A case of severe hyperlipidemia caused by long-term tube feedings.
A 77-year-old woman with type II diabetes mellitus was admitted to our hospital in August/ 1995 with severe hyperlipidemia. She had taken feedings through a nasogastric tube with 1000 ml (1000 kcal) of Ensureliquid daily since 1993 because of the muscle weakness after rhabdomyolysis. Her serum total cholesterol was 515 mg/dl and triglyceride was 3378 mg/dl despite administration of 10 mg of simvastatin daily. After substitution of a standard diet starting August 21, we found significant decreases of total cholesterol from 725 mg/dl to 194 mg/dl and triglyceride from 4680 mg/dl to 550 mg/dl within 37 days. We also found a severe decrease in her serum total carnitine level of 22 micromol/l (normal range 45-91 micromol/l) before changing the diet, suggesting secondary carnitine deficiency. Severe hyperlipidemia was reversed by changing the carnitine deficient diet (Ensureliquid) to a carnitine-containing diet. We suggested that the development of hyperlipidemia was related to the carnitine deficiency.
Tanaka
Shin-ichiro
S
Department of Internal Medicine, Hidaka Hospital, Hyogo, Japan. chee@mxa.nkansai.ne.jp
Miki
Tetsuo
T
Hsieh
Shao-Tung
ST
Kim
Jong-Il
JI
Yasumoto
Tsuguo
T
Taniguchi
Takahiro
T
Ishikawa
Yuichi
Y
Yokoyama
Mitsuhiro
M
D000368:Aged; D002331:Carnitine / Q000008:administration & dosage / Q000172:deficiency*; D019422:Dietary Sucrose / Q000008:administration & dosage / Q000009:adverse effects*; D004750:Enteral Nutrition; D005260:Female; D005526:Food, Formulated; D006801:Humans; D006949:Hyperlipidemias / Q000178:diet therapy* / Q000188:drug therapy / Q000209:etiology*; D000960:Hypolipidemic Agents / Q000008:administration & dosage; D012206:Rhabdomyolysis / Q000178:diet therapy; D019821:Simvastatin / Q000008:administration & dosage
D019422:Dietary Sucrose; D000960:Hypolipidemic Agents; C082131:Ensure formulated food; D019821:Simvastatin; D002331:Carnitine