title: The relationship between the parenteral dose of fish oil supplementation and the variation of liver function tests in hospitalized adult patients.
abstract: BACKGROUND
  Hepatic dysfunction is a complication associated with parenteral nutrition (PN). Our primary objective was to study the relationship between doses of intravenous fish oil (FO) emulsion in PN and the variation in the main liver function tests (LFTs) in hospitalized PN-treated adults. As a secondary objective, we studied the safety of FO administration.
  
  
  METHODS
  We conducted a retrospective study in adult patients receiving FO supplementation in PN. Demographic, nutritional and safety variables were collected. Variation of LFTs was defined as the difference between values just before the first administration of FO and values at the end of PN. A multiple linear regression was performed to study the association between PN-lipids (FO or vegetable) and the variation of each LFT; the following variables were used to adjust the effect of lipids: sepsis, length of stay in the intensive care unit and lipids dose. Student t-test was used to study safety variables. Data were analyzed using SPSS 19.0.
  
  
  RESULTS
  Patients (53, median age 68 years (24-90); 62% men) with the principal diagnosis of digestive neoplasm (42%) received PN for a median of 19 (7-75) days. In the multivariate analysis, the amount of FO was related to a decrease in gamma-glutamyl transferase (GGT) (B = -2.23;CI95 % = -4.41/-0.05), a decrease in alkaline phosphatase (AP) (B = -1.23;CI95 % = -2.07/-0.37), and a decrease in alanine aminotransferase (ALT) (B = -0.82; CI95 % = -1.19/-0.44). No differences were found in safety variables.
  
  
  CONCLUSIONS
  GGT, AP and ALT improved with FO PN-supplementation. Moreover, the improvement was greater when the doses of FO were higher. FO administration in PN is safe.
authors.affiliation: Pharmacy Department, Hospital Universitari Bellvitge. IDIBELL. C/Feixa Llarga s/n. 08907 L'Hospitalet de Llobregat, Barcelona, Spain. mbadia@bellvitgehospital.cat.
authors.forename: Maria B
authors.initials: MB
authors.lastname: Badia-Tahull
authors.affiliation: Pharmacy Department, Hospital Universitari Bellvitge. IDIBELL. C/Feixa Llarga s/n. 08907 L'Hospitalet de Llobregat, Barcelona, Spain. eleiva@bellvitgehospital.cat.
authors.forename: Elisabet
authors.initials: E
authors.lastname: Leiva-Badosa
authors.affiliation: Pharmacy Department, Hospital Universitari Bellvitge. IDIBELL. C/Feixa Llarga s/n. 08907 L'Hospitalet de Llobregat, Barcelona, Spain. rjodar@bellvitgehospital.cat.
authors.forename: Ramon
authors.initials: R
authors.lastname: Jodar-Masanes
authors.affiliation: Preventive Medicine Department, Hospital Universitari Bellvitge. IDIBELL. C/Feixa Llarga s/n. 08907 L'Hospitalet de Llobregat, Barcelona, Spain. jramon@bellvitgehospital.cat.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Ramon-Torrell
authors.affiliation: Pharmacy Department, Hospital Universitari Bellvitge. IDIBELL. C/Feixa Llarga s/n. 08907 L'Hospitalet de Llobregat, Barcelona, Spain. josep.llop@bellvitgehospital.cat.
authors.forename: Josep
authors.initials: J
authors.lastname: Llop-Talaveron
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000378:metabolism; D000469:Alkaline Phosphatase / Q000378:metabolism; D001663:Bilirubin / Q000378:metabolism; D001792:Blood Platelets / Q000187:drug effects / Q000378:metabolism; D015992:Body Mass Index; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage*; D006760:Hospitalization; D006801:Humans; D016014:Linear Models; D008099:Liver / Q000187:drug effects* / Q000378:metabolism; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition; D012189:Retrospective Studies; D014280:Triglycerides / Q000097:blood; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000378:metabolism
chemical_list: D004041:Dietary Fats; D004044:Dietary Proteins; D005395:Fish Oils; D014280:Triglycerides; D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D001663:Bilirubin