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Effects of administration of different intravenous lipid emulsions on plasma LP-X concentrations in the rat
E Tomsits1, K Rischák, M Molnár
1Department of Pathophysiology, Semmelweis University of Medicine, Budapest, Hungary.
Insights
Lowering the phospholipid-triglyceride (PL-TG) ratio in lipid emulsions may prevent abnormal plasma lipid and LP-X levels in preterm infants. This ratio, not the phospholipid source, is key to managing lipid concentrations.
Area of Science:
- Biochemistry
- Neonatal Nutrition
- Lipid Metabolism
Background:
- Parenteral nutrition with lipid emulsions is vital for preterm infants, providing energy and preventing essential fatty acid deficiency.
- However, long-term use can lead to abnormal plasma lipid and lipoprotein-X (LP-X) concentrations.
- The study investigates the impact of phospholipid-triglyceride (PL-TG) ratio and phospholipid source in lipid emulsions on these parameters.
Purpose of the Study:
- To determine the relative importance of the phospholipid-triglyceride (PL-TG) ratio versus the phospholipid source in lipid emulsions.
- To assess their impact on plasma lipid and lipoprotein-X (LP-X) concentrations in a rat model.
Main Methods:
- Rats received intravenous lipid emulsions with varying phospholipid sources (egg lecithin, soya lecithin) and PL-TG ratios for 9 days.
- Lipid emulsions included IL-10, IL-20, and Lipofundin (LF) with specific PL-TG ratios.
- Plasma lipid profiles, including triglyceride, cholesterol, phospholipid, and LP-X levels, were analyzed.
Main Results:
- Lipofundin significantly elevated plasma triglyceride levels.
- Increased cholesterol was mainly due to low-density lipoprotein cholesterol across all emulsions.
- A strong correlation was found between the PL-TG ratio and plasma phospholipid and LP-X concentrations (r² = .91 and .96, respectively).
Conclusions:
- The phospholipid-triglyceride (PL-TG) ratio, not the phospholipid source, primarily influences plasma lipid and LP-X concentrations.
- Administering lipid emulsions with lower PL-TG ratios is recommended to prevent pathological plasma lipoprotein levels.
Background:
Prolonged parenteral nutrition with lipid emulsions is essential to provide sufficient energy supply and to avoid essential fatty acid deficiency in preterm infants. However, chronic administration of lipid emulsions may lead to the development of pathological plasma lipid and LP-X concentrations. The aim of this study was to evaluate the relative importance of the phospholipid-triglyceride (PL-TG) ratio and the source of phospholipid in lipid emulsions, with respect to plasma lipid and LP-X levels.
Methods:
Rats were infused for 9 days with IV lipid emulsion containing 10% (IL-10) or 20% (IL-20) egg lecithin or Lipofundin containing 20% soya lecithin (LF), with PL-TG ratios of .12, .06, and 0.75, respectively.
Results:
LF significantly increased plasma triglyceride concentration (p < .01), whereas the rise in cholesterol levels observed with all emulsions was primarily caused by the increase in low-density lipoprotein cholesterol concentrations. The plasma phospholipid concentration was increased most by IL-10 (p < .005). There was a strong correlation between the PL-TG ratio of emulsions and the developing plasma phospholipid and LP-X concentrations (r2 = .91 and .96, respectively), despite the different origin of phospholipids in the emulsions, suggesting that it is the PL-TG ratio, rather than the source of phospholipids in lipid emulsions that primarily influences developing plasma lipid and LP-X concentrations.
Conclusion:
These results indicate that the administration of lipid emulsions with lower PL-TG ratios should be considered, to avoid the development of pathological plasma lipoprotein concentrations.