title: Substitution of standard soybean oil with olive oil-based lipid emulsion in parenteral nutrition: comparison of vascular, metabolic, and inflammatory effects.
abstract: BACKGROUND
  Soybean oil-based lipid emulsions are the only Food and Drug Administration-approved lipid formulation for clinical use in parenteral nutrition (PN). Recently concerns with its use have been raised due to the proinflammatory effects that may lead to increased complications because they are rich in ω-6 polyunsaturated fatty acids.
  
  
  METHODS
  This was a prospective, randomized, controlled, crossover study comparing the vascular, metabolic, immune, and inflammatory effects of 24-h infusion of PN containing soybean oil-based lipid emulsion (Intralipid), olive oil-based (ClinOleic), lipid free, and normal saline in 12 healthy subjects.
  
  
  RESULTS
  Soybean oil-PN increased systolic blood pressure compared with olive oil-PN (P < 0.05). Soybean oil PN reduced brachial artery flow-mediated dilatation from baseline (-23% at 4 h and -25% at 24 h, both P < 0.01); in contrast, olive oil PN, lipid free PN, and saline did not change either systolic blood pressure or flow-mediated dilatation. Compared with saline, soybean oil PN, olive oil PN, and lipid free PN similarly increased glucose and insulin concentrations during infusion (P < 0.05). There were no significant changes in plasma free fatty acids, lipid profile, inflammatory and oxidative stress markers, immune function parameters, or sympathetic activity between soybean oil- and olive oil-based lipid emulsions.
  
  
  CONCLUSIONS
  The 24-h infusion of PN containing soybean oil-based lipid emulsion increased blood pressure and impaired endothelial function compared with PN containing olive oil-based lipid emulsion and lipid-free PN in healthy subjects. These vascular changes may have significant implications in worsening outcome in subjects receiving nutrition support. Randomized controlled trials with relevant clinical outcome measures are needed in patients receiving PN with olive oil-based and soybean oil-based lipid emulsions.
authors.affiliation: Department of Medicine, Emory University, Atlanta, Georgia 30303, USA.
authors.forename: Joselita
authors.initials: J
authors.lastname: Siqueira
authors.forename: Dawn
authors.initials: D
authors.lastname: Smiley
authors.forename: Christopher
authors.initials: C
authors.lastname: Newton
authors.forename: Ngoc-Anh
authors.initials: NA
authors.lastname: Le
authors.forename: Aidar R
authors.initials: AR
authors.lastname: Gosmanov
authors.forename: Ronnie
authors.initials: R
authors.lastname: Spiegelman
authors.forename: Limin
authors.initials: L
authors.lastname: Peng
authors.forename: Samantha J
authors.initials: SJ
authors.lastname: Osteen
authors.forename: Dean P
authors.initials: DP
authors.lastname: Jones
authors.forename: Arshed A
authors.initials: AA
authors.lastname: Quyyumi
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Ziegler
authors.forename: Guillermo E
authors.initials: GE
authors.lastname: Umpierrez
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000187:drug effects; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects; D001808:Blood Vessels / Q000187:drug effects*; D002096:C-Peptide / Q000378:metabolism; D004106:Dilatation; D004730:Endothelium, Vascular / Q000187:drug effects / Q000502:physiology; D005217:Fat Emulsions, Intravenous / Q000032:analysis*; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D005526:Food, Formulated; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007109:Immunity / Q000187:drug effects; D007249:Inflammation / Q000139:chemically induced*; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D008660:Metabolism / Q000187:drug effects*; D008875:Middle Aged; D000069463:Olive Oil; D018384:Oxidative Stress / Q000187:drug effects; D010288:Parenteral Nutrition; D010938:Plant Oils / Q000009:adverse effects / Q000494:pharmacology*; D013024:Soybean Oil / Q000009:adverse effects / Q000494:pharmacology*; D013564:Sympathetic Nervous System / Q000187:drug effects
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D005217:Fat Emulsions, Intravenous; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D008055:Lipids; D000069463:Olive Oil; D010938:Plant Oils; D013024:Soybean Oil