Higher Docosahexaenoic acid, lower Arachidonic acid and reduced lipid tolerance with high doses of a lipid emulsion containing 15% fish oil: A randomized clinical trial

Rita D'Ascenzo, Sara Savini, Chiara Biagetti, Maria P. Bellagamba, Paolo Marchionni, Adriana Pompilio, Paola E. Cogo, Virgilio P. Carnielli

Research output: Contribution to journalArticle

Abstract

Background & aims: Lipid emulsions containing fish oil, as source of long chain omega 3 fatty acids, have recently became available for parenteral nutrition in infants, but scanty data exist in extremely low birth weight preterms. The objective of this study was to compare plasma fatty acids and lipid tolerance in preterm infants receiving different doses of a 15% fish oil vs. a soybean oil based lipid emulsion. Methods: Preterm infants (birth weight 500-1249g) were randomized to receive parenteral nutrition with MOSF (30% Medium-chain triglycerides, 25% Olive oil, 30% Soybean oil, 15% Fish oil) or S (S, 100% Soybean oil) both at two levels of fat intake: 2.5 or 3.5gkg-1d-1, named 2.5Fat and 3.5Fat respectively. Plasma lipid classes and their fatty acid composition were determined on postnatal day 7 and 14 by gas chromatography together with routine biochemistry. Results: We studied 80 infants. MOSF infants had significantly higher plasma phospholipid Docosahexaenoic acid and Eicosapentaenoic and lower Arachidonic acid. Plasma phospholipids, triglycerides and free cholesterol were all significantly higher in the MOSF-3.5Fat group, while cholesterol esters were lower with MOSF than with S. The area under the curve of total bilirubin was significantly lower with MOSF than with S. Conclusions: The use of a lipid emulsion with 15% FO resulted in marked changes of plasma long-chain fatty acids. Whether the benefits of increasing Docosahexaenoic acid outweigh the potential negative effect of reduced Arachidonic acid should be further studied. MOSF patients exhibited reduced lipid tolerance at 3.5gkg-1d-1 fat intake. The trial was conducted between January 2008 and December 2012 so we had not registered it in a public trials registry as it is now required for trials that started after July 2008.

Original languageEnglish
Pages (from-to)1002-1009
Number of pages8
JournalClinical Nutrition
Volume33
Issue number6
DOIs
Publication statusPublished - Dec 1 2014

Fingerprint

Docosahexaenoic Acids
Fish Oils
Emulsions
Arachidonic Acid
Randomized Controlled Trials
Lipids
Soybean Oil
Fatty Acids
Parenteral Nutrition
Premature Infants
Phospholipids
Triglycerides
Fats
Cholesterol Esters
Premature Birth
Omega-3 Fatty Acids
Low Birth Weight Infant
Bilirubin
Birth Weight
Gas Chromatography

Keywords

  • Arachidonic acid
  • Docosahexaenoic acid
  • Fish oil
  • Lipid tolerance
  • Parenteral nutrition
  • Preterm infants

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Nutrition and Dietetics
  • Medicine(all)

Cite this

Higher Docosahexaenoic acid, lower Arachidonic acid and reduced lipid tolerance with high doses of a lipid emulsion containing 15% fish oil : A randomized clinical trial. / D'Ascenzo, Rita; Savini, Sara; Biagetti, Chiara; Bellagamba, Maria P.; Marchionni, Paolo; Pompilio, Adriana; Cogo, Paola E.; Carnielli, Virgilio P.

In: Clinical Nutrition, Vol. 33, No. 6, 01.12.2014, p. 1002-1009.

Research output: Contribution to journalArticle

D'Ascenzo, Rita ; Savini, Sara ; Biagetti, Chiara ; Bellagamba, Maria P. ; Marchionni, Paolo ; Pompilio, Adriana ; Cogo, Paola E. ; Carnielli, Virgilio P. / Higher Docosahexaenoic acid, lower Arachidonic acid and reduced lipid tolerance with high doses of a lipid emulsion containing 15% fish oil : A randomized clinical trial. In: Clinical Nutrition. 2014 ; Vol. 33, No. 6. pp. 1002-1009.
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abstract = "Background & aims: Lipid emulsions containing fish oil, as source of long chain omega 3 fatty acids, have recently became available for parenteral nutrition in infants, but scanty data exist in extremely low birth weight preterms. The objective of this study was to compare plasma fatty acids and lipid tolerance in preterm infants receiving different doses of a 15{\%} fish oil vs. a soybean oil based lipid emulsion. Methods: Preterm infants (birth weight 500-1249g) were randomized to receive parenteral nutrition with MOSF (30{\%} Medium-chain triglycerides, 25{\%} Olive oil, 30{\%} Soybean oil, 15{\%} Fish oil) or S (S, 100{\%} Soybean oil) both at two levels of fat intake: 2.5 or 3.5gkg-1d-1, named 2.5Fat and 3.5Fat respectively. Plasma lipid classes and their fatty acid composition were determined on postnatal day 7 and 14 by gas chromatography together with routine biochemistry. Results: We studied 80 infants. MOSF infants had significantly higher plasma phospholipid Docosahexaenoic acid and Eicosapentaenoic and lower Arachidonic acid. Plasma phospholipids, triglycerides and free cholesterol were all significantly higher in the MOSF-3.5Fat group, while cholesterol esters were lower with MOSF than with S. The area under the curve of total bilirubin was significantly lower with MOSF than with S. Conclusions: The use of a lipid emulsion with 15{\%} FO resulted in marked changes of plasma long-chain fatty acids. Whether the benefits of increasing Docosahexaenoic acid outweigh the potential negative effect of reduced Arachidonic acid should be further studied. MOSF patients exhibited reduced lipid tolerance at 3.5gkg-1d-1 fat intake. The trial was conducted between January 2008 and December 2012 so we had not registered it in a public trials registry as it is now required for trials that started after July 2008.",
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AU - Savini, Sara

AU - Biagetti, Chiara

AU - Bellagamba, Maria P.

AU - Marchionni, Paolo

AU - Pompilio, Adriana

AU - Cogo, Paola E.

AU - Carnielli, Virgilio P.

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