Abstract
Most lipid emulsions for parenteral feeding of premature infants are based on long-chain triacylglycerols (LCTs), but inclusion of medium-chain triacylglycerols (MCTs) might provide a more readily oxidizable energy source. The influence of these emulsions on fatty acid composition and metabolism was studied in 12 premature neonates, who were randomly assigned to an LCT emulsion (control) or an emulsion with a mixture of MCT and LCT (1:1). On study day 7, all infants received [13C]linoleic (LA) and [13C]alpha-linolenic acid (ALA) tracers orally. Plasma phospholipid (PL) and triacylglycerol (TG) fatty acid composition and 13C enrichments of plasma PL fatty acids were determined on day 8. After 8 days of lipid infusion, plasma TGs in the MCT/LCT group had higher contents of C8:0 (0.50 +/- 0.60% vs. 0.10 +/- 0.12%; means +/- SD) and C10:0 (0.66 +/- 0.51% vs. 0.15 +/- 0.17%) than controls. LA content of plasma PLs was slightly lower in the MCT/LCT group (16.47 +/- 1.16% vs. 18.57 +/- 2.09%), whereas long-chain polyunsaturated derivatives (LC-PUFAs) of LA and ALA tended to be higher. The tracer distributions between precursors and products (LC-PUFAs) were not significantly different between groups. Both lipid emulsions achieve similar plasma essential fatty acid (EFA) contents and similar proportional conversion of EFAs to LC-PUFAs. The MCT/LCT emulsion seems to protect EFAs and LC-PUFAs from beta-oxidation.
Highlights
Most lipid emulsions for parenteral feeding of premature infants are based on long-chain triacylglycerols (LCTs), but inclusion of medium-chain triacylglycerols (MCTs) might provide a more readily oxidizable energy source
All assigned to the medium-chain triacylglycerol/long-chain triacylglycerol (MCT/LCT) group, were excluded because of wrong randomization, breaching of the study conditions, and contraindication against the feeding protocol
Birth weights were appropriate for gestational age in five infants and small for gestational age in one, whereas all infants in the MCT/LCT group had birth weights appropriate for gestational age
Summary
Premature neonates were recruited in the Division of Neonatology at the University of Pecs. Inclusion criteria for the study were as follows: gestational age between 25 and 37 weeks; birth weight , 3,000 g; the indication for total parenteral feeding (expected enteral feeding , 20% of daily energy intake) for at least 8 days; and the intention to supply a lipid emulsion within 48 h after birth. Infants with known metabolic diseases were excluded. In this randomized, double-blind trial, premature infants were assigned either to the control group, receiving a conventional. Composition of the two fat emulsions used (data as provided by the manufacturer). The study protocol was approved by the ethical committee of the University of Pecs, and written informed consent was obtained from the parents of each infant before study entry
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