title: Parenteral MCT/ω-3 Polyunsaturated Fatty Acid-Enriched Intravenous Fat Emulsion Is Associated With Cytokine and Fatty Acid Profiles Consistent With Attenuated Inflammatory Response in Preterm Neonates: A Randomized, Double-Blind Clinical Trial.
abstract: BACKGROUND
  Soybean oil-based intravenous fat emulsion (IVFE) administered to preterm neonates can induce oxidative stress and inflammatory response, which are associated with severe complications of prematurity. This study aimed to test the hypothesis that administration of medium-chain triglyceride (MCT)/ω-3 polyunsaturated fatty acid (PUFA)-enriched IVFE in preterm neonates is associated with a cytokine and fatty acid (FA) profile consistent with attenuated inflammatory response.
  
  
  METHODS
  In a double-blind randomized study, 60 preterm neonates (gestational age 26-32 weeks) were randomized to receive either MCT/ω-3 PUFA-enriched IVFE (intervention group) or soybean oil-based IVFE (control group). Serum biochemistry, tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, α-tocopherol, and FAs were assessed at baseline, on day of life 15, and day of life 30 or at the end of intervention.
  
  
  RESULTS
  All cytokine levels changed significantly across the 3 time points, whereas the type of IVFE had a significant effect on final IL-6 and IL-8 levels, which were lower in the intervention group. The difference in final IL-6 and IL-8 levels remained significant after controlling for bronchopulmonary dysplasia and/or infection. α-Tocopherol and FA values changed significantly over time. MCT/ω-3 PUFA-enriched IVFE administration was associated with significantly higher α-tocopherol, eicosapentaenoic acid, docosahexaenoic acid, and ω-3 PUFAs and lower linolenic acid, total PUFA, and ω-6/ω-3 PUFA values compared with soybean oil-based IVFE. Both IVFEs were well tolerated.
  
  
  CONCLUSIONS
  Compared with the soybean oil-based IVFE, the MCT/ω-3 PUFA-enriched IVFE is associated with a more favorable cytokine and FA profile consistent with attenuated inflammatory response in preterm neonates.
authors.affiliation: Harokopio University, Department of Nutrition and Dietetics, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Skouroliakou
authors.affiliation: "IASO" Maternity Hospital, Neonates Intensive Care Unit, Athens, Greece.
authors.forename: Dimitris
authors.initials: D
authors.lastname: Konstantinou
authors.affiliation: Clinical Nutrition Lab, Nutrition/Dietetics Department, Technological Education Institute, Thessaloniki, Greece.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Agakidis
authors.affiliation: Harokopio University, Department of Nutrition and Dietetics, Athens, Greece.
authors.forename: Andriana
authors.initials: A
authors.lastname: Kaliora
authors.affiliation: Harokopio University, Department of Nutrition and Dietetics, Athens, Greece.
authors.forename: Nick
authors.initials: N
authors.lastname: Kalogeropoulos
authors.affiliation: Harokopio University, Department of Nutrition and Dietetics, Athens, Greece.
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Massara
authors.affiliation: "IASO" Maternity Hospital, Neonates Intensive Care Unit, Athens, Greece.
authors.forename: Marina
authors.initials: M
authors.lastname: Antoniadi
authors.affiliation: Harokopio University, Department of Nutrition and Dietetics, Athens, Greece.
authors.forename: Demosthenes
authors.initials: D
authors.lastname: Panagiotakos
authors.affiliation: Clinical Nutrition Lab, Nutrition/Dietetics Department, Technological Education Institute, Thessaloniki, Greece clinicalnutritionrlab@yahoo.gr thomaiskl@hotmail.com.
authors.forename: Thomais
authors.initials: T
authors.lastname: Karagiozoglou-Lampoudi
mesh_terms: D004281:Docosahexaenoic Acids / Q000097:blood; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid / Q000097:blood; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage* / Q000737:chemistry; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage* / Q000097:blood; D043371:Fatty Acids, Omega-6 / Q000097:blood; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D010288:Parenteral Nutrition; D013024:Soybean Oil / Q000008:administration & dosage; D016896:Treatment Outcome; D014280:Triglycerides / Q000008:administration & dosage*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D017962:alpha-Linolenic Acid / Q000097:blood; D024502:alpha-Tocopherol / Q000097:blood
chemical_list: C508606:CXCL8 protein, human; D005217:Fat Emulsions, Intravenous; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; C508600:IL6 protein, human; D015850:Interleukin-6; D016209:Interleukin-8; D014280:Triglycerides; D014409:Tumor Necrosis Factor-alpha; D017962:alpha-Linolenic Acid; D004281:Docosahexaenoic Acids; D013024:Soybean Oil; D015118:Eicosapentaenoic Acid; D024502:alpha-Tocopherol
keywords: SMOFlipid; fatty acids; interleukins; intravenous fat emulsions; parenteral nutrition; premature infant; preterm neonates; soybean oil; total parenteral nutrition