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A more recent version of this article appeared on February 1, 2006

Papers In Press, published online ahead of print November 18, 2005
J. Lipid Res., doi:10.1194/jlr.M500423-JLR200
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Submitted on September 26, 2005
Revised on November 17, 2005
Accepted on November 18, 2005

Metabolic effects of intravenous lipid emulsions based on LCT (soybean oil) or LCT/MCT (soybean oil/coconut oil) in preterm infants

Frauke Lehner, Hans Demmelmair, Wulf Röschinger, Tamás Decsi, Mária Szász, Károly Adamovich, Ralf Arnecke, and Berthold Koletzko

Labor fuer Stoffwechsel und Ernaehrung, Dr von Hauner Childrens Hospital, Muenchen D-80337

Corresponding Author: Hans.Demmelmair{at}med.uni-muenchen.de

Most lipid emulsions for parenteral feeding of premature infants are based on long-chain triacylglycerols (LCT), but inclusion of medium-chain-triacylglycerols (MCT) might provide a more readily oxidisable energy source. The influence of these emulsions on plasma fatty acid composition and essential fatty acid (EFA) metabolism was studied in twelve premature neonates, who were randomly assigned to receive either an LCT emulsion (control) or an emulsion with a mixture of MCT and LCT (1/1, wt/wt) for 8 days. On day 7, all infants received tracer doses of 13C-labeled linoleic (LA) and alpha -linolenic acids (ALA) orally. The fatty acid composition of plasma phospholipids and triacylglycerols and 13C-enrichments of plasma phospholipid fatty acids were determined on day 8. After 8 days of lipid infusion plasma triacylglycerols in the MCT/LCT group had higher contents of C8:0 (0.50±0.60% vs. 0.10±0.12%, M±SD ) and C10:0 (0.66±0.51% vs. 0.15±0.17%) than controls. The MCT/LCT-group showed a slightly lower LA content of plasma phospholipids (16.47±1.16% vs. 18.57±2.09%), while long chain polyunsaturated derivatives (LC-PUFA) of LA and ALA tended to be higher in the MCT/LCT group. The tracer distributions between precursor fatty acids and products (LC-PUFA) were not significantly different between groups. Both lipid emulsions achieve similar plasma EFA contents and similar proportional conversion of EFA to LC-PUFA. The MCT/LCT emulsion seems to protect EFA and LC-PUFA from beta -oxidation.


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