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Administration of an Intravenous Fat Emulsion Enriched with Medium-Chain Triglyceride/ω-3 Fatty Acids is Beneficial
Panos Papandreou1,2, Aristea Gioxari3, Dimitrios Ntountaniotis4
1First Department of Pediatrics, Medical School, National & Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Goudi, 11527 Athens, Greece.
Insights
Medium-chain triglyceride (MCT)/ω-3 polyunsaturated fatty acid (PUFA)-enriched intravenous fat emulsion (IVFE) improved fatty acid profiles in preterm neonates. This specialized IVFE shows potential for an attenuated inflammatory response in vulnerable infants.
Area of Science:
- Neonatal Nutrition
- Biochemistry
- Clinical Pediatrics
Background:
- Soybean oil-based intravenous fat emulsions (IVFEs) in preterm neonates may increase inflammation.
- Preterm infants require specialized nutritional support to manage metabolic and inflammatory processes.
Purpose of the Study:
- To evaluate the impact of a medium-chain triglyceride (MCT)/ω-3 polyunsaturated fatty acid (PUFA)-enriched IVFE on plasma fatty acid (FA) profiles.
- To assess the effect of this specialized IVFE on serum interleukin-6 (IL-6) levels in preterm neonates.
Main Methods:
- A double-blind randomized study involving 92 preterm neonates (<32 weeks gestation, <1500 g birth weight).
- Infants received either MCT/ω-3 PUFA-enriched IVFE or standard soybean oil-based IVFE.
- Plasma fatty acid analysis via gas-chromatography mass-spectrometry and serum IL-6 measurement using ELISA at baseline and day 15.
Main Results:
- The MCT/ω-3 PUFA-IVFE group exhibited significantly higher levels of ω-3 PUFAs, eicosapentaenoic acid, and oleic acid.
- This group also showed a lower ω-6/ω-3 PUFAs ratio and reduced ω-6 PUFAs compared to the control group.
- Linoleic acid was higher in the soybean oil group, while IL-6 levels decreased in both groups without significant inter-group differences.
Conclusions:
- Administration of MCT/ω-3 PUFA-enriched IVFE positively alters the plasma FA profile in preterm neonates.
- The observed changes in FA profile suggest a potential for an attenuated inflammatory response.
- This specialized IVFE may offer a more beneficial nutritional strategy for preterm infants.
Abstract:
Intravenous administration of pure soybean oil emulsions high in linoleic acid may lead to inflammation and lipid peroxidation in preterm neonates. We aimed to investigate the effects of a medium-chain triglyceride (MCT)/ω-3 polyunsaturated fatty acid (PUFA)-enriched intravenous fat emulsion (IVFE) on plasma fatty acid (FA) profile and serum interleukin-6 (IL-6) in preterm neonates. In this double-blind randomized study, 92 preterm neonates (gestational age < 32 weeks, birth weight < 1500 g) were assigned to receive either MCT/ω-3 PUFA-enriched IVFE (Intervention Group) or soybean oil-based IVFE (Control Group). Levels of FAs were measured at baseline (day 0) and day 15 of parenteral nutrition with gas-chromatography mass-spectrometry. Serum IL-6 was measured with sandwich ELISA in 59 neonates. Plasma FAs changed significantly over time; the MCT/ω-3 PUFA-IVFE group showed higher ω-3 PUFAs (p = 0.031), eicosapentaenoic acid (p = 0.000), and oleic acid (p = 0.003), and lower ω-6/ω-3 PUFAs ratio (p = 0.001) and ω-6 PUFAs (p = 0.023) compared to control group. Linoleic acid was higher in the soybean oil (SO)-based IVFE arm compared to the MCT/ω-3 PUFAs-IVFE arm (p = 0.006). Both fat emulsion types decreased IL-6 compared to baseline, but changes were insignificant between groups. Administration of MCT/ω-3 PUFA-enriched IVFE in preterm neonates is beneficial in changing the FA profile consistent with attenuated inflammatory response.
