Plasma lecithin: cholesterol acyltransferase and plasma lipolytic activity in preterm infants given total parenteral nutrition with 10% or 20% Intralipid

Abstract

The effect of 10% or 20% Intralipid on lipid clearing enzymes, plasma lipids and apoproteins was investigated during the first 5 days after birth in 37 premature infants maintained on total parenteral nutrition; 21 infants received 20% and 16 received 10% Intralipid, respectively. Lipid was infused over a 20-h period at rates of 1, 2 and 3 g/kg/day on consecutive days. Plasma lecithin: cholesterol acyltransferase (LCAT) activity was low and increased significantly (p<0.05) only during infusions of 3 g/kg/day in both groups of infants. Plasma lipolytic activity was generally not affected by the regimen or preparation (10% or 20%) of Intralipid infused, except for higher (p<0.05) levels at 3 g/kg/day of 20% compared with prelipid infusion. Plasma triglyceride concentrations wer similar after 10% or 20% Intralipid, whereas plasma total cholesterol was significantly higher during infusion of 2 and 3 g/kg/day of 10% compared with 20% Intralipid. The efficient clearing of 20% Intralipid might be related to the lower lecithin: triglyceride ration which is compatible with the low LCAT activity of premature infants.

Neonatology/Paediatrics – Guidelines on Parenteral Nutrition, Chapter 13

“…Lipid emulsions with a low PL/TG ratio as in the standard 20% emulsions, should be favoured in PN [98], [125], [181], [182]. Higher amounts of phospholipids impair the clearance of triglycerides from the plasma, resulting in an increase in the plasma triglyceride concentration and of cholesterol and phospholipids in Low-Density-Lipoproteins [98].…”

13 Neonatologie/Pädiatrie

“…Das Verhältnis zwischen Phospholipiden (PL) und Triglyzeriden (TG) ist in üblichen 20 %igen Lipidemulsionen niedriger als in Standard 10 %−igen Lipidemulsionen [180]. Lipidemulsionen mit niedrigen PL/TG−Verhältnis, wie es in Standard−20 %igen Emul− sionen vorliegt, sollten daher bei der PE bevorzugt werden [98,125,181,182]. Höhere Mengen an Phospholipiden beein− trächtigen die Klärung von Triglyzeriden aus dem Plasma, was zu einer Zunahme der Plasmatriglyzeridkonzentration sowie von Cholesterin und Phospholipiden in Low−Density−Lipoprotei− nen führt [98].…”

4. Lipids

“…Standard 20% emulsions contain a lower ratio of phospholipid emulsifier/triglycerides than standard 10% lipid emulsions (55) and should preferably be used for intravenous PN (56,57). Higher amounts of PL (i.e.…”