title: Liver Disease, Systemic Inflammation, and Growth Using a Mixed Parenteral Lipid Emulsion, Containing Soybean Oil, Fish Oil, and Medium Chain Triglycerides, Compared With Soybean Oil in Parenteral Nutrition-Fed Neonatal Piglets.
abstract: The optimal parenteral lipid emulsion for neonates should reduce the risk of intestinal failure-associated liver disease and inflammation, while supporting growth and development. This could be best achieved by balanced content of ω-6 and ω-3 polyunsaturated fatty acids (PUFAs). Using a neonatal piglet model of parenteral nutrition (PN), we compared a 100% soy oil-based emulsion (ω-6:ω-3 PUFA: 7:1) with a mixed lipid emulsion comprising 30% soy oil, 30% medium-chain triglycerides, 25% olive oil, and 15% fish oil (ω-6:ω-3 PUFA: approximately 2.5:1) with regard to liver disease, inflammation, and fatty acid content in plasma and brain.
  
  
  
  Neonatal piglets, 3-6 days old, underwent jugular catheter insertion for isonitrogenous, isocaloric PN delivery over 14 days. The IL group (n = 8) was treated with Intralipid; the ML group (n = 10) was treated with the mixed lipid (SMOFlipid). Bile flow, liver chemistry, C-reactive protein (CRP), and PUFA content in plasma phospholipids and brain were compared.
  
  
  
  Compared with the IL group, ML-treated piglets had increased bile flow (P = .008) and lower total bilirubin (P = .001) and CRP (P = .023) concentrations. The ω-6 long-chain PUFA content was lower in plasma and brain for the ML group. The key ω-3 long-chain PUFA for neonatal development, docosahexaenoic acid (DHA), was not different between groups.
  
  
  
  The mixed lipid, having less ω-6 PUFA and more ω-3 PUFA, was able to prevent liver disease and reduce systemic inflammation in PN-fed neonatal piglets. However, this lipid did not increase plasma or brain DHA status, which would be desirable for neonatal developmental outcomes.
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Canada Department of Agricultural Food and Nutritional Science, University of Alberta, Edmonton, Canada justine.turner@albertahealthservices.ca.
authors.forename: Justine M
authors.initials: JM
authors.lastname: Turner
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Canada.
authors.forename: Jessica
authors.initials: J
authors.lastname: Josephson
authors.affiliation: Department of Agricultural Food and Nutritional Science, University of Alberta, Edmonton, Canada.
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Field
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Canada.
authors.forename: Pamela R
authors.initials: PR
authors.lastname: Wizzard
authors.affiliation: Department of Agricultural Food and Nutritional Science, University of Alberta, Edmonton, Canada.
authors.forename: Ronald O
authors.initials: RO
authors.lastname: Ball
authors.affiliation: Research Institute, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada Departments of Pediatrics and Nutritional Sciences, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Pencharz
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Canada Research Institute, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada Division of General Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada Group for Improvement of Intestinal Function and Treatment, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Paul W
authors.initials: PW
authors.lastname: Wales
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D001663:Bilirubin / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D004655:Emulsions / Q000008:administration & dosage; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage / Q000097:blood; D043371:Fatty Acids, Omega-6 / Q000008:administration & dosage / Q000097:blood; D005395:Fish Oils / Q000008:administration & dosage*; D007249:Inflammation / Q000628:therapy*; D008099:Liver / Q000378:metabolism; D008107:Liver Diseases / Q000209:etiology / Q000628:therapy*; D008297:Male; D000069463:Olive Oil / Q000008:administration & dosage; D010288:Parenteral Nutrition / Q000009:adverse effects*; D010743:Phospholipids / Q000008:administration & dosage; D012307:Risk Factors; D013024:Soybean Oil / Q000008:administration & dosage*; D013552:Swine; D014280:Triglycerides / Q000008:administration & dosage* / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D004655:Emulsions; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D005395:Fish Oils; D000069463:Olive Oil; D010743:Phospholipids; D014280:Triglycerides; D014409:Tumor Necrosis Factor-alpha; C545823:soybean oil, phospholipid emulsion; D013024:Soybean Oil; D002097:C-Reactive Protein; D001663:Bilirubin
keywords: intestinal failure; life cycle; lipids; liver disease; neonates; nutrition; parenteral nutrition; pediatrics; research and diseases