Erythrocyte fatty acid membrane composition in children on long-term parenteral nutrition enriched with ω-3 fatty acids. Issue 2 (28th September 2021)

• Record Type: Journal Article
• Authors: Goulet, Olivier; Lamazière, Antonin; Abi Nader, Elie; Talbotec, Cécile; Wolf, Claude; Lambe, Cécile
• Is Part Of: American journal of clinical nutrition. Volume 115:Issue 2(2022)
• Page Start: 422
• Page End: 431
• Publication Date: 2021-09-28
• Subjects: intestinal failure -- home parenteral nutrition -- fish oil–based intravenous lipid emulsion -- SMOFlipid® -- cholestatic liver disease -- erythrocyte membrane fatty acid profile -- ω-3 fatty acids -- essential fatty acids -- Holman ratio; Diet therapy -- Periodicals; Nutrition -- Periodicals; Dietetics -- Periodicals; 613.205
• DOI: 10.1093/ajcn/nqab263
• Languages: English
• ISSNs: 0002-9165

Abstract

ABSTRACT: Background: Composite lipid emulsions containing soybean oil (30%), medium-chain triglycerides (30%), olive oil (25%), and fish oil (15%) (SMOF) are now widely used. Objectives: We aimed to evaluate the tolerance, the efficiency, and the erythrocyte fatty acid (FA) profile for children on long-term home parenteral nutrition (HPN) receiving a composite fish oil–based emulsion (FOLE). Methods: At baseline, children ( n = 46) with severe intestinal failure highly dependent on parenteral nutrition (PN) for ≥1 y were included in the study when they had received the composite FOLE for >6 mo. Out of this baseline group, only 25 children remained highly PN-dependent (SMOF1, n = 25) and could be assessed a second time, 2.4 y later (SMOF2, n = 25). An independent control group ("weaned off PN" group; n = 24) included children who had been weaned off PN for >2 y (median: 4 y). RBC-FA composition was established by GC-MS. Growth parameters, plasma citrulline, conjugated bilirubin, FA profiles, and the Holman ratio (20:3ω-9/20:4ω-6) were compared between groups. Results: No difference for growth parameters, citrulline, and bilirubin was observed between the SMOF groups after 2.4 y (0.2 < P < 0.8). The weaned-off group did not differ from the SMOF groups for growth parameters (0.2 < P < 0.4) but citrulline was higher ( P < 0.0001) and conjugated bilirubin lower ( P < 0.01). The composite FOLE induced higher proportions of EPA (20:5n–3) (8.4% ± 2.9%) and DHA (22:6n–3) (11.7% ± 2.2%) than what was observed in weaned-off children (0.8% ± 0.4% and 6.6% ± 2.3%, respectively) but lower proportions of arachidonic acid (20:4n–6). However, the Holman ratio did not vary between groups ( P = 0.9), whereas the PUFA concentrations varied widely. Conclusions: Long-term use of the composite FOLE was well tolerated in HPN-dependent children. The RBC-FA profile alterations were consistent with the ω-3 PUFA–enriched composition of this emulsion without evidence of essential FA deficiency.