Effects of two different lipid emulsions on antioxidant status, lipid peroxidation and parenteral nutrition- related cholestasis in premature babies, a randomized-controlled study

Pediatr Neonatol. 2019 Aug;60(4):359-367. doi: 10.1016/j.pedneo.2018.07.012. Epub 2018 Aug 2.

Abstract

Background: Olive oil-soybean oil (OO/SO) based lipid emulsions (LE) lack ω-3 PUFAs eicosapentaenoic acid -EPA and docosahexaenoic acid- DHA, which have clinical benefits on inflammatory processes. Fish oil based LEs are good sources of DHA and EPA. Fish oil, MCT, Olive oil and Soya oil (FMOS) lipid is one of the fish oil containing LEs supplemented with high levels of α-tocopherol and lower levels of phytosterol compared to OO/SO lipid emulsions. We investigated the effects of OO/SO and FMOS lipid preparations on cholestasis, levels of antioxidant enzymes and lipid peroxidation.

Methods: Preterm neonates ≤32 gestational weeks age and/or ≤1500 g were randomly assigned to receive either FMOS or OO/SO in the first day of life. Catalase, superoxide dismutase (SOD), glutathione peroxidase (GPx) and thiobarbituric acid reactive substances (TBARS) levels in the first day of life, 7th day of lipid use and 28th day of life were measured and cholestasis during parenteral nutrition was recorded.

Results: 34 and 33 patients were in FMOS and OO/SO lipid groups respectively. Although the TBARS levels were higher in the first day of life and 7th day of LEs in OO/SO lipid group (p=0.014 and p=0.022), on the 28th day of life TBARS level was similar and SOD level was higher (p=0.014) in OO/SO group. Cholestasis was significantly lower in FMOS lipid group (0% vs. 18.2%), (p=0.011) and neonates regained birth weight earlier (p=0.006). There was no significant difference in other morbidities.

Conclusions: FMOS and OO/SO lipid emulsions have similar effects on lipid peroxidation on 28th day of life and on morbidities in short term period except for cholestasis.

Keywords: cholestasis; fish oil/MCT/olive oil/soy bean lipid; olive oil/soybean lipid; preterm.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bronchopulmonary Dysplasia / epidemiology
  • Catalase / metabolism
  • Cerebral Intraventricular Hemorrhage / epidemiology
  • Cholestasis / epidemiology*
  • Docosahexaenoic Acids
  • Eicosapentaenoic Acid
  • Enteral Nutrition
  • Enterocolitis, Necrotizing / epidemiology
  • Fat Emulsions, Intravenous / chemistry*
  • Fat Emulsions, Intravenous / therapeutic use*
  • Female
  • Fish Oils*
  • Glutathione Peroxidase / metabolism
  • Humans
  • Infant
  • Infant, Extremely Premature
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / epidemiology
  • Infant, Very Low Birth Weight
  • Lipid Peroxidation
  • Male
  • Olive Oil*
  • Parenteral Nutrition / methods*
  • Retinopathy of Prematurity / epidemiology
  • Soybean Oil*
  • Superoxide Dismutase / metabolism
  • Thiobarbituric Acid Reactive Substances / metabolism
  • Triglycerides
  • Weight Gain
  • alpha-Tocopherol

Substances

  • Fat Emulsions, Intravenous
  • Fish Oils
  • Olive Oil
  • Thiobarbituric Acid Reactive Substances
  • Triglycerides
  • Docosahexaenoic Acids
  • Soybean Oil
  • Eicosapentaenoic Acid
  • Catalase
  • Glutathione Peroxidase
  • Superoxide Dismutase
  • alpha-Tocopherol