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Effects of parenteral nutrition with high doses of linoleate on the developing human liver and brain
Insights
Infants receiving total parenteral nutrition (TPN) showed altered fatty acid profiles in liver and brain phospholipids. High linoleic acid in TPN impacted essential fatty acid metabolism in developing infants.
Area of Science:
- Biochemistry
- Neonatal Nutrition
- Developmental Biology
Background:
- Phospholipid fatty acid composition is crucial for infant development.
- Understanding developmental changes in liver and brain lipids is essential for neonatal care.
Purpose of the Study:
- To investigate developmental changes in ethanolamine phosphoglycerides (EPG) and choline phosphoglycerides (CPG) fatty acid composition in infant liver and brain.
- To assess the impact of total parenteral nutrition (TPN) with high linoleic acid on these developmental patterns.
Main Methods:
- Analyzed fatty acid composition of liver and brain EPG and CPG in 18 newborn infants (20-44 wk gestational age).
- Compared a TPN group (n=5) receiving Intralipid 20% with control infants.
- Quantified specific fatty acids including linoleic acid (18:2 omega 6), arachidonic acid (20:4 omega 6), oleic acid (18:1 omega 9), and docosahexaenoic acid (22:6 omega 3).
Main Results:
- Control infants showed increased 22:6 omega 3 and decreased 20:4 omega 6 and 18:1 omega 9 in liver and brain EPG/CPG towards term.
- TPN infants exhibited significantly altered liver EPG/CPG with increased 18:2 omega 6 and reduced elongation/desaturation to longer omega 6 fatty acids and lower 22:6 omega 3.
- Brain CPG in TPN infants showed increased 18:2 omega 6 but not longer omega 6 derivatives.
Conclusions:
- Normal development involves specific shifts in fatty acid composition of EPG and CPG in infant liver and brain.
- TPN with high linoleic acid significantly alters hepatic fatty acid metabolism and impacts brain lipid composition in neonates.
- These findings highlight the importance of balanced fatty acid profiles in neonatal nutrition.
Abstract:
The developmental changes in the fatty acid composition of ethanolamine phosphoglycerides (EPG) and choline phosphoglycerides (CPG) were studied in the liver and brain of 18 newborn infants with gestational ages ranging from 20 to 44 wk. A small group of five newborns receiving total parenteral nutrition (TPN) with high doses of linoleic acid (18:2 omega 6) was also studied and compared to controls of the same gestational age to look for effects on the developmental fatty acid patterns of liver and brain EPG and CPG. TPN with Intralipid 20% was given for 4-12 days, the total fat intake being 14.7-90 g (mean +/- S.D. = 47.1 +/- 29.8 g). The main developmental changes in the liver and brain of the control group were an increase in 22:6 omega 3 (docosahexaenoic acid) at the end of gestation and a linear decrease in 20:4 omega 6 (arachidonic acid) and 18:1 omega 9 (oleic acid) in EPG and CPG. A very good correlation in the percent values of these fatty acids in the brain and liver tissues was obtained. Very significant changes in the fatty acid composition of liver EPG and CPG could be found in the infants receiving TPN with Intralipid-mainly an increase in 18:2 omega 6, a decrease in the linoleate elongation/desaturation to longer members of the series and a decrease in the 22:6 omega 3 levels of liver EPG and CPG. In the brain, only an increase in the 18:2 omega 6 value of CPG, not accompanied by any increase in the longer omega 6 fatty acids, could be detected.(ABSTRACT TRUNCATED AT 250 WORDS)