title: Cholestasis, bronchopulmonary dysplasia, and lipid profile in preterm infants receiving MCT/ω-3-PUFA-containing or soybean-based lipid emulsions.
abstract: BACKGROUND
  This study aimed to compare the effect of 2 lipid emulsions (LEs), a medium-chain triglyceride (MCT)/ω-3-polyunsaturated fatty acid (PUFA)-containing LE and a soybean-based LE, on the incidence of neonatal cholestasis, bronchopulmonary dysplasia (BPD), and lipid profile of preterm infants. Patients and
  
  
  METHODS
  In this prospective, observational study, 2 groups of preterm neonates, the very low birth weight (VLBW) (n = 129) and the low birth weight (LBW) groups (n = 153), which received parenteral LEs for at least 7 days, were included. Infants received either MCT/ω-3-PUFA-containing LE (SMOFlipid, subgroup I) or soybean-based LE (Intralipid, subgroup II) according to the attending neonatologist's preference and availability. Full biochemical assessment was performed on days of life 15, 30, and 45 and on discharge.
  
  
  RESULTS
  Of the VLBW infants, 7.4% and 13.3% of infants in subgroups I and II, respectively, developed cholestasis (P = .39; odds ratio [OR], 0.52; 95% confidence interval [CI], 0.15-1.76). The duration of LE administration was independently associated with cholestasis (P < .001; OR, 0.925; 95% CI, 0.888-0.963). The maximum amounts of lipids administered ranged between 1.6 and 3.6 g/kg/d in both VLBW subgroups. The VLBW subgroup I had lower incidence of BPD, lower alkaline phosphatase and phosphate, higher high-density lipoprotein (HDL), and lower cholesterol-to-HDL ratio on discharge than the VLBW subgroup II. The type of LE was independently associated with BPD and alkaline phosphatase. In the LBW group, the type of LE was not associated with clinical and biochemical parameters.
  
  
  CONCLUSIONS
  In VLBW infants, the MCT/ω-3-PUFA-containing LE administration is associated with decreased BPD and more favorable lipoprotein profile. Although a trend toward a lower incidence of cholestasis was observed, a preventive effect of MCT/ω-3-PUFA-containing LE on parenteral nutrition-associated cholestasis is not supported.
authors.affiliation: Harokopio University, Department of Nutrition and Dietetics, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Skouroliakou
authors.forename: Dimitris
authors.initials: D
authors.lastname: Konstantinou
authors.forename: Charalampos
authors.initials: C
authors.lastname: Agakidis
authors.forename: Natalia
authors.initials: N
authors.lastname: Delikou
authors.forename: Katerina
authors.initials: K
authors.lastname: Koutri
authors.forename: Marina
authors.initials: M
authors.lastname: Antoniadi
authors.forename: Thomais
authors.initials: T
authors.lastname: Karagiozoglou-Lampoudi
mesh_terms: D001663:Bilirubin / Q000097:blood; D001997:Bronchopulmonary Dysplasia / Q000517:prevention & control*; D002779:Cholestasis / Q000209:etiology / Q000517:prevention & control*; D004655:Emulsions / Q000008:administration & dosage; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D006801:Humans; D015994:Incidence; D007223:Infant; D052577:Infant, Extremely Low Birth Weight; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000209:etiology / Q000517:prevention & control; D008055:Lipids / Q000097:blood*; D016015:Logistic Models; D018384:Oxidative Stress; D010288:Parenteral Nutrition / Q000009:adverse effects / Q000379:methods; D010743:Phospholipids / Q000008:administration & dosage*; D011446:Prospective Studies; D013024:Soybean Oil / Q000008:administration & dosage*; D014280:Triglycerides / Q000008:administration & dosage*
chemical_list: D004655:Emulsions; D005217:Fat Emulsions, Intravenous; D015525:Fatty Acids, Omega-3; D008055:Lipids; D010743:Phospholipids; D014280:Triglycerides; C545823:soybean oil, phospholipid emulsion; D013024:Soybean Oil; D001663:Bilirubin