title: No Clinical or Biochemical Evidence for Essential Fatty Acid Deficiency in Home Patients Who Depend on Long-Term Mixed Olive Oil- and Soybean Oil-Based Parenteral Nutrition.
abstract: Home parenteral nutrition (HPN) patients depend on lipid emulsions as part of their parenteral nutrition regimen to provide essential fatty acids (EFAs). Mixed-oil sources are used in modern lipid emulsions to decrease the amount of proinflammatory EFAs, mainly linoleic acid, which is present in large amounts in soybean oil. It is unknown whether patients who fully depend on such mixed lipids have adequate EFA supply. We therefore evaluated whether HPN patients who depend on mixed olive oil- and soybean oil-based HPN show clinical or biochemical evidence of EFA deficiency.
  
  
  
  Fatty acid status was assessed in plasma phosphatidylcholine (PC) and peripheral blood mononuclear cells from 30 patients receiving mixed olive oil- and soybean oil-based HPN (>3 months, ≥5 times per week) and 30 healthy controls. Innate immune cell functions were evaluated by assessing expression of surface membrane molecules, and reactive oxygen species, and cytokine production.
  
  
  
  None of the patients or controls showed clinical evidence (skin rash) or biochemical evidence (increased Holman index [>0.2]) for EFA deficiency. The Holman index in plasma PC (median [25th-75th percentile]) was significantly higher in patients (0.019 [0.015-0.028]) compared with controls (0.015 [0.011-0.017]). No differences were found in innate immune cell functions between groups, except for a 3.6-fold higher tumor necrosis factor-α production in patients.
  
  
  
  We found no clinical or biochemical evidence that HPN patients who fully and long-term depend on mixed olive oil- and soybean oil-based lipids have an increased risk for EFA deficiency.
authors.affiliation: Intestinal Failure Unit, Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Evelyn D
authors.initials: ED
authors.lastname: Olthof
authors.affiliation: Intestinal Failure Unit, Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Hennie M J
authors.initials: HM
authors.lastname: Roelofs
authors.affiliation: Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
authors.forename: Helena L
authors.initials: HL
authors.lastname: Fisk
authors.affiliation: Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom.
authors.forename: Philip C
authors.initials: PC
authors.lastname: Calder
authors.affiliation: Intestinal Failure Unit, Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, The Netherlands geert.wanten@radboudumc.nl.
authors.forename: Geert J A
authors.initials: GJ
authors.lastname: Wanten
mesh_terms: D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood; D019317:Evidence-Based Medicine; D005217:Fat Emulsions, Intravenous / Q000737:chemistry; D005228:Fatty Acids, Essential / Q000097:blood / Q000172:deficiency*; D015525:Fatty Acids, Omega-3 / Q000097:blood; D043371:Fatty Acids, Omega-6 / Q000097:blood; D005260:Female; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000378:metabolism; D019787:Linoleic Acid / Q000097:blood / Q000172:deficiency; D008297:Male; D008875:Middle Aged; D000069463:Olive Oil / Q000008:administration & dosage*; D016331:Parenteral Nutrition, Home; D010713:Phosphatidylcholines / Q000097:blood; D013024:Soybean Oil / Q000008:administration & dosage*
chemical_list: D016207:Cytokines; D005217:Fat Emulsions, Intravenous; D005228:Fatty Acids, Essential; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D000069463:Olive Oil; D010713:Phosphatidylcholines; D013024:Soybean Oil; D002097:C-Reactive Protein; D019787:Linoleic Acid
keywords: essential fatty acid; innate immune function; parenteral nutrition