Short-term parenteral nutrition with glucose and Intralipid: effects on serum lipids and lipoproteins

We prospectively investigated the effect of a 3-wk course of parenteral nutrition with 20% glucose, 4.25% amino acids, and 10% Intralipid on plasma lipids and lipoproteins in a cohort of 12 nutritionally replete patients with inflammatory bowel disease. Mean total serum cholesterol and mean total serum phospholipids increased in parallel throughout the study; density gradient ultracentrifugation demonstrated these increases were due to the appearance of lipoprotein-X. The mean low-density lipoprotein (LDL) mass on the density gradients decreased during the study and high-density lipoprotein (HDL) cholesterol levels decreased by 28% by the end of the third week. Plasma free fatty acids decreased by 42%. These results demonstrate that the glucose and 10% Intralipid regimen caused modest decreases in serum HDL cholesterol and LDL mass and the prompt appearance of lipoprotein-X with attendant hypercholesterolemia and hyperphospholipidemia. Patients undergoing long-term treatment with glucose and Intralipid should be closely monitored for the occurrence of significant dyslipoproteinemia.