title: Plasma malondialdehyde levels in children on 12-hour cyclic parenteral nutrition: are there health risks?
abstract: In children undergoing total parenteral nutrition (PN), lipids provide a key source of calories preventing or correcting energy deficits and improving outcomes. However, some of these lipids may undergo oxidation leading to the formation of malondialdehyde (MDA), a cytotoxic byproduct found in these patients. This paper aims to describe a sensitive method for detecting MDA and discuss its role in certain diseases commonly found in children on regular PN. To quantify MDA levels in children benefitting from long-term cyclic PN, a reliable and sensitive high-performance liquid chromatographic method based on a 1-step derivatization/extraction procedure analysis with ultraviolet determination at 305 nm wavelength was achieved. In control children without PN, MDA levels were on average 3.30 ± 0.08 µM. However, in children nourished intravenously by fat emulsion for a long time, in which liver problems have been identified, the circulating concentrations of MDA ranged widely at both the start and the end of a session, 3- to 10-fold, respectively, in comparison with the levels measured in controls. This finding indicates that PN administrated long term raises plasma MDA levels, indicating chronic exposure and therefore a possible health risk, particularly liver damage. This preliminary study using a limited number of patients and controls showed that children undergoing long-term PN are strongly exposed to MDA, which must be considered as a potent toxic compound rather than a simple marker of lipid peroxidation.
authors.affiliation: 1  Department of Pharmacology, Pharmacokinetic and Clinical Pharmacy (EA 4481), Université Lille Nord de France, F-59000 Lille, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Dine
authors.forename: Bernard
authors.initials: B
authors.lastname: Gressier
authors.forename: Michel
authors.initials: M
authors.lastname: Luyckx
authors.forename: Fréderic
authors.initials: F
authors.lastname: Gottrand
authors.forename: Laurent
authors.initials: L
authors.lastname: Michaud
authors.forename: Nicolas
authors.initials: N
authors.lastname: Kambia
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006801:Humans; D007223:Infant; D015227:Lipid Peroxidation; D008297:Male; D008315:Malondialdehyde / Q000097:blood*; D010289:Parenteral Nutrition, Total / Q000009:adverse effects / Q000379:methods*; D012307:Risk Factors; D013056:Spectrophotometry, Ultraviolet; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D008315:Malondialdehyde
keywords: children; lipid peroxidation; long term; malondialdehyde; parenteral nutrition; toxicity