A309 EFFECT OF MIXED LIPID, ω-3 FISH OIL AND ω-6 SOYBEAN OIL PARENTERAL LIPID EMULSIONS ON LIVER DISEASE, HEPATIC LIPID AND PHYTOSTEROL COMPOSITION IN NEONATAL PIGLETS. (1st March 2018)

• Record Type: Journal Article
• Authors: Migliarese Isaac, D; Alzaben, A; Mazurak, V C; Yap, J; Wizzard, P; Nation, P N; Zhao, Y; Curtis, J M; Sergi, C; Wales, P; Mager, D R; Turner, J
• Is Part Of: Journal of the Canadian Association of Gastroenterology. Volume 1(2018)Supplement 2
• Page Start: 443
• Page End: 444
• Publication Date: 2018-03-01
• Subjects: Gastroenterology -- Periodicals; 616.33005
• DOI: 10.1093/jcag/gwy009.309
• Languages: English
• ISSNs: 2515-2084

Abstract

Abstract: Background: Determining the optimal lipid emulsion in parenteral nutrition (PN) for pediatric intestinal failure (PIF) patients remains an important clinical question given the risk of PN associated liver disease (PNALD). Aims: Using a neonatal piglet model, this study compared mixed lipid (ML; ω-6:ω-3 fatty acid [FA] 2.5:1), ω-3 fish oil (FO; ω-6:ω-3 FA 1:8), and ω-6 soybean oil (SO; ω-6:ω-3 FA 7:1) emulsions for the following markers of PNALD: i) hepatic histology, neutral lipid (NL), FA and phytosterol (PS) composition, and ii) biochemical cholestasis. Methods: Neonatal piglets received iso-nitrogenous PN with variation in the dose (5=5g/kg/d or 10=10g/kg/d) and type of lipid provided: SO5 (n=5), SO10 (n=5), FO5 (n=5), and ML10 (n=5). Biochemical evidence of cholestasis was assessed by measuring bile flow, γ-glutamyl transpeptidase (GGT), bile acids (BA) and total bilirubin (TB). Liver tissue was assessed on day 14 of PN for: histology, NL accumulation using Oil Red O (ORO) staining, hepatic FA composition in triglyceride (TG) fraction, and PS composition. Data were expressed as mean ± standard deviation. Chi-square was used for categorical variables, and one-way Anova for continuous variables. Results: TB was significantly higher (p<0.02) and bile flow significantly lower (p<0.001) in SO groups versus (vs) FO5 and ML10. Serum BA were 3-fold higher in SO vs FO5 and ML10 piglets (p=0.04). There were no differences in GGT (p=0.19), NL accumulation (p=0.3), or overall liver histology scores (p=0.16) between groups; however, only SO piglets showed cholestasis on histology (SO10 n=2, SO5 n=1). Total FA in the TG fraction was higher in SO vs FO5 and ML10 groups (p<0.03), with SO10 levels 4-fold greater than FO5 (p=0.02). Eicosapentaenoic acid and docosahexaenoic acid were higher in FO5 and ML10 vs SO piglets (p<0.001), with no significant differences between ML10 and FO5. The ω-6/ω-3 FA ratio was significantly higher in SO groups (SO5 9.0 ± 0.7, SO10 8.7 ± 1.8, p<0.0001), but not different between ML10 and FO5 (1.5 ± 0.3 vs 0.4 ± 0.3, p=0.32). FO5 and ML10 were markedly lower in campesterol than SO (p<0.0001). Stigmasterol and β-sitosterol were not detected in FO5, but were significantly higher in SO than ML10 (p<0.0001). β-sitostanol was only detected in the SO10 group. Conclusions: ML and FO lipid emulsions were associated with reduced cholestasis and lower hepatic lipid and PS accumulation. Alterations in hepatic lipid and PS composition in piglets given SO emulsions may contribute to PNALD. Considering typical infant diets, ML provided a more balanced ω-6/ω-3 hepatic FA composition than SO and FO. These results provide guidance on lipid selection for PIF patients receiving PN. Funding Agencies: CIHRLiver Foundation Research Grant; Industry Partner Fresenius Kabi (provision of parenteral nutrition); and Saudi Cultural Bureau, Ministry of Education, Saudi Arabia (personal training funding for Abeer Alzaben).