Effect of omega-3 polyunsaturated fatty acids to reverse biopsy-proven parenteral nutrition-associated liver disease in adults.
OBJECTIVE
Parenteral nutrition-associated liver disease (PNALD) complicates the treatment of patients with short bowel syndrome (SBS). Some studies have shown omega-3 polyunsaturated fatty acids (ω-3 PUFAs) have favorable effects in treating PNALD in children. We, therefore, investigate the effects of ω-3 PUFAs supplemented intravenous lipid emulsion (ILE) on PNALD in adults.


METHODS
We performed an open-labeled study of a ω-3 PUFAs based ILE in 15 adults with SBS who developed cholestasis while receiving soybean oil-based ILE. Liver biopsies were performed before and after the initiation of ω-3 PUFAs to confirm the presence and improvement of cholestasis. Blood samples were collected every week for analysis of fatty acid composition and liver function.


RESULTS
12 of the 15 patients had their direct bilirubin normalized within 4 weeks and our data demonstrated a significant decrease in both DB (P ≤ 0.001) and TB (P ≤ 0.001) after 4 weeks compared to baseline. There were ameliorations of liver function and fatty acid patterns in all patients and serial liver biopsy specimens showed progressive histologic improvement.


CONCLUSIONS
Parenteral ω-3 PUFAs supplemented fat emulsions are safe and effective in the treatment of PNALD in adults.
Department of Surgery, Jinling Hospital, Nanjing University School of Medicine, 305 E Zhongshan Rd, Nanjing 210002, PR China.
Ziwei
Z
Xu
Yousheng
Y
Li
Jian
J
Wang
Bo
B
Wu
Jieshou
J
Li
D000328:Adult; D001663:Bilirubin / Q000097:blood; D001706:Biopsy; D002779:Cholestasis / Q000150:complications / Q000188:drug therapy; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage; D006801:Humans; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000150:complications / Q000188:drug therapy*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000009:adverse effects*; D012778:Short Bowel Syndrome / Q000150:complications / Q000188:drug therapy; D013024:Soybean Oil / Q000008:administration & dosage; D016896:Treatment Outcome; D055815:Young Adult
D005217:Fat Emulsions, Intravenous; D015525:Fatty Acids, Omega-3; D005395:Fish Oils; D013024:Soybean Oil; D001663:Bilirubin