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Lipid clearing in premature infants during continuous heparin infusion: role of circulating lipases
Insights
Heparin administration in low birth weight infants receiving parenteral nutrition stimulates lipolytic activity. Approximately two-thirds of this activity originates from hepatic lipase, regardless of infusion or bolus administration.
Area of Science:
- Biochemistry
- Pediatric Endocrinology
- Lipid Metabolism
Background:
- Heparin administration is common in infants receiving parenteral nutrition.
- Understanding the source of lipolytic activity is crucial for metabolic management in neonates.
Purpose of the Study:
- To investigate the nature of lipases released into circulation in low birth weight infants.
- To differentiate between hepatic lipase and extra-hepatic lipoprotein lipase activity following heparin administration.
Main Methods:
- Study involved 11 low birth weight infants receiving total parenteral nutrition with Intralipid.
- Lipase activity was measured after continuous low-level heparin infusion and bolus heparin injection.
- Hepatic lipase was differentiated using a specific antibody.
Main Results:
- Continuous heparin infusion maintained a baseline postheparin lipolytic activity.
- Bolus heparin injection resulted in peak lipolytic activity 10 minutes post-injection.
- Approximately two-thirds of the total postheparin lipolytic activity was identified as hepatic lipase.
Conclusions:
- Both continuous and bolus heparin administration stimulate lipolytic activity in infants.
- Hepatic lipase constitutes a significant portion of the postheparin lipolytic activity in this population.
Abstract:
The nature of the lipases released into the circulation during low level continuous infusion of heparin (1 unit/ml total parenteral nutrition) and after bolus heparin injection (10 units/kg) was investigated in a group of 11 low birth weight infants (gestational age 27-34 wk, and postnatal age of 7-26 days) receiving total parenteral nutrition with Intralipid (0.5 g/kg). Hepatic lipase and extra-hepatic lipoprotein lipase were differentiated with the aid of an antibody specific for human hepatic lipase. The data show that continuous low level heparin infusion leads to a constant baseline postheparin lipolytic activity of 0.77 +/- 0.18 mumol free fatty acids released per milliliter serum per hour. Bolus heparin injection leads to peak lipolytic activity levels of 3.77 +/- 0.46 mumol free fatty acids per milliliter serum per hour, 10 min after injection. About two-thirds of the total postheparin lipolytic activity was of the hepatic type during low level continuous infusion or after bolus injection of heparin.