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Journal of Lipid Research, Vol. 47, 404-411, February 2006
Copyright © 2006 by American Society for Biochemistry and Molecular Biology

Metabolic effects of intravenous LCT or MCT/LCT lipid emulsions in preterm infants

Frauke Lehner^*, Hans Demmelmair^*, Wulf Röschinger^*, Tamás Decsi, Mária Szász, Károly Adamovich, Ralf Arnecke and Berthold Koletzko^1,*

^* Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
Department of Pediatrics, University Medical School of Pécs, Pécs, Hungary
Laboratory Becker, Olgemöller & Colleagues, Munich, Germany

Published, JLR Papers in Press, November 18, 2005.

¹ To whom correspondence should be addressed. e-mail: berthold.koletzko{at}med.uni-muenchen.de

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]-linolenic acid (ALA) tracers orally. Plasma phospholipid (PL) and triacylglycerol (TG) fatty acid composition and¹³C 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 ß-oxidation.

Supplementary key words medium-chain triacylglycerols • long-chain triacylglycerols • long-chain polyunsaturated fatty acids • essential fatty acids • stable isotope

Abbreviations: AA, arachidonic acid; ALA, -linolenic acid; APE, atom percent excess; DGLA, dihomo -linolenic acid; DHA, docosahexaenoic acid; DPA, docosapentaenoic acid; EFA, essential fatty acid; EPA, eicosapentaenoic acid; LA, linoleic acid; LC-PUFA, long-chain polyunsaturated fatty acid; LCT, long-chain triacylglycerol; MCT, medium-chain triacylglycerol; PL, phospholipid; TG, triacylglycerol

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