Triglycerides, free fatty acids, free fatty acids/albumin molar ratio, and cholesterol levels in serum of neonates receiving long-term lipid infusions: Controlled trial of continuous and intermittent regimens

Kao, Lily C.; Cheng, Mary Hongying; Warburton, David

doi:10.1016/s0022-3476(84)81111-7

Cited by 77 publications

(43 citation statements)

References 26 publications

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“…Total plasma cholesterol increased in both groups during low and high fat intravenous feeding. HDL-cholesterol, however, did not change with iv-fat where mean values for groups I and II at baseline, iv-low fat and -high fat were: group I, 31.2 ± 7.1, 30.0 ± 8.8, and 36.6 ± 16.7 mg/dl, respectively; and group II, 20.0 ± 7.8, 20.2 ± 7.4, and 19.8 ± 8.8 mg/dl, respectively. Unlike HDL-cholesterol levels that remained constant with iv-fat, apolipoprotein (apo)AI concentrations increased significantly: group I, 73.0 ± 11.0, 88.3 ± 15.9, and 93.1 ± 21.9 mg/dl, respectively; and group II, 31.8 ± 10.5, 41.0 ± 12.8, and 59.3 ± 18.5 mg/dl, respectively.…”

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confidence: 87%

Effect of Total Parenteral Nutrition with Intravenous Fat on Lipids and High Density Lipoprotein Heterogeneity in Neonates

Forte

Genzel‐Boroviczény²,

Austin

et al. 1989

J Parenter Enteral Nutr

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Plasma lipid concentrations and high density lipoprotein (HDL) subclass distributions were evaluated in 22 newborn infants nourished with intravenous (iv)-fat. The majority of infants were premature with respiratory distress syndrome. Based on baseline (prior to iv-fat) HDL subclass profiles determined by gradient gel electrophoresis (GGE), infants fell into two classes, one with two or more pronounced peaks within the normal HDL spectrum (group I, 17 subjects) and the other with highly unusual HDL distribution (group II, five subjects). Total plasma cholesterol increased in both groups during low and high fat intravenous feeding. HDL-cholesterol, however, did not change with iv-fat where mean values for groups I and II at baseline, iv-low fat and -high fat were: group I, 31.2 +/- 7.1, 30.0 +/- 8.8, and 36.6 +/- 16.7 mg/dl, respectively; and group II, 20.0 +/- 7.8, 20.2 +/- 7.4, and 19.8 +/- 8.8 mg/dl, respectively. Unlike HDL-cholesterol levels that remained constant with iv-fat, apolipoprotein (apo) AI concentrations increased significantly: group I, 73.0 +/- 11.0, 88.3 +/- 15.9, and 93.1 +/- 21.9 mg/dl, respectively; and group II, 31.8 +/- 10.5, 41.0 +/- 12.8, and 59.3 +/- 18.5 mg/dl, respectively. In group I infants, iv-fat is associated with an increase in larger-sized particles, particularly in the (HDL2b)gge range; in group II there is an increase in (HDL3b)gge and (HDL3c)gge components and a disappearance of particles that fall outside of the size range of normal HDL. In both groups, enteral feeding is associated with a further normalization of HDL subclass distribution. The aberrant GGE profiles and very low apoAI levels of group II infants at baseline were associated with unusual HDL morphology determined by electron microscopy where discoidal structures were prominent. With iv-fat, discoidal particles decline in number while normal spherical structures increase. Prevalence of discoidal HDL at baseline was associated with low concentrations of lecithin:cholesterol acyltransferase (LCAT) (1.12 +/- 0.5 micrograms/ml); with iv-fat this enzyme rose to 1.61 +/- 0.18 micrograms/ml. Increased LCAT is associated with the normalization of HDL morphology. It is likely that iv-fat improves the nutritional status of premature infants, thereby stimulating increased liver synthesis of important proteins, including apoAI and LCAT, associated with HDL metabolism.

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confidence: 87%

Effect of Total Parenteral Nutrition with Intravenous Fat on Lipids and High Density Lipoprotein Heterogeneity in Neonates

Forte

Genzel‐Boroviczény²,

Austin

et al. 1989

J Parenter Enteral Nutr

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“…LCAT is released from the liver into the circulation, where it acts specifically on plasma HDL by converting the lecithin and unesterified cholesterol of HDL to cholesterylester and lysolecithin [40]. Once esterified, the cholesteryl ester leaves the surface coat and moves into the Lipid is administered to infants on an empirical basis; it is generally advised that it be given in amounts that do not cause lipemia (plasma triglycerides in excess of 100-150 mg/dl) [41,42], The widespread use of lipid in parenteral nutrition is in marked contrast to the limited knowledge of the en zymes and cofactors active in the lipid-clear ing process in low birth weight infants [43,44], Recent studies indicate that infusion period and infusion rate affect the clearing of lipid in low birth weight infants maintained on total parenteral nutrition [45,46], Fur thermore, the presence of heparin in solu tions prepared for intravenous (i.v.) use (even the low concentration of 1 U/ml i.v.…”

Section: Lecithin Cholesterol Acyltransferasementioning

confidence: 99%

Lipid Metabolism in Premature Infants

Hamosh¹

1987

Neonatology

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Fats provide 40–50% of the total calories in human milk or infant formula. The milk secreted by mothers of preterm infants differs in fat composition from that of mothers of full-term infants in having higher levels of medium chain fatty acids (C₁₂, C₁₄) throughout the first 3 months of lactation, and higher levels of long chain polyenoic fatty acids during the first 3 months of lactation. These differences in composition benefit the preterm infant by providing higher levels of rapidly absorbed medium chain fatty acids and long chain polyenoic fatty acids needed for brain development. Fat digestion: The low levels of pancreatic lipase and bile salts in the preterm infant are compensated for by lipolysis in the stomach by lingual and gastric lipase and by the intestinal hydrolysis of fat through the action of human milk bile salt-stimulated lipase. Fat digestion is efficient in the preterm infant who absorbs about 80–90% of ingested fat. Lipid clearing from the circulation depends upon the activity of the enzymes lipoprotein lipase, hepatic lipase, and lecithin-cholesterol acyltransferase. The activity of these enzymes is lower or equal to that of term infants, depending upon the degree of prematurity and the nutritional regimen, especially in parenterally fed infants.

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“…Free fatty acids can displace protein-bound TT4 which elevates FT4; 30,33 the parenteral nutrition of premature infants typically includes triglyceride emulsions at concentrations which are known to generate average ratios of free fatty acids to albumin of 12 or higher, which is four times higher than the ratio needed to inhibit protein binding in vitro. 33,34 The artefactual rise in FT4 is potentially compounded by the use of heparin which, even at low doses, can lead to in vitro activation of lipoprotein lipase with the subsequent generation of free fatty acids. 35 Albumin is a major component of total fetal serum protein concentrations, but TBG is the preferred carrier for TT4 even in the midtrimester fetus.…”

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confidence: 99%

The measurement, definition, aetiology and clinical consequences of neonatal transient hypothyroxinaemia

Williams

Hume

2010

Ann Clin Biochem

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This review focuses on neonatal transient hypothyroxinaemia, a condition characterized by temporary postnatal reductions in concentrations of Total T4 or Free T4, with normal or low concentrations of thyroid stimulating hormone (TSH). There is neither an agreed quantitative definition, nor an agreed mode of measurement for the condition. Transient hypothyroxinaemia is not routinely monitored yet it is thought to affect about 50% of preterm infants; it was thought to be without long-term sequelae but observational studies indicate that neurodevelopment may be compromised. The aetiology of transient hypothyroxinaemia is complex. There are significant contributions from the withdrawal of maternal -placental thyroxine transfer, hypothalamic-pituitary -thyroid immaturity, developmental constraints on the synthesis and peripheral metabolism of iodothyronines and iodine deficiency. It is not possible to distinguish clinically, or from laboratory measurements, whether transient hypothyroxinaemia is an independent condition or simply a consequence of non-thyroidal illness and/or drug usage. An answer to this question is important because studies of thyroid hormone replacement have been instigated, with mixed results. Until the aetiology of transient hypothyroxinaemia is better understood it would seem prudent not to routinely supplement preterm infants with thyroid hormones. Iodine deficiency, non-thyroidal illness and drug usage are the most modifiable risk factors for transient hypothyroxinaemia and are the clear choices for attempts at reducing its incidence. We suggest that transient hypothyroxinaemia in preterm infants is defined as a normal or low TSH concentration in conjunction with a concentration of Total T4, that is 10th percentile of cord Total T4 of the equivalent gestational age had the infant remained in utero.Ann Clin Biochem 2011; 48: 7-22.

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Triglycerides, free fatty acids, free fatty acids/albumin molar ratio, and cholesterol levels in serum of neonates receiving long-term lipid infusions: Controlled trial of continuous and intermittent regimens

Cited by 77 publications

References 26 publications

Effect of Total Parenteral Nutrition with Intravenous Fat on Lipids and High Density Lipoprotein Heterogeneity in Neonates

Effect of Total Parenteral Nutrition with Intravenous Fat on Lipids and High Density Lipoprotein Heterogeneity in Neonates

Lipid Metabolism in Premature Infants

The measurement, definition, aetiology and clinical consequences of neonatal transient hypothyroxinaemia

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