal development, docosahexaenoic acid (DHA), was not different between groups.

CONCLUSION

The mixed lipid, having less ω-6 PUFA and more ω-3 PUFA, was able to prevent liver disease and reduce systemic inflammation in PN-fed neonatal piglets. However, this lipid did not increase plasma or brain DHA status, which would be desirable for neonatal developmental outcomes.

Authors+Show Affiliations

Department of Pediatrics, University of Alberta, Edmonton, Canada Department of Agricultural Food and Nutritional Science, University of Alberta, Edmonton, Canada justine.turner@albertahealthservices.ca.Department of Pediatrics, University of Alberta, Edmonton, Canada.Department of Agricultural Food and Nutritional Science, University of Alberta, Edmonton, Canada.Department of Pediatrics, University of Alberta, Edmonton, Canada.Department of Agricultural Food and Nutritional Science, University of Alberta, Edmonton, Canada.Research Institute, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada Departments of Pediatrics and Nutritional Sciences, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.Department of Pediatrics, University of Alberta, Edmonton, Canada Research Institute, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada Division of General Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada Group for Improvement of Intestinal Function and Treatment, Hospital for Sick Children, Toronto, Ontario, Canada.

Pub Type(s)

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

Language

eng

PubMed ID

25837680

Citation

Turner, Justine M., et al. "Liver Disease, Systemic Inflammation, and Growth Using a Mixed Parenteral Lipid Emulsion, Containing Soybean Oil, Fish Oil, and Medium Chain Triglycerides, Compared With Soybean Oil in Parenteral Nutrition-Fed Neonatal Piglets." JPEN. Journal of Parenteral and Enteral Nutrition, vol. 40, no. 7, 2016, pp. 973-81.
Turner JM, Josephson J, Field CJ, et al. Liver Disease, Systemic Inflammation, and Growth Using a Mixed Parenteral Lipid Emulsion, Containing Soybean Oil, Fish Oil, and Medium Chain Triglycerides, Compared With Soybean Oil in Parenteral Nutrition-Fed Neonatal Piglets. JPEN J Parenter Enteral Nutr. 2016;40(7):973-81.
Turner, J. M., Josephson, J., Field, C. J., Wizzard, P. R., Ball, R. O., Pencharz, P. B., & Wales, P. W. (2016). Liver Disease, Systemic Inflammation, and Growth Using a Mixed Parenteral Lipid Emulsion, Containing Soybean Oil, Fish Oil, and Medium Chain Triglycerides, Compared With Soybean Oil in Parenteral Nutrition-Fed Neonatal Piglets. JPEN. Journal of Parenteral and Enteral Nutrition, 40(7), pp. 973-81. doi:10.1177/0148607115579711.
Turner JM, et al. Liver Disease, Systemic Inflammation, and Growth Using a Mixed Parenteral Lipid Emulsion, Containing Soybean Oil, Fish Oil, and Medium Chain Triglycerides, Compared With Soybean Oil in Parenteral Nutrition-Fed Neonatal Piglets. JPEN J Parenter Enteral Nutr. 2016;40(7):973-81. PubMed PMID: 25837680.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Liver Disease, Systemic Inflammation, and Growth Using a Mixed Parenteral Lipid Emulsion, Containing Soybean Oil, Fish Oil, and Medium Chain Triglycerides, Compared With Soybean Oil in Parenteral Nutrition-Fed Neonatal Piglets. AU - Turner,Justine M, AU - Josephson,Jessica, AU - Field,Catherine J, AU - Wizzard,Pamela R, AU - Ball,Ronald O, AU - Pencharz,Paul B, AU - Wales,Paul W, Y1 - 2015/04/02/ PY - 2014/11/24/received PY - 2015/02/28/accepted PY - 2015/4/4/entrez PY - 2015/4/4/pubmed PY - 2017/12/29/medline KW - intestinal failure KW - life cycle KW - lipids KW - liver disease KW - neonates KW - nutrition KW - parenteral nutrition KW - pediatrics KW - research and diseases SP - 973 EP - 81 JF - JPEN. Journal of parenteral and enteral nutrition JO - JPEN J Parenter Enteral Nutr VL - 40 IS - 7 N2 - BACKGROUND: The optimal parenteral lipid emulsion for neonates should reduce the risk of intestinal failure-associated liver disease and inflammation, while supporting growth and development. This could be best achieved by balanced content of ω-6 and ω-3 polyunsaturated fatty acids (PUFAs). Using a neonatal piglet model of parenteral nutrition (PN), we compared a 100% soy oil-based emulsion (ω-6:ω-3 PUFA: 7:1) with a mixed lipid emulsion comprising 30% soy oil, 30% medium-chain triglycerides, 25% olive oil, and 15% fish oil (ω-6:ω-3 PUFA: approximately 2.5:1) with regard to liver disease, inflammation, and fatty acid content in plasma and brain. METHOD: Neonatal piglets, 3-6 days old, underwent jugular catheter insertion for isonitrogenous, isocaloric PN delivery over 14 days. The IL group (n = 8) was treated with Intralipid; the ML group (n = 10) was treated with the mixed lipid (SMOFlipid). Bile flow, liver chemistry, C-reactive protein (CRP), and PUFA content in plasma phospholipids and brain were compared. RESULTS: Compared with the IL group, ML-treated piglets had increased bile flow (P = .008) and lower total bilirubin (P = .001) and CRP (P = .023) concentrations. The ω-6 long-chain PUFA content was lower in plasma and brain for the ML group. The key ω-3 long-chain PUFA for neonatal development, docosahexaenoic acid (DHA), was not different between groups. CONCLUSION: The mixed lipid, having less ω-6 PUFA and more ω-3 PUFA, was able to prevent liver disease and reduce systemic inflammation in PN-fed neonatal piglets. However, this lipid did not increase plasma or brain DHA status, which would be desirable for neonatal developmental outcomes. SN - 1941-2444 UR - https://www.unboundmedicine.com/medline/citation/25837680/Liver_Disease_Systemic_Inflammation_and_Growth_Using_a_Mixed_Parenteral_Lipid_Emulsion_Containing_Soybean_Oil_Fish_Oil_and_Medium_Chain_Triglycerides_Compared_With_Soybean_Oil_in_Parenteral_Nutrition_Fed_Neonatal_Piglets_ L2 - https://doi.org/10.1177/0148607115579711 DB - PRIME DP - Unbound Medicine ER -