title: Assessment of long chain n-3 polyunsaturated fatty acid status and clinical outcome in adults receiving home parenteral nutrition.
abstract: OBJECTIVE
  Long term parenteral nutrition rarely supplies the long chain n-3 polyunsaturated fatty acids (PUFA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA). The aim of this study was to assess long chain n-3 PUFA status in patients receiving home parenteral nutrition (HPN).
  
  
  METHODS
  Plasma phospholipid fatty acids were measured in 64 adult HPN patients and compared with 54 age, sex and BMI matched controls. Logistic regression analysis was used to identify factors related to plasma fatty acid fractions in the HPN patients, and to identify factors associated with the risk of clinical complications.
  
  
  RESULTS
  Plasma phospholipid fractions of EPA, DPA and DHA were significantly lower in patients receiving HPN. Factors independently associated with low fractions included high parenteral energy provision, low parenteral lipid intake, low BMI and prolonged duration of HPN. Long chain n-3 PUFA fractions were not associated with incidence of either central venous catheter associated infection or central venous thrombosis. However, the fraction of EPA were inversely associated with plasma alkaline phosphatase concentrations.
  
  
  CONCLUSIONS
  This study demonstrates abnormal long chain n-3 PUFA profiles in patients receiving HPN. Reduced fatty acid intake may be partly responsible. Fatty acid metabolism may also be altered.
authors.affiliation: Lennard-Jones Intestinal Failure Unit, St Mark's Hospital, Harrow, UK. dajl@btinternet.com
authors.forename: David A J
authors.initials: DA
authors.lastname: Lloyd
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Paynton
authors.forename: Paul
authors.initials: P
authors.lastname: Bassett
authors.forename: Anna Rodriguez
authors.initials: AR
authors.lastname: Mateos
authors.forename: Julie A
authors.initials: JA
authors.lastname: Lovegrove
authors.forename: Simon M
authors.initials: SM
authors.lastname: Gabe
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Griffin
mesh_terms: D000469:Alkaline Phosphatase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D015525:Fatty Acids, Omega-3 / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016331:Parenteral Nutrition, Home / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D012044:Regression Analysis; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D015525:Fatty Acids, Omega-3; D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase; D001663:Bilirubin