Parenteral Fish Oil as Monotherapy Improves Lipid Profiles in Children With Parenteral Nutrition–Associated Liver Disease
- 17 September 2010
- journal article
- clinical trial
- Published by Wiley in Journal of Parenteral and Enteral Nutrition
- Vol. 34 (5), 477-484
- https://doi.org/10.1177/0148607110371806
Abstract
Background: Parenteral nutrition (PN) is a life‐saving therapy but has been associated with dyslipidemia. Because fish oil has been shown to have positive effects on lipid profiles, the authors hypothesize that a parenteral fish oil lipid emulsion will improve lipid profiles in children who are PN dependent. Methods: The authors examined the lipid profiles of a unique cohort of 10 children who were exclusively administered a fish oil–based lipid emulsion while on PN for a median duration of 14 weeks. Longitudinal data analysis with a generalized estimating equations approach was used to determine the sterol and bilirubin levels based on duration of the fish oil–based lipid emulsion. Results: After 14 weeks of fish oil monotherapy, children had a 24% increase in high‐density lipoprotein. Compared to baseline, serum low‐density lipoprotein, very low‐density lipoprotein, total cholesterol, and triglyceride levels all significantly decreased by 22%, 41%, 17%, and 46%, respectively. Eight children had their bilirubin improved with a decreased direct bilirubin from 6.9 mg/dL (range, 4.4‐10.7) at baseline to 2.3 mg/dL (range, 1.3‐4.0) after 14 weeks, and a decrease in total bilirubin from 8.7 mg/dL (range, 5.5‐13.7) to 3.8 mg/dL (range, 2.2‐6.5). Conclusion: A fish oil–based lipid emulsion used as monotherapy in children who exclusively depended on PN for survival was associated with significant improvement in all major lipid panels as well as improvement of hyperbilirubinemia. Parenteral fish oil may be the preferred lipid source in children with dyslipidemia.Keywords
Funding Information
- National Institutes of Health (DK069621‐05)
This publication has 43 references indexed in Scilit:
- Lipid Screening and Cardiovascular Health in ChildhoodPediatrics, 2008
- Comparative Effect of Fish Oil Feeding and Other Dietary Fatty Acids on Plasma Lipoproteins, Biliary Lipids, and Hepatic Expression of Proteins Involved in Reverse Cholesterol Transport in the RatAnnals of Nutrition and Metabolism, 2005
- Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control studyThe Lancet, 2004
- The importance of clinical factors in parenteral nutrition-associated hypertriglyceridemiaClinical Nutrition, 2003
- Decrease of hepatic triglyceride lipase levels and increase of cholesteryl ester transfer protein levels in patients with primary biliary cirrhosis: Relationship to abnormalities in high-density lipoproteinHepatology, 1993
- Plasma lipid and plasma lipoprotein concentrations in low birth weight infants given parenteral nutrition with twenty or ten percent lipid emulsionThe Journal of Pediatrics, 1989
- Alteration of Lipoprotein Profile during Total Parenteral Nutrition with Intralipid 10%Journal of Parenteral and Enteral Nutrition, 1986
- The Inverse Relation between Fish Consumption and 20-Year Mortality from Coronary Heart DiseaseNew England Journal of Medicine, 1985
- Effects of Intravenous Phospholipid on Low Density Lipoprotein Turnover in ManEuropean Journal of Clinical Investigation, 1976