Effects of intravenous supplementation with alpha-tocopherol in patients receiving total parenteral nutrition containing medium- and long-chain triglycerides.
OBJECTIVE
To compare the effects of a lipid emulsion containing medium-chain triglycerides (MCT) and supplemented with alpha-tocopherol to a conventional long-chain triglyceride (LCT) emulsion.


METHODS
Randomised double blind study.


METHODS
Department of Internal Medicine, Antwerp University Hospital.


METHODS
Twenty-four patients with an indication for total parenteral nutrition for a minimum of 10 days were randomly assigned to two groups: group E received as lipid source MCT/LCT (50/50) suplemented with 100 mg DL-alpha-tocopherol/day and group C received LCT. Blood samples were analysed at inclusion, after 4-6 and after 9-11 days.


RESULTS
In group E, serum alpha-tocopherol doubled from 11.4+/-6.9 at inclusion to 20.9+/-7.9 and to 23.8+/-8.8 microg/ml after 4 and 9 days, respectively, but did not change in group C (P=0.008). Production of thiobarbituric acid-reacting substances (TBARS) after 120 min incubation with copper decreased from 66+/-34 at inclusion to 29+/-25 nmol MDA/mg LDL and VLDL-cholesterol after 4 and to 42+/-17 after 9 days (P=0.022 when compared to group C, which underwent no significant changes). Velocity of production of fluorescent products decreased in group E but not in group C (P=0.026).


CONCLUSIONS
Supplementation of TPN containing MCT/LCT with 100 mg DL-alpha-tocopherol/day leads to a doubling in serum alpha-tocopherol and to a decrease in the susceptibility of LDL and VLDL to peroxidation in vitro.


BACKGROUND
This study was partly financed by B Braun Medical NVSA, Diegem, Belgium.
Manuel-y-Keenoy
B
B
Laboratory of Endocrinology, University Hospital, University of Antwerp, Antwerp, Belgium. begona@uia.ua.ac.be
Nonneman
L
L
De Bosscher
H
H
Vertommen
J
J
Schrans
S
S
Klütsch
K
K
De Leeuw
I
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D005217:Fat Emulsions, Intravenous / Q000737:chemistry*; D005260:Female; D006801:Humans; D015227:Lipid Peroxidation / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D017392:Thiobarbituric Acid Reactive Substances / Q000378:metabolism; D014280:Triglycerides / Q000008:administration & dosage* / Q000737:chemistry; D024502:alpha-Tocopherol / Q000008:administration & dosage* / Q000097:blood
D005217:Fat Emulsions, Intravenous; D017392:Thiobarbituric Acid Reactive Substances; D014280:Triglycerides; D024502:alpha-Tocopherol