Phytosterolemia and γ-glutamyl transferase in adults with parenteral nutrition: Fish versus vegetal lipids: A randomized clinical trial

Llop-Talaverón, J.; Badia-Tahull, M.ª B.; Lozano-Andreu, Toni; Rigo-Bonnin, Raül; Virgili-Casas, Núria; Farran-Teixidó, Leandre; Miró-Martín, Mònica; Suárez-Lledó, Ana; Leiva‐Badosa, Elisabet

doi:10.1016/j.nut.2019.110587

Cited by 8 publications

(19 citation statements)

References 26 publications

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“…In the previous clinical randomised trial with the same population and design, we found a positive association between plasma values of PS (and their fractions) and values of γglutamyltransferase and ALT, whereas these associations were not seen in AP (19) . Now our results show that there is an accumulation of PS because their elimination is slower than the usual administration rate.…”

Section: Study In Patients: Sterol Plasma Valuesmentioning

confidence: 50%

Phytosterolaemia associated with parenteral nutrition administration in adult patients

et al. 2020

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Vegetable lipid emulsions (LE) contain non-declared phytosterols (PS). We aimed to determine PS content depending on the brand and LE batch, and in adult hospitalised patients treated with parenteral nutrition (PN), to establish the association between plasma and administered PS. Part I was the LE study: totals and fractions of PS in three to four non-consecutive batches from six LE were analysed. Part II was the patient study: patients with at least 7 previous days of PN with 0·8 g/kg per d of an olive/soyabean (O/S) LE were randomised (day 0) 1:1 to O/S or 100 % fish oil (FO) at a dose of 0·4 g/kg per d for 7 d (day 7). Plasma PS, its fractions, total cholesterol on days 0 and 7, their clearance and their association with PS administered by LE were studied. In part I, LE study: differences were found in the total PS, their fractions and cholesterol among different LE brands and batches. Exclusive soyabean LE had the highest content of PS (422·36 (sd 130·46) μg/ml). In part II, patient study: nineteen patients were included. In the O/S group, PS levels were maintained (1·11 (sd 6·98) μg/ml) from day 0 to 7, while in the FO group, significant decreases were seen in total PS (−6·21 (sd 4·73) μg/ml) and their fractions, except for campesterol and stigmasterol. Plasma PS on day 7 were significantly associated with PS administered (R2 0·443). PS content in different LE brands had great variability. PS administered during PN resulted in accumulation and could be prevented with the exclusive administration of FO LE.

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Section: Study In Patients: Sterol Plasma Valuesmentioning

confidence: 50%

Phytosterolaemia associated with parenteral nutrition administration in adult patients

et al. 2020

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“…The administration of high doses of intravenous lipids, that are high in n-6 PUFAs and phytosterols (like the ones based on soybean oils), can contribute to the development of parenteral nutrition-associated liver disease [23]. ILEs based exclusively on fish oil reduce plasmatic phytosterol levels and are associated with an improvement in liver profile [24,25]. In our study, regarding analytical data, we did not find any differences in liver profile, neither in the percentage of patients with an increase in liver enzymes nor in the number of patients with liver complications.…”

Section: Lipid Control and Liver Enzymesmentioning

confidence: 99%

Fish Oil Enriched Intravenous Lipid Emulsions Reduce Triglyceride Levels in Non-Critically Ill Patients with TPN and Type 2 Diabetes. A Post-Hoc Analysis of the INSUPAR Study

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There are no studies that have specifically assessed the role of intravenous lipid emulsions (ILE) enriched with fish oil in people with diabetes receiving total parenteral nutrition (TPN). The objective of this study was to assess the metabolic control (glycemic and lipid) and in-hospital complications that occurred in non-critically ill inpatients with TPN and type 2 diabetes with regard to the use of fish oil emulsions compared with other ILEs. We performed a post-hoc analysis of the Insulin in Parenteral Nutrition (INSUPAR) trial that included patients who started with TPN for any cause and that would predictably continue with TPN for at least five days. The study included 161 patients who started with TPN for any cause. There were 80 patients (49.7%) on fish oil enriched ILEs and 81 patients (50.3%) on other ILEs. We found significant decreases in triglyceride levels in the fish oil group compared to the other patients. We did not find any differences in glucose metabolic control: mean capillary glucose, glycemic variability, and insulin dose, except in the number of mild hypoglycemic events that was significantly higher in the fish oil group. We did not observe any differences in other metabolic, liver or infectious complications, in-hospital length of stay or mortality.

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“…This single center, retrospective, cohort study evaluated timing and dose of protein intake in 455 mechanically ventilated patients during the first 7 days of intensive care unit (ICU) stay. The majority (66%) of the patients were medical ICU patients with a median age of 70 (interquartile range, 61-77) years, Acute Physiology and Chronic Health Evaluation (APACHE) II score of 22 (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28), and a body mass index (BMI) of 26.4 (23.5-30) kg/m 2 . Protein provision was stratified into 3 groups: low (<0.8 g/kg/day), intermediate (0.8-1.2 g/kg/day), and high (>1.2 g/kg/day).…”

Section: *mentioning

confidence: 99%

“…26 The ideal ILE for patients receiving HPN in the absence of PN-associated liver disease (PNALD) remains unclear and limited to small trials outside the United States, namely in countries with clinical nutrition centers. Newer ILEs, especially those containing fish oil (FO), contain lower phytosterol content and may minimize risk of PNALD associated with serum phytosterols, 27 although this was not evaluated in the current study. Larger trials in HPN patients comparing OO, SO-based ILE, SO, MCT,OO,FO-based ILE, and FO alone with-and without PNALD for greater than 3 months are warranted to determine the ideal ILE for long-term use without resulting in an EFAD.…”

Section: Osowska Et Al 12 Effect Of Changing the Lipid Component Of mentioning

confidence: 99%

Significant Published Articles for Pharmacy Nutrition Support Practice in 2019

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Purpose The purpose of this article is to assist the pharmacist engaged in nutrition support therapy in staying current with pertinent literature. Methods: Several clinical pharmacists engaged in nutrition support therapy compiled a list of articles published in 2019 considered important to their clinical practice. The citation list was compiled into a single spreadsheet where the author participants were asked to assess whether the article was considered important to nutrition support pharmacy practice. A culled list of publications was then identified whereby at least 5 out of the 8 author participants considered the paper to be important. Guideline and consensus papers from professional organizations, important to practice but not ranked, were also included. Results: A total of 111 articles were identified; 6 from the primary literature were voted by the group to be of high importance. An additional 9 organizational guidelines, position, recommendation, or consensus papers were also identified. The top-ranked articles from the primary literature were summarized and a narrative regarding its implications to pharmacy nutrition support practice were provided. Conclusion: We recommend that pharmacists engaged in nutrition support therapy be familiar with these articles as it pertains to their practice.

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Phytosterolemia and γ-glutamyl transferase in adults with parenteral nutrition: Fish versus vegetal lipids: A randomized clinical trial

Cited by 8 publications

References 26 publications

Phytosterolaemia associated with parenteral nutrition administration in adult patients

Phytosterolaemia associated with parenteral nutrition administration in adult patients

Fish Oil Enriched Intravenous Lipid Emulsions Reduce Triglyceride Levels in Non-Critically Ill Patients with TPN and Type 2 Diabetes. A Post-Hoc Analysis of the INSUPAR Study

Significant Published Articles for Pharmacy Nutrition Support Practice in 2019

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