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Effect of a fish oil-based lipid emulsion on intestinal failure-associated liver disease in children.
Eur J Clin Nutr 2018; 72(10):1364-1372EJ

Abstract

BACKGROUND/OBJECTIVES

The aim of this study was to assess the effects of a fish oil-based lipid emulsion on intestinal failure-associated liver disease (IFALD) in children.

SUBJECTS/METHODS

From January 2014 through June 2017, we enrolled 32 children with IF on long-term parenteral nutrition (PN). When the levels of any three of seven liver indicators (TBA, alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase, gamma glutamyl transferase (γ-GT), total bilirubin (TB), or direct bilirubin (DB)) were two times higher than normal levels, we switched a 50:50 mix of soybean oil and medium-chain triglycerides (MCT) lipid emulsion (with an average dose of 1.30 g/kg/day) to a fish oil-based lipid emulsion (1 g/kg/day) and measured liver function in the children. Meanwhile, inflammation and oxidative stress-related markers were also measured.

RESULTS

The average fish oil therapy duration was 26 ± 21 days, and the median duration of PN support was 84 days. With fish oil therapy, levels of TBA, ALT, AST, γ-GT, TB, and DB all significantly decreased. Enteral nutrition was introduced following fish oil resulting in higher energy intake (99.88 ± 31.06 kcal/kg/day) compared with before fish oil (67.90 ± 27.31 kcal/kg/day, P = 0.001). No significant difference was found in average PN energy (P = 0.147). In addition, levels of inflammatory indicators like tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), and white blood cell (WBC) significantly decreased.

CONCLUSIONS

Fish oil therapy alleviates IFALD in children.

Authors+Show Affiliations

Department of Pediatric Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. Shanghai Institute of Pediatric Research, Shanghai, China. Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China.Shanghai Institute of Pediatric Research, Shanghai, China. Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China. Department of Clinical Nutrition, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.Shanghai Institute of Pediatric Research, Shanghai, China. Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China. Department of Clinical Nutrition, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.Shanghai Institute of Pediatric Research, Shanghai, China. Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China. Department of Clinical Nutrition, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.Shanghai Institute of Pediatric Research, Shanghai, China. Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China. Department of Clinical Nutrition, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.Department of Pharmacy, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.Shanghai Institute of Pediatric Research, Shanghai, China. wangying02@xinhuamed.com.cn. Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China. wangying02@xinhuamed.com.cn. Department of Clinical Nutrition, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. wangying02@xinhuamed.com.cn.Department of Pediatric Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. caiw204@sjtu.edu.cn. Shanghai Institute of Pediatric Research, Shanghai, China. caiw204@sjtu.edu.cn. Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China. caiw204@sjtu.edu.cn.

Pub Type(s)

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

Language

eng

PubMed ID

29382923

Citation

Zhang, Tian, et al. "Effect of a Fish Oil-based Lipid Emulsion On Intestinal Failure-associated Liver Disease in Children." European Journal of Clinical Nutrition, vol. 72, no. 10, 2018, pp. 1364-1372.
Zhang T, Wang N, Yan W, et al. Effect of a fish oil-based lipid emulsion on intestinal failure-associated liver disease in children. Eur J Clin Nutr. 2018;72(10):1364-1372.
Zhang, T., Wang, N., Yan, W., Lu, L., Tao, Y., Li, F., ... Cai, W. (2018). Effect of a fish oil-based lipid emulsion on intestinal failure-associated liver disease in children. European Journal of Clinical Nutrition, 72(10), pp. 1364-1372. doi:10.1038/s41430-018-0096-z.
Zhang T, et al. Effect of a Fish Oil-based Lipid Emulsion On Intestinal Failure-associated Liver Disease in Children. Eur J Clin Nutr. 2018;72(10):1364-1372. PubMed PMID: 29382923.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of a fish oil-based lipid emulsion on intestinal failure-associated liver disease in children. AU - Zhang,Tian, AU - Wang,Nan, AU - Yan,Weihui, AU - Lu,Lina, AU - Tao,Yijing, AU - Li,Fang, AU - Wang,Ying, AU - Cai,Wei, Y1 - 2018/01/30/ PY - 2017/08/06/received PY - 2017/12/29/accepted PY - 2017/12/28/revised PY - 2018/2/1/pubmed PY - 2019/6/6/medline PY - 2018/2/1/entrez SP - 1364 EP - 1372 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 72 IS - 10 N2 - BACKGROUND/OBJECTIVES: The aim of this study was to assess the effects of a fish oil-based lipid emulsion on intestinal failure-associated liver disease (IFALD) in children. SUBJECTS/METHODS: From January 2014 through June 2017, we enrolled 32 children with IF on long-term parenteral nutrition (PN). When the levels of any three of seven liver indicators (TBA, alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase, gamma glutamyl transferase (γ-GT), total bilirubin (TB), or direct bilirubin (DB)) were two times higher than normal levels, we switched a 50:50 mix of soybean oil and medium-chain triglycerides (MCT) lipid emulsion (with an average dose of 1.30 g/kg/day) to a fish oil-based lipid emulsion (1 g/kg/day) and measured liver function in the children. Meanwhile, inflammation and oxidative stress-related markers were also measured. RESULTS: The average fish oil therapy duration was 26 ± 21 days, and the median duration of PN support was 84 days. With fish oil therapy, levels of TBA, ALT, AST, γ-GT, TB, and DB all significantly decreased. Enteral nutrition was introduced following fish oil resulting in higher energy intake (99.88 ± 31.06 kcal/kg/day) compared with before fish oil (67.90 ± 27.31 kcal/kg/day, P = 0.001). No significant difference was found in average PN energy (P = 0.147). In addition, levels of inflammatory indicators like tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), and white blood cell (WBC) significantly decreased. CONCLUSIONS: Fish oil therapy alleviates IFALD in children. SN - 1476-5640 UR - https://www.unboundmedicine.com/medline/citation/29382923/Effect_of_a_fish_oil_based_lipid_emulsion_on_intestinal_failure_associated_liver_disease_in_children_ DB - PRIME DP - Unbound Medicine ER -