title: Metabolic effects of intravenous LCT or MCT/LCT lipid emulsions in preterm infants.
abstract: Most lipid emulsions for parenteral feeding of premature infants are based on long-chain triacylglycerols (LCTs), but inclusion of medium-chain triacylglycerols (MCTs) might provide a more readily oxidizable energy source. The influence of these emulsions on fatty acid composition and metabolism was studied in 12 premature neonates, who were randomly assigned to an LCT emulsion (control) or an emulsion with a mixture of MCT and LCT (1:1). On study day 7, all infants received [13C]linoleic (LA) and [13C]alpha-linolenic acid (ALA) tracers orally. Plasma phospholipid (PL) and triacylglycerol (TG) fatty acid composition and 13C enrichments of plasma PL fatty acids were determined on day 8. After 8 days of lipid infusion, plasma TGs in the MCT/LCT group had higher contents of C8:0 (0.50 +/- 0.60% vs. 0.10 +/- 0.12%; means +/- SD) and C10:0 (0.66 +/- 0.51% vs. 0.15 +/- 0.17%) than controls. LA content of plasma PLs was slightly lower in the MCT/LCT group (16.47 +/- 1.16% vs. 18.57 +/- 2.09%), whereas long-chain polyunsaturated derivatives (LC-PUFAs) of LA and ALA tended to be higher. The tracer distributions between precursors and products (LC-PUFAs) were not significantly different between groups. Both lipid emulsions achieve similar plasma essential fatty acid (EFA) contents and similar proportional conversion of EFAs to LC-PUFAs. The MCT/LCT emulsion seems to protect EFAs and LC-PUFAs from beta-oxidation.
authors.affiliation: Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Frauke
authors.initials: F
authors.lastname: Lehner
authors.forename: Hans
authors.initials: H
authors.lastname: Demmelmair
authors.forename: Wulf
authors.initials: W
authors.lastname: Röschinger
authors.forename: Tamás
authors.initials: T
authors.lastname: Decsi
authors.forename: Mária
authors.initials: M
authors.lastname: Szász
authors.forename: Károly
authors.initials: K
authors.lastname: Adamovich
authors.forename: Ralf
authors.initials: R
authors.lastname: Arnecke
authors.forename: Berthold
authors.initials: B
authors.lastname: Koletzko
mesh_terms: D020155:3-Hydroxybutyric Acid / Q000097:blood / Q000378:metabolism; D001835:Body Weight; D002247:Carbon Isotopes; D002331:Carnitine / Q000031:analogs & derivatives / Q000097:blood / Q000378:metabolism; D002784:Cholesterol / Q000097:blood / Q000378:metabolism; D004311:Double-Blind Method; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage / Q000494:pharmacology*; D005227:Fatty Acids / Q000032:analysis / Q000097:blood / Q000378:metabolism*; D005228:Fatty Acids, Essential / Q000032:analysis / Q000097:blood / Q000378:metabolism; D005230:Fatty Acids, Nonesterified / Q000097:blood / Q000378:metabolism; D005231:Fatty Acids, Unsaturated / Q000032:analysis / Q000097:blood / Q000378:metabolism; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D050356:Lipid Metabolism / Q000187:drug effects*; D008297:Male; D010743:Phospholipids / Q000097:blood / Q000737:chemistry / Q000378:metabolism; D014280:Triglycerides / Q000097:blood / Q000737:chemistry / Q000378:metabolism*; D017962:alpha-Linolenic Acid / Q000008:administration & dosage / Q000494:pharmacology; D024502:alpha-Tocopherol / Q000097:blood / Q000378:metabolism; D024504:gamma-Tocopherol / Q000097:blood / Q000378:metabolism
chemical_list: D002247:Carbon Isotopes; D005217:Fat Emulsions, Intravenous; D005227:Fatty Acids; D005228:Fatty Acids, Essential; D005230:Fatty Acids, Nonesterified; D005231:Fatty Acids, Unsaturated; D010743:Phospholipids; D014280:Triglycerides; C116917:acylcarnitine; D017962:alpha-Linolenic Acid; D024504:gamma-Tocopherol; D002784:Cholesterol; D024502:alpha-Tocopherol; D002331:Carnitine; D020155:3-Hydroxybutyric Acid