title: Supplemental Parenteral Vitamin E Into Conventional Soybean Lipid Emulsion Does Not Prevent Parenteral Nutrition-Associated Liver Disease in Full-Term Neonatal Piglets.
abstract: Parenteral nutrition-associated liver disease (PNALD) continues to cause morbidity and mortality for neonates with intestinal failure. Lipid peroxidation is one potential etiological factor. This study was designed to test if supplementing vitamin E into conventional soy-based lipid would reduce the risk of PNALD.
  
  
  
  Sixteen piglets, aged 2-5 days and weighing 1.8-2.5 kg, were randomized to parenteral nutrition (PN) with soy lipid (SO, n = 8) or the same lipid plus α-tocopherol, the most bioactive form of vitamin E (SO+E, n = 8). After 17 days, bile flow, liver chemistry, gene expression associated with bile acid metabolism, and bile acid composition were assessed. C-reactive protein (CRP) and oxidative stress markers, including plasma 8-isoprostane, were measured. All results were compared with a sow-reared control group (CON).
  
  
  
  Comparing PN-treated groups, SO vs SO+E mean bile flow (5.91 vs 5.54 µL/g liver; P = .83), serum bile acid concentration (39.2 vs 26.6 µmol/L; P = .12), and total bilirubin (35.2 vs 26.9 µmol/L; P = .56) were not different. Gene expression related to bile acid metabolism and bile composition was not different between PN groups. There was no difference in CRP (41.8 vs 36.8 µg/mL; P = .22) or in plasma 8-isoprostane (27.9 vs 26.1 pg/mL; P = .77).
  
  
  
  In term neonatal piglets, supplemental vitamin E did not prevent cholestasis. Additional vitamin E was not associated with reduced inflammation or oxidative stress. The benefit of supplementing vitamin E into conventional lipid, vs adding fish oil, to prevent early onset of PNALD requires further clarification.
authors.affiliation: 1 Department of Pediatrics, University of Alberta, Canada.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Muto
authors.affiliation: 2 Department of Surgery, University of Alberta, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Lim
authors.affiliation: 1 Department of Pediatrics, University of Alberta, Canada.
authors.forename: Amanda
authors.initials: A
authors.lastname: Soukvilay
authors.affiliation: 3 Department of Agricultural Food and Nutritional Science, University of Alberta, Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Field
authors.affiliation: 1 Department of Pediatrics, University of Alberta, Canada.
authors.forename: Pamela R
authors.initials: PR
authors.lastname: Wizzard
authors.affiliation: 3 Department of Agricultural Food and Nutritional Science, University of Alberta, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Goruk
authors.affiliation: 3 Department of Agricultural Food and Nutritional Science, University of Alberta, Canada.
authors.forename: Ronald O
authors.initials: RO
authors.lastname: Ball
authors.affiliation: 4 Department of Gastroenterology and Nutrition, Hospital for Sick Children, Toronto, Ontario, Canada.|5 Group for Improvement of Intestinal Function and Treatment, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Pencharz
authors.affiliation: 3 Department of Agricultural Food and Nutritional Science, University of Alberta, Canada.
authors.forename: Si
authors.initials: S
authors.lastname: Mi
authors.affiliation: 3 Department of Agricultural Food and Nutritional Science, University of Alberta, Canada.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Curtis
authors.affiliation: 1 Department of Pediatrics, University of Alberta, Canada.|5 Group for Improvement of Intestinal Function and Treatment, Hospital for Sick Children, Toronto, Ontario, Canada.|6 Division of General Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Paul W
authors.initials: PW
authors.lastname: Wales
authors.affiliation: 1 Department of Pediatrics, University of Alberta, Canada.|2 Department of Surgery, University of Alberta, Canada.
authors.forename: Justine M
authors.initials: JM
authors.lastname: Turner
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D000818:Animals; D000831:Animals, Newborn; D001647:Bile Acids and Salts / Q000097:blood; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002779:Cholestasis / Q000209:etiology / Q000517:prevention & control; D015237:Dinoprost / Q000031:analogs & derivatives / Q000097:blood; D004195:Disease Models, Animal; D005217:Fat Emulsions, Intravenous / Q000009:adverse effects*; D005260:Female; D008107:Liver Diseases / Q000209:etiology / Q000517:prevention & control*; D018384:Oxidative Stress / Q000187:drug effects; D010288:Parenteral Nutrition / Q000009:adverse effects*; D013024:Soybean Oil / Q000494:pharmacology*; D013552:Swine; D024502:alpha-Tocopherol / Q000494:pharmacology*; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D001647:Bile Acids and Salts; D015415:Biomarkers; D005217:Fat Emulsions, Intravenous; C075750:8-epi-prostaglandin F2alpha; D013024:Soybean Oil; D002097:C-Reactive Protein; D015237:Dinoprost; D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D024502:alpha-Tocopherol; D001663:Bilirubin
keywords: cholestasis; lipid peroxidation; parenteral nutrition; parenteral nutrition–associated liver disease; vitamin E; α-tocopherol