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Liver composition and histology in growing infant miniature pigs given different total parenteral nutrition fuel
Insights
Newborn pigs receiving glucose-only total parenteral nutrition (TPN) developed hepatic steatosis. Adding fat to TPN regimens in infants may prevent TPN-related liver disease.
Area of Science:
- Pediatric Gastroenterology
- Neonatal Nutrition
- Hepatology
Background:
- Infants are more susceptible to total parenteral nutrition (TPN)-related liver disease than adults.
- Previous studies on TPN energy sources and hepatic steatosis focused on adult models.
- The impact of TPN composition on neonatal liver health requires further investigation.
Purpose of the Study:
- To investigate the effect of glucose versus glucose/fat TPN on hepatic steatosis in newborn pigs.
- To analyze the hepatic chemical composition and hormonal profiles in response to different TPN regimens.
- To determine the optimal TPN energy source for preventing liver complications in neonates.
Main Methods:
- Twenty newborn miniature pigs were randomized into two groups receiving either glucose or glucose/fat TPN for 8 days.
- Blood samples were collected to measure insulin, glucagon, SGPT, albumin, and bilirubin levels.
- Liver samples were analyzed for chemical composition (glycogen, fat, protein, DNA, RNA, water) and histological examination for steatosis.
Main Results:
- Pigs on glucose-only TPN had higher insulin and lower glucagon levels compared to the glucose/fat group.
- No significant differences were observed in SGPT, albumin, bilirubin, glycogen, fat, protein, DNA, or RNA between groups.
- The glucose-only TPN group exhibited higher liver water content and centrilobular steatosis, unlike the glucose/fat group which showed minimal fat accumulation in Kupffer cells.
Conclusions:
- Glucose-only TPN in newborn pigs leads to increased hepatic water content and steatosis.
- The addition of fat to TPN regimens may mitigate the development of TPN-associated liver disease in neonates.
- These findings suggest that fat-containing TPN may be a safer energy source for infants at risk of liver complications.
Abstract:
Although young infants are at greater risk for total parenteral nutrition (TPN)-related liver disease than adults, previous studies on the effect of the TPN energy source on the development of hepatic steatosis have been carried out in adult rats and adult humans. We studied the effect of a glucose and a glucose/fat TPN energy regimen on hepatic chemical composition and the development of steatosis in newborn miniature pigs. Twenty miniature pigs were randomized at 10 days of age to receive a TPN regimen which utilized either glucose (group A) or glucose/fat (group B) as the non-nitrogen energy source. After 8 days, blood was drawn for insulin, glucagon, SGPT, albumin, and bilirubin determinations. Samples of liver were obtained at 9 days. Plasma insulin levels were significantly higher and glucagon levels lower in group A piglets than in those in group B. Normal values were obtained for SGPT, albumin, and bilirubin, and no differences were found between groups. Chemical analysis of the livers revealed no differences between groups in the concentrations of glycogen, fat, protein, DNA, and RNA. Group A animals had significantly higher concentrations of water than group B (group A: 0.75 +/- 0.01 liter/kg; group B: 0.74 +/- 0.01; p less than 0.03). A significant correlation was found in group B between the plasma insulin/glucagon ratio and the hepatic glycogen concentration (r = 0.73, p less than 0.05). Group A animals had fat vacuoles in centrilobular hepatocytes, in contrast with group B animals who had visible fat only in Kupffer cells.(ABSTRACT TRUNCATED AT 250 WORDS)