Administration of an Intravenous Fat Emulsion Enriched with Medium-Chain Triglyceride/ω-3 Fatty Acids is Beneficial Towards Anti-Inflammatory Related Fatty Acid Profile in Preterm Neonates: A Randomized, Double-Blind Clinical Trial

Nutrients. 2020 Nov 16;12(11):3526. doi: 10.3390/nu12113526.


Intravenous administration of pure soybean oil emulsions high in linoleic acid may lead to inflammation and lipid peroxidation in preterm neonates. We aimed to investigate the effects of a medium-chain triglyceride (MCT)/ω-3 polyunsaturated fatty acid (PUFA)-enriched intravenous fat emulsion (IVFE) on plasma fatty acid (FA) profile and serum interleukin-6 (IL-6) in preterm neonates. In this double-blind randomized study, 92 preterm neonates (gestational age < 32 weeks, birth weight < 1500 g) were assigned to receive either MCT/ω-3 PUFA-enriched IVFE (Intervention Group) or soybean oil-based IVFE (Control Group). Levels of FAs were measured at baseline (day 0) and day 15 of parenteral nutrition with gas-chromatography mass-spectrometry. Serum IL-6 was measured with sandwich ELISA in 59 neonates. Plasma FAs changed significantly over time; the MCT/ω-3 PUFA-IVFE group showed higher ω-3 PUFAs (p = 0.031), eicosapentaenoic acid (p = 0.000), and oleic acid (p = 0.003), and lower ω-6/ω-3 PUFAs ratio (p = 0.001) and ω-6 PUFAs (p = 0.023) compared to control group. Linoleic acid was higher in the soybean oil (SO)-based IVFE arm compared to the MCT/ω-3 PUFAs-IVFE arm (p = 0.006). Both fat emulsion types decreased IL-6 compared to baseline, but changes were insignificant between groups. Administration of MCT/ω-3 PUFA-enriched IVFE in preterm neonates is beneficial in changing the FA profile consistent with attenuated inflammatory response.

Keywords: fish oil; inflammation; neonates; oleic acid; omega-3 fatty acids; parenteral nutrition; preterm.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Double-Blind Method
  • Eicosapentaenoic Acid / blood
  • Fat Emulsions, Intravenous / administration & dosage*
  • Fat Emulsions, Intravenous / chemistry
  • Fatty Acids, Omega-3 / administration & dosage*
  • Fatty Acids, Omega-3 / blood
  • Fatty Acids, Omega-6 / blood
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature / growth & development*
  • Interleukin-6 / blood
  • Linoleic Acid / blood
  • Male
  • Oleic Acid / blood
  • Parenteral Nutrition*
  • Soybean Oil / administration & dosage
  • Triglycerides / administration & dosage*


  • Fat Emulsions, Intravenous
  • Fatty Acids, Omega-3
  • Fatty Acids, Omega-6
  • Interleukin-6
  • Triglycerides
  • Oleic Acid
  • Soybean Oil
  • Linoleic Acid
  • Eicosapentaenoic Acid