About this item:

759 Views | 0 Downloads

Author Notes:

Address all correspondence and requests for reprints to: Guillermo E. Umpierrez, M.D., Professor of Medicine, Emory University School of Medicine, 49 Jesse Hill Jr. Drive, Atlanta, Georgia 30303. Email: geumpie@emory.edu.

The authors have nothing to disclose.

Subjects:

Research Funding:

This investigator-initiated study was supported by a research grant from Baxter Pharmaceuticals (to G.E.U.) and National Institutes of Health Grant UL1 RR025008 (Atlanta Clinical and Translational Science Institute), American Diabetes Association Grant 7-03-CR-35 (to G.E.U.) and Grant K24 RR023356 (to T.R.Z.).

Substitution of Standard Soybean Oil with Olive Oil-Based Lipid Emulsion in Parenteral Nutrition: Comparison of Vascular, Metabolic, and Inflammatory Effects

Show all authors Show less authors

Tools:

Journal Title:

Journal of Clinical Endocrinology and Metabolism

Volume:

Volume 96, Number 10

Publisher:

, Pages 3207-3216

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Context: Soybean oil-based lipid emulsions are the only Food and Drug Administration-approved lipid formulation for clinical use in parenteral nutrition (PN). Recently concerns with its use have been raised due to the proinflammatory effects that may lead to increased complications because they are rich in ω-6 polyunsaturated fatty acids. Methods: This was a prospective, randomized, controlled, crossover study comparing the vascular, metabolic, immune, and inflammatory effects of 24-h infusion of PN containing soybean oil-based lipid emulsion (Intralipid), olive oil-based (ClinOleic), lipid free, and normal saline in 12 healthy subjects. Results: Soybean oil-PN increased systolic blood pressure compared with olive oil-PN (P < 0.05). Soybean oil PN reduced brachial artery flow-mediated dilatation from baseline (−23% at 4 h and −25% at 24 h, both P < 0.01); in contrast, olive oil PN, lipid free PN, and saline did not change either systolic blood pressure or flow-mediated dilatation. Compared with saline, soybean oil PN, olive oil PN, and lipid free PN similarly increased glucose and insulin concentrations during infusion (P < 0.05). There were no significant changes in plasma free fatty acids, lipid profile, inflammatory and oxidative stress markers, immune function parameters, or sympathetic activity between soybean oil- and olive oil-based lipid emulsions. Conclusion: The 24-h infusion of PN containing soybean oil-based lipid emulsion increased blood pressure and impaired endothelial function compared with PN containing olive oil-based lipid emulsion and lipid-free PN in healthy subjects. These vascular changes may have significant implications in worsening outcome in subjects receiving nutrition support. Randomized controlled trials with relevant clinical outcome measures are needed in patients receiving PN with olive oil-based and soybean oil-based lipid emulsions.

Copyright information:

© 2011 by The Endocrine Society

Export to EndNote