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Abstract

Patients receiving home total parenteral nutrition (HTPN) are at risk for the development of essential fatty acid deficiency (EFAD). This study examined the essential fatty acid status of patients on long-term HTPN for gut failure. Serum phospholipid and triglyceride fatty acids were measured in 11 patients and 10 healthy volunteers. Patients had similar levels of linoleic acid (18:2w6) in serum triglyceride fatty acids but significantly lower levels of 18:2w6 in serum phospholipids compared to controls. Although there was accumulation of Mead acid (20:3w9) in both fatty acid fractions, the ratio of 20:3w9 to arachidonic acid (20:4w6) remained less than 0.2, reflecting an adequate essential fatty acid status in these patients. There were, however, substantial increases in 20:4w6 content in both triglyceride and phospholipid fractions in serum despite the lower levels of 18:2w6 in serum phospholipids, suggesting that an accelerated hepatic conversion of 18:2w6 to 20:4w6 occurs in HTPN patients, as well as the 20-carbon members of w3 (20:3w3) and w9 (20:3w9) families. The determination of optimal parenteral fat intakes should be investigated further as important priority in patients receiving long term HTPN.

Whole Blood Levels of the n-6 Essential Fatty Acid Linoleic Acid Are Inversely Associated with Stunting in 2-to-6 Year Old Tanzanian Children: A Cross-Sectional Study

“…Mead acid is less abundant in cholesterol esters and the non-esterified lipid fraction [ 16 ]. Studies assessing EFAD have shown no significant difference when assessing Mead acid in either phospholipids or triglycerides [ 15 ]. The dried blood spot method utilized in the current study analyzes whole blood samples in which the FA proportions are roughly derived 50:50 from red blood cells and plasma [ 94 ].…”

“…Thus, in situations where individuals do not consume sufficient amounts of the EFAs, the non-essential n-9 FA oleic acid (C18:1n9) is converted to Mead acid (C20:3n9) [ 14 ]. Mead acid is incorporated in phospholipids, cholesterol esters, and triglycerides, as well as being found as a non-esterified free FA [ 15 , 16 ]. EFA deficiency (EFAD) leads to higher levels of Mead acid and an elevated triene to tetraene ratio (the T/T ratio), which is defined as the ratio of Mead acid to arachidonic acid (ARA) [ 17 – 19 ].…”

Association of Whole Blood Fatty Acids and Growth in Southern Ghanaian Children 2–6 Years of Age

“…More specifically, when an individual’s diet is deficient of EFAs, oleic acid (C18:1n9), a non-essential n-9 FA, is converted to Mead acid (C20:3n9) [ 12 ]. Mead acid is then incorporated into phospholipids, cholesterol esters, triglycerides and non-esterified free FAs [ 13 , 14 ]. Therefore, in EFA deficiency, there are elevated levels of Mead acid with a decrease in the production of other EFA metabolites such as AA.…”