Double blind exploratory study on de novo lipogenesis in preterm infants on parenteral nutrition with a lipid emulsion containing 10% fish oil.
OBJECTIVE
Provision of long chain polyunsaturated fatty acids (LCP) both of the omega-3 and omega-6 families is recommended for preterm infants (PI). Fish oil (FO) contains omega-3 and omega-6 LCP and it is incorporated in the fat blend of the new generation lipid emulsions (LE). Omega-3 LCP have been shown to reduce the expression of genes involved in lipogenesis, which could be important for several organs development. The aim of this study was to ascertain if the use of intravenous FO has an effect on lipogenesis in PI.


METHODS
Forty PI were randomized to receive two LE: MSF (50:40:10 Medium Chain Triglycerides (MCT): Soybean oil (SO): FO) or MS (50:50 MCT:SO). We measured plasma lipids on day 7 and the fractional and absolute synthesis rates (FSR and ASR) of cholesterol and of selected fatty acids (FA) after (2)H2O body water labeling.


RESULTS
Plasma phospholipids (PL), free cholesterol (FC), and cholesterol esters (CE) concentrations were all lower in MSF than in MS. In spite of lower plasma FC and CE concentrations, cholesterol biosynthesis was similar between the two study groups (FC: FSR 16.0 ± 1.4 vs 14.1  ± 1.1%/d, p = 0.74; ASR 6.8 ± 0.6 vs 7.1 ± 0.6 mg kg(-1) d(-1), p = 0.93; CE: FSR 3.6 ± 0.5 vs 4.2 ± 0.4%/d, p = 0.38; ASR: 3.3 ± 0.4 vs 4.4 ± 0.5 mg kg(-1) d(-1), p = 0.13, in MSF and MS respectively). FSR and ASR of selected FA were, or tended to be, lower in MSF than in MS. ASR of PL palmitate (4.0 ± 0.3 vs 4.8 ± 0.4 mg kg(-1) d(-1), p = 0.045), PL oleate (0.2 ± 0.04 vs 0.4 ± 0.05 mg kg(-1) d(-1), p = 0.02) and CE oleate (0.5 ± 0.1 vs 0.9 ± 0.1 mg kg(-1) d(-1), p = 0.03) were significantly lower in MSF than in MS. There were no differences in plasma TG FA biosynthesis.


CONCLUSIONS
Cholesterol biosynthesis was not affected by 10% FO during neonatal parenteral nutrition. Ten percent FO caused a statistically significant reduction in the lipogenesis of selected FA and an overall tendency towards a reduced lipogenesis. The magnitude seems to be limited and the biological significance is unknown. Our data warrant follow-up studies in PI who receive intravenous FO, especially in those infants who receive larger doses than in the present study. Since this trial started in 2007, trial registration was not required.
Division of Neonatology, Polytechnic University of Marche, Salesi Children's Hospital, Via Corridoni 11, 60123 Ancona, Italy. Electronic address: chiara.biagetti@ospedaliriuniti.marche.it.
Chiara
C
Biagetti
Pediatric Research Institute "Città della Speranza", C.so Stati Uniti 4, 35127 Padova, Italy. Electronic address: l.vedovelli@irpcds.org.
Luca
L
Vedovelli
Division of Neonatology, Polytechnic University of Marche, Salesi Children's Hospital, Via Corridoni 11, 60123 Ancona, Italy. Electronic address: sara86ss@libero.it.
Sara
S
Savini
Pediatric Research Institute "Città della Speranza", C.so Stati Uniti 4, 35127 Padova, Italy. Electronic address: m.simonato@irpcds.org.
Manuela
M
Simonato
Division of Neonatology, Polytechnic University of Marche, Salesi Children's Hospital, Via Corridoni 11, 60123 Ancona, Italy. Electronic address: rita.dascenzo@gmail.com.
Rita
R
D'Ascenzo
Division of Neonatology, Polytechnic University of Marche, Salesi Children's Hospital, Via Corridoni 11, 60123 Ancona, Italy. Electronic address: adriana.pompilio@ospedaliriuniti.marche.it.
Adriana
A
Pompilio
Cardiac Anaesthesia/Intensive Care Unit, Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165 Roma, Italy. Electronic address: paola.cogo@opbg.net.
Paola E
PE
Cogo
Division of Neonatology, Polytechnic University of Marche, Salesi Children's Hospital, Via Corridoni 11, 60123 Ancona, Italy. Electronic address: v.carnielli@univpm.it.
Virgilio P
VP
Carnielli
D002784:Cholesterol / Q000097:blood; D004041:Dietary Fats / Q000008:administration & dosage / Q000032:analysis; D004044:Dietary Proteins / Q000008:administration & dosage / Q000032:analysis; D004311:Double-Blind Method; D002149:Energy Intake; D005217:Fat Emulsions, Intravenous / 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* / Q000032:analysis; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D050155:Lipogenesis / Q000187:drug effects*; D010288:Parenteral Nutrition; D010743:Phospholipids / Q000097:blood; D010865:Pilot Projects; D013024:Soybean Oil / Q000008:administration & dosage / Q000032:analysis; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
D004041:Dietary Fats; D004044:Dietary Proteins; D005217:Fat Emulsions, Intravenous; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D005395:Fish Oils; D010743:Phospholipids; D014280:Triglycerides; D013024:Soybean Oil; D002784:Cholesterol
Isotope labeling; Lipids; Lipogenesis; Omega-3 fatty acids; Omega-6 fatty acids; Premature infants