title: Relationship Between Triglyceride Tolerance, Body Mass Index, and Fat Depots in Hospitalized Patients Receiving Parenteral Nutrition.
abstract: BACKGROUND
  Hypertriglyceridemia has been associated with adverse outcomes in patients receiving intravenous fat emulsions (IVFEs), but little is known about its prevalence and causes.
  
  
  METHODS
  The study investigated whether a relationship exists between body mass index (BMI) and triglyceride tolerance in parenterally fed patients. We conducted a retrospective analysis of 287 adults receiving parenteral nutrition to determine whether patients with very low BMI (VLBMI, <16 kg/m(2)) tolerate IVFEs better than do patients with low BMI (LBMI, 16-18.4 kg/m(2)), normal-weight patients (NBMI, 18.5-24.9 kg/m(2)), and overweight/obese patients (HBMI, ≥25 kg/m(2)).
  
  
  RESULTS
  The median triglyceride concentration during IVFE was significantly lower in VLBMI patients at 107 mg/dL compared with 124 mg/dL in non-VLBMI patients (P = .016), despite higher lipid infusion rates in the VLBMI group. There was a significant association between triglycerides and BMI in the aggregate cohort (R = 0.2375, P < .0001), with the highest frequency of hypertriglyceridemia occurring in HBMI patients despite relatively lower lipid and energy supply. In a subset of VLBMI patients (n = 36) who had an abdominal computed tomography scan, there was 25- to 100-fold variability in the size of the abdominal adipose tissue depots. In this subgroup, triglyceride concentrations correlated with visceral fat but not subcutaneous abdominal fat.
  
  
  CONCLUSIONS
  In summary, patients with VLBMI have lower triglyceride concentrations during IVFEs than do other individuals, but there is considerable variability in triglycerides and body fat in this group. Caution should be employed with the use of IVFEs, especially in HBMI patients.
authors.affiliation: Department of Pharmacy, Mayo Clinic, Rochester, Minnesota.
authors.forename: Erin N
authors.initials: EN
authors.lastname: Frazee
authors.affiliation: Department of Pharmacy, Mayo Clinic, Rochester, Minnesota.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Nystrom
authors.affiliation: Department of Medicine, Division of Endocrinology, Diabetes, Nutrition and Metabolism, Mayo Clinic, Rochester, Minnesota.
authors.forename: M Molly
authors.initials: MM
authors.lastname: McMahon
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Eric E
authors.initials: EE
authors.lastname: Williamson
authors.affiliation: Department of Medicine, Division of Endocrinology, Diabetes, Nutrition and Metabolism, Mayo Clinic, Rochester, Minnesota miles.john@mayo.edu.
authors.forename: John M
authors.initials: JM
authors.lastname: Miles
mesh_terms: D000273:Adipose Tissue; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001835:Body Weight; D003428:Cross Infection / Q000097:blood / Q000209:etiology; D005217:Fat Emulsions, Intravenous / Q000009:adverse effects*; D005260:Female; D006760:Hospitalization; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010288:Parenteral Nutrition / Q000009:adverse effects*; D012189:Retrospective Studies; D013851:Thinness / Q000150:complications; D014280:Triglycerides / Q000009:adverse effects* / Q000097:blood; D055815:Young Adult
chemical_list: D005217:Fat Emulsions, Intravenous; D014280:Triglycerides
keywords: adult; life cycle; lipids; nutrition; obesity; parenteral nutrition; research and diseases