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Effect of changing the lipid component of home parenteral nutrition in adults

Effect of changing the lipid component of home parenteral nutrition in adults
Effect of changing the lipid component of home parenteral nutrition in adults
Background: The effect of different lipid emulsions (LEs) within the parenteral nutrition (PN) regimen of adult home PN (HPN) patients is not clear. This study investigated the effect of changing adult HPN patients from a soybean oil based LE (Intralipid) to either a fish oil containing LE (providing n-3 fatty acids) (SMOFLipid) or an olive oil based LE (ClinOleic). Methods: Thirty two adults receiving long-term HPN with Intralipid as the LE were transferred to receive either SMOFLipid (n = 13) or ClinOleic (n = 19) for 60 days. Liver function markers, cholesterol, triglycerides, a full profile of fatty acids, and several cytokines were measured at study entry and after 60 days. Results: SMOFLipid did not affect liver function markers, blood lipids or plasma cytokines. ClinOleic lowered both gamma-glutamyltranspeptidase (P = 0.044) and interleukin-8 (P = 0.030) concentrations. Both LEs induced marked changes in the fatty acid profile of plasma. SMOFLipid resulted in significant decreases in the proportions of linoleic acid, several other n-6 fatty acids and the essential fatty acid (EFA) deficiency indicator mead acid and significant increases in the proportions of the n-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid. ClinOleic resulted in significant decreases in the proportions of some saturated fatty acids, linoleic acid, several n-6 fatty acids, all n-3 fatty acids and mead acid and a significant increase in the proportion of oleic acid. The ratio of mead to arachidonic acid in plasma was not altered by either SMOFLipid or ClinOleic. No patient had a mead acid to arachidonic acid ratio of >0.2, the cut-off used to indicate EFA deficiency. Conclusion: Both SMOFLipid and ClinOleic significantly alter the fatty acid profile of plasma in adult HPN patients previously using Intralipid. Neither LE induces EFA deficiency in these patients. SMOFLipid did not alter liver function markers or inflammation. In contrast, ClinOleic decreased some, though not all, markers of liver function and inflammation. SMOFLipid and ClinOleic may both be considered for use in adult HPN patients.
0261-5614
1355-1361
Osowska, Sylwia
2c35ca18-22ba-48c9-9ec1-9694d217e707
Kunecki, Marek
3e10fe06-5bd1-4d3c-86f4-cc57c42df828
Sobocki, Jacek
38541ea5-cd49-48f8-8290-5ff350bad0a5
Tokarczyk, Joanna
f378778b-f7ef-41fa-b0c5-36ff421ba3a8
Majewska, Krystyna
bf9c2132-3467-45f1-a1a7-b42292ebd916
Omidi, Mohamed
2156aa96-9dbf-4250-9e41-e9b1ddeb2eb5
Radkowski, Marek
b68a7941-1e5b-4c4b-8e6d-0567e620dc5b
Fisk, Helena
2483d346-75dd-41b3-a481-10f8bb39cd9f
Calder, Philip
1797e54f-378e-4dcb-80a4-3e30018f07a6
Osowska, Sylwia
2c35ca18-22ba-48c9-9ec1-9694d217e707
Kunecki, Marek
3e10fe06-5bd1-4d3c-86f4-cc57c42df828
Sobocki, Jacek
38541ea5-cd49-48f8-8290-5ff350bad0a5
Tokarczyk, Joanna
f378778b-f7ef-41fa-b0c5-36ff421ba3a8
Majewska, Krystyna
bf9c2132-3467-45f1-a1a7-b42292ebd916
Omidi, Mohamed
2156aa96-9dbf-4250-9e41-e9b1ddeb2eb5
Radkowski, Marek
b68a7941-1e5b-4c4b-8e6d-0567e620dc5b
Fisk, Helena
2483d346-75dd-41b3-a481-10f8bb39cd9f
Calder, Philip
1797e54f-378e-4dcb-80a4-3e30018f07a6

Osowska, Sylwia, Kunecki, Marek, Sobocki, Jacek, Tokarczyk, Joanna, Majewska, Krystyna, Omidi, Mohamed, Radkowski, Marek, Fisk, Helena and Calder, Philip (2019) Effect of changing the lipid component of home parenteral nutrition in adults. Clinical Nutrition, 38 (3), 1355-1361. (doi:10.1016/j.clnu.2018.05.028).

Record type: Article

Abstract

Background: The effect of different lipid emulsions (LEs) within the parenteral nutrition (PN) regimen of adult home PN (HPN) patients is not clear. This study investigated the effect of changing adult HPN patients from a soybean oil based LE (Intralipid) to either a fish oil containing LE (providing n-3 fatty acids) (SMOFLipid) or an olive oil based LE (ClinOleic). Methods: Thirty two adults receiving long-term HPN with Intralipid as the LE were transferred to receive either SMOFLipid (n = 13) or ClinOleic (n = 19) for 60 days. Liver function markers, cholesterol, triglycerides, a full profile of fatty acids, and several cytokines were measured at study entry and after 60 days. Results: SMOFLipid did not affect liver function markers, blood lipids or plasma cytokines. ClinOleic lowered both gamma-glutamyltranspeptidase (P = 0.044) and interleukin-8 (P = 0.030) concentrations. Both LEs induced marked changes in the fatty acid profile of plasma. SMOFLipid resulted in significant decreases in the proportions of linoleic acid, several other n-6 fatty acids and the essential fatty acid (EFA) deficiency indicator mead acid and significant increases in the proportions of the n-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid. ClinOleic resulted in significant decreases in the proportions of some saturated fatty acids, linoleic acid, several n-6 fatty acids, all n-3 fatty acids and mead acid and a significant increase in the proportion of oleic acid. The ratio of mead to arachidonic acid in plasma was not altered by either SMOFLipid or ClinOleic. No patient had a mead acid to arachidonic acid ratio of >0.2, the cut-off used to indicate EFA deficiency. Conclusion: Both SMOFLipid and ClinOleic significantly alter the fatty acid profile of plasma in adult HPN patients previously using Intralipid. Neither LE induces EFA deficiency in these patients. SMOFLipid did not alter liver function markers or inflammation. In contrast, ClinOleic decreased some, though not all, markers of liver function and inflammation. SMOFLipid and ClinOleic may both be considered for use in adult HPN patients.

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Osowska et al. Manuscript Second Revision Clean - Accepted Manuscript
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More information

Accepted/In Press date: 27 May 2018
e-pub ahead of print date: 6 June 2018
Published date: 1 June 2019

Identifiers

Local EPrints ID: 421421
URI: http://eprints.soton.ac.uk/id/eprint/421421
ISSN: 0261-5614
PURE UUID: d2a27d7c-d4f4-4d03-bed5-4f8c880f82f2
ORCID for Helena Fisk: ORCID iD orcid.org/0000-0002-9534-3246
ORCID for Philip Calder: ORCID iD orcid.org/0000-0002-6038-710X

Catalogue record

Date deposited: 11 Jun 2018 16:30
Last modified: 26 Nov 2021 06:07

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Contributors

Author: Sylwia Osowska
Author: Marek Kunecki
Author: Jacek Sobocki
Author: Joanna Tokarczyk
Author: Krystyna Majewska
Author: Mohamed Omidi
Author: Marek Radkowski
Author: Helena Fisk ORCID iD
Author: Philip Calder ORCID iD

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