title: Cholestasis induced by total parenteral nutrition: effects of the addition of Taurine (Tauramin®) on hepatic function parameters; possible synergistic action of structured lipids (SMOFlipid®).
abstract: OBJECTIVE
  Assess the hepatoprotective effect of Taurine (Tau) in cases of hepatic cholestasis induced by Total Parenteral Nutrition (TPN).
  
  
  METHODS
  We describe a retrospective series of 54 patients who received TPN, in which cholestasis was detected at an (Intermediate) point that separates the duration of TPN into 2 Phases. From this moment -Phase 2- on, and according to clinical criteria, some patients (Group A, n = 27) received amino acids with Tau (22.41 ± 3.57 mg/kg/day)(Tauramin®), while the rest (Group B, n = 27) received the standard solution without Tau. The mean TPN durations were 39.2 ± 17.1 and 36.4 ± 18.1 days respectively, with the Intermediate points on days 19.56 ± 10.51 and 17.89 ± 11.14. They all received diets that were homogeneous in terms of kcal and macronutrients. In Phase 2, 21 patients from Group A received structured lipids (SMOFlipid®); while 20 from Group B received soy MCT/LCT [ Medium Chain Triglycerides/Long Chain Triglycerides ] (physical or structured mixture). In a retrospective study, differences could not be avoided. The analytical parameters from three periods (Initial, Intermediate, and Final) were obtained from Nutridata® and Servolab®. We compared interperiod values using the Wilcoxon test SPSS® (p < 0.05).
  
  
  RESULTS
  After introducing Taurine AST, ALT, and GGT were significantly reduced; Bilirubin was also reduced, but not significantly. The values obtained for GGT in Group A were (Mean(σ)/median): Initial 48.6 (23.1)/46; Intermediate 473.7 (276.2)/438, and Final 328.9 (190.4)/305. We stress that the mean GGT value is reduced by 30.56% after adding Taurine, while in its absence all parameters are elevated, and mean GGT increases 45.36%.
  
  
  CONCLUSIONS
  These results show Taurine's hepatoprotective effect and support its use in cases of TPN-induced cholestasis. We acknowledge the possibility that the differences between SMOF and the MCT/LCT mixtures also may have influenced the results in a combined effect with taurine.
authors.affiliation: Sección de Nutrición, Unidad de Gestión Clínica de Farmacia, Hospital Universitario Virgen de la Victoria, Málaga, España.
authors.forename: J
authors.initials: J
authors.lastname: González-Contreras
authors.forename: J L
authors.initials: JL
authors.lastname: Villalobos Gámez
authors.forename: A I
authors.initials: AI
authors.lastname: Gómez-Sánchez
authors.forename: J M
authors.initials: JM
authors.lastname: García-Almeida
authors.forename: A
authors.initials: A
authors.lastname: Enguix Armanda
authors.forename: F
authors.initials: F
authors.lastname: Rius Díaz
authors.forename: M I
authors.initials: MI
authors.lastname: Lucena González
mesh_terms: D000368:Aged; D001660:Biliary Tract Diseases / Q000139:chemically induced / Q000188:drug therapy; D002779:Cholestasis / Q000139:chemically induced* / Q000188:drug therapy*; D005217:Fat Emulsions, Intravenous / Q000494:pharmacology*; D005260:Female; D005526:Food, Formulated; D006801:Humans; D008055:Lipids / Q000494:pharmacology*; D008099:Liver / Q000187:drug effects*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000139:chemically induced / Q000188:drug therapy; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D012189:Retrospective Studies; D013654:Taurine / Q000627:therapeutic use*
chemical_list: D005217:Fat Emulsions, Intravenous; D008055:Lipids; D013654:Taurine