Specific changes in n -6 fatty acid metabolism in patients with chronic intestinal failure

Replacement of long‐chain triglyceride with medium‐chain triglyceride/long‐chain triglyceride lipid emulsion in patients receiving long‐term parenteral nutrition: effects on essential fatty acid status and plasma vitamin K1 levels

“…Moreover, as previously described, plasma fatty acid phospholipid levels were significantly different from normal values during the LCT period. 12,[15][16][17] Several short-term studies have shown that MCT/LCT lipid emulsion did not induce essential fatty acid deficiency, but the lipid amounts were higher (80 g to 100 g per day) than those in our study. 18 -20 However, in malnourished patients needing parenteral nutrition, fatty acid deficiencies were more slowly corrected with MCT/LCT emulsion than with LCT lipid emulsion.…”

“…Normal ranges were obtained from 14 healthy subjects (5 men and 9 women). 12 Vitamin K 1 plasma concentrations were only measured in 7 patients by high-performance liquid chromatography (normal ranges: 100 to 1000 ng/L). 13 Prothrombin times were not analyzed in this study because 7 of the 11 patients had received antithrombic therapy for deep venous thrombosis.…”

“…12,[15][16][17]21 These findings suggest that severe malabsorption or chronic intestinal failure per se induces specific troubles of the biosynthesis pathway of -6 polyunsaturated fatty acids with a stimulation of -6 fatty acid biosynthesis, which could lead to an inhibition of -3 fatty acid elongation. 12,17 No study has evaluated the effect of MCT/LCT lipid emulsion on plasma vitamin K 1 status. As did previous studies, this study showed that an LCT lipid emulsion is able to maintain plasma vitamin K 1 status even with a small amount of infused lipid emulsion (0.41 Ϯ 0.22 g kg -1 day -1 ) without vitamin K 1 adjunction.…”

“…Conclusions: An amount of 2.85 Ϯ 1.55 g.kg -1 week -1 of MCT/LCT lipid emulsion neither induced essential fatty acid deficiency nor improved the fatty acid disturbances usually observed in LTPN patients but did induce a drop in plasma vitamin K 1 levels. ( Journal of Parenteral and Enteral Nutrition 28: [7][8][9][10][11][12]2004) In patients receiving long-term parenteral nutrition, chronic abnormalities of liver function are reported to occur at a rate ranging from 15% to 85%. [1][2][3][4] Pathogenesis is multifactorial and involves patient-and nutrition-dependent factors such as IV hyperalimentation and lipid parenteral intake of 1 g or more per kilogram body weight and per day of long-chain triglyceride (LCT) lipid emulsion.…”

Alteration of polyunsaturated fatty acid status and metabolism in health and disease

“…The deficiency can be corrected by intravenous lipids, but essential fatty acid abnormalitie persist. Stimulation of n-6 PUFA biosynthesis which could lead to an inhibition of n-3 PUFA elongation has been observed [58]. This could be related to the severe malabsorption.…”