Intradialytic parenteral nutrition: comparison of olive oil versus soybean oil-based lipid emulsions.
Lipid, oxidative and inflammatory parameters are frequently altered in dialysis patients and may be worsened by intravenous lipid emulsions (ILE). We assessed the efficacy and tolerance of olive as compared with standard soybean oil-based ILE during intradialytic parenteral nutrition (IDPN). IDPN mixtures containing amino acids, glucose, and either olive oil (OO group, n 17) or soybean oil-based ILE (SO group, n 18) were administered in a 5-week randomized, double-blind study. On days 0 and 35, patients' nutritional status was assessed by BMI, normalized protein catabolic rate, predialytic creatinine, serum albumin and transthyretin; lipid metabolism by plasma LDL- and HDL-cholesterol, triacylglycerols, phospholipids, apo A-I, A-II, B, C-II, C-III, E and lipoprotein (a); oxidative status by alpha-tocopherol, retinol, selenium, glutathione peroxidase, malondialdehyde and advanced oxidized protein products; inflammatory status by serum C-reactive protein, orosomucoid, IL-2 and IL-6. No serious adverse event was observed. Significant changes were observed from day 0 to day 35 (P<0.05): nutritional criteria improved (albumin in OO; albumin, transthyretin and creatinine in SO); LDL-cholesterol, apo B, C-II, C-III and apo A-I/A-II ratio increased in both groups. HDL-cholesterol decreased in OO; apo E increased and lipoprotein (a) decreased in SO; alpha-tocopherol/cholesterol ratio increased in OO; malondialdehyde decreased in both groups; IL-2 increased in both groups. The between-group comparison only showed the following differences: alpha-tocopherol/cholesterol increased in OO; lipoprotein (a) decreased in SO. From these data, it was concluded that OO- and SO-based IDPNs similarly improved nutritional status and influenced plasma lipid, oxidative, inflammatory and immune parameters.
Cano
Noël J M
NJ
Service d'Hépatogastroentérologie et Nutrition, Clinique Résidence du Parc, Rue Gaston Berger, 13362, Marseille cedex 10, France. njm.cano@wanadoo.fr
Saingra
Yannick
Y
Dupuy
Anne-Marie
AM
Lorec-Penet
Anne-Marie
AM
Portugal
Henri
H
Lairon
Denis
D
Cristol
Jean-Paul
JP
Come
Adrien
A
Le Brun
Alexia
A
Atlan
Philippe
P
Leverve
Xavier M
XM
D000368:Aged; D002784:Cholesterol / Q000097:blood; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage; D004311:Double-Blind Method; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage* / Q000737:chemistry; D005260:Female; D006801:Humans; D008297:Male; D009748:Nutrition Disorders / Q000276:immunology / Q000628:therapy; D000069463:Olive Oil; D018384:Oxidative Stress; D010288:Parenteral Nutrition / Q000009:adverse effects / Q000379:methods*; D010743:Phospholipids / Q000097:blood; D010938:Plant Oils / Q000008:administration & dosage*; D011446:Prospective Studies; D006435:Renal Dialysis; D013024:Soybean Oil / Q000008:administration & dosage*; D014280:Triglycerides / Q000097:blood
D004042:Dietary Fats, Unsaturated; D005217:Fat Emulsions, Intravenous; D000069463:Olive Oil; D010743:Phospholipids; D010938:Plant Oils; D014280:Triglycerides; D013024:Soybean Oil; D002784:Cholesterol