title: Short-term exposure to exogenous lipids in premature infants and long-term changes in aortic and cardiac function.
abstract: OBJECTIVE
  Intravenous lipid use is associated with an acute hyperlipidemia, but long-term consequences have not been studied. We investigated whether elevated lipids in humans during the critical period of preterm neonatal life have a long-term impact on aortic and myocardial function relevant to adult disease.
  
  
  RESULTS
  We followed up 102 subjects born prematurely and now aged 23 to 28 years. Eighteen received intravenous lipids as neonates and were matched to controls with equivalent perinatal characteristics. Global and regional aortic stiffness and left ventricular function were assessed by cardiovascular magnetic resonance. Those who received intravenous lipids had greater aortic stiffness in early adulthood (P=0.0002), with greater stiffness in the abdominal aorta (P=0.012). The relationship was graded according to the elevation in neonatal cholesterol induced by intravenous lipids (P<0.0001) but not other metabolic parameters altered by the infusion. Peak systolic circumferential strain was also reduced in the lipid group (P=0.006), which, again, was proportional to neonatal cholesterol level (P<0.01).
  
  
  CONCLUSIONS
  Aortic and myocardial function in young adulthood is associated with intralipid exposure during neonatal life for preterm infants, in a graded manner related to the rise in cholesterol. Circulating cholesterol during critical developmental periods may have long-term impacts on the human cardiovascular system.
authors.affiliation: Cardiovascular Clinical Research Facility, Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Lewandowski
authors.forename: Merzaka
authors.initials: M
authors.lastname: Lazdam
authors.forename: Esther
authors.initials: E
authors.lastname: Davis
authors.forename: Ilias
authors.initials: I
authors.lastname: Kylintireas
authors.forename: Jonathan
authors.initials: J
authors.lastname: Diesch
authors.forename: Jane
authors.initials: J
authors.lastname: Francis
authors.forename: Stefan
authors.initials: S
authors.lastname: Neubauer
authors.forename: Atul
authors.initials: A
authors.lastname: Singhal
authors.forename: Alan
authors.initials: A
authors.lastname: Lucas
authors.forename: Brenda
authors.initials: B
authors.lastname: Kelly
authors.forename: Paul
authors.initials: P
authors.lastname: Leeson
mesh_terms: D000328:Adult; D001011:Aorta / Q000502:physiology*; D002784:Cholesterol / Q000097:blood; D004655:Emulsions / Q000494:pharmacology; D006321:Heart / Q000502:physiology*; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000209:etiology; D007231:Infant, Newborn; D007234:Infant, Premature; D010743:Phospholipids / Q000494:pharmacology*; D011673:Pulsatile Flow; D013024:Soybean Oil / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D004655:Emulsions; D010743:Phospholipids; C545823:soybean oil, phospholipid emulsion; D013024:Soybean Oil; D002784:Cholesterol