Liver function and plasma antioxidant status in intensive care unit patients requiring total parenteral nutrition: comparison of 2 fat emulsions.
Liver function and plasma antioxidant status in intensive care unit patients requiring total parenteral nutrition: comparison of 2 fat emulsions.
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DOI：
10.1177/0148607104028003142
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发表时间：
2004-05-01
期刊：
影响因子：
--
通讯作者：
Alcindor, L G
中科院分区：
文献类型：
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作者：
Antebi, H;Mansoor, O;Alcindor, L G
背景：从生物学参数上比较了含有大豆、椰子、橄榄和鱼油的α-生育酚强化乳剂(SMOF)和以大豆油为基础的乳剂(LIPOVEN)的有效性和安全性。方法：在一项双盲研究中，20名应激患者被随机分配，接受至少5天的全肠外营养。测定肝酶活性、C反应蛋白、抗氧化能力、α-生育酚、视黄醇和低密度脂蛋白(LDL)-α-生育酚水平。结果：两组大鼠血浆肝酶活性及磷脂/载脂蛋白A1比值均升高。但SMOF组较LIPOVEN组升高幅度较小，对血浆CRP水平和丙氨酸氨基转移酶活性无明显影响。肠外营养前，两组患者血浆抗氧化状态均明显降低。停用肠外营养后，两组的抗氧化能力和低密度脂蛋白衍生氧化副产物的生成量相当。仅SMOF组血浆脂溶性抗氧化维生素和低密度脂蛋白-α-生育酚水平明显改善。结论：SMOF组血浆肝酶活性和磷脂/载脂蛋白A1比值较LIPOVEN组明显升高，提示肝功能改善。这种有益的效果导致更高的肝脏动员和血浆中亲脂性抗氧化剂的水平。它们与向外周组织输送更高的omega-3脂肪酸一起，可以对应激患者的存活率做出积极贡献。
BACKGROUND: Efficacy and safety of an alpha-tocopherol-enriched emulsion incorporating soybean, coconut, olive, and fish oils (SMOF) are compared in terms of biologic parameters to those of soybean oil-based emulsion (LIPOVEN).METHODS: Twenty stressed patients were randomly assigned in a double-blind study to receive at least a 5-day course of total parenteral nutrition. Plasma activities of liver enzymes, C-reactive protein, antioxidant capacity, alpha-tocopherol, retinol, and low density lipoprotein (LDL)-alpha-tocopherol levels were determined. LDL-lipid oxidation is measured after incubation of the LDL in the presence of a prooxidant.RESULTS: The plasma activities of liver enzymes and the phospholipids/apo A1 ratio were increased in both groups. However, in the SMOF group the increases were lower than in the LIPOVEN group and non-significant for the CRP plasma level and the alanineamino-transferase activity. Before parenteral nutrition, the plasma antioxidant status was markedly reduced in both groups. After parenteral nutrition discontinuation, the antioxidant capacity and the amount of LDL-derived oxidation by-products formed were comparable in both groups. There was a significant improvement in plasma lipophilic antioxidant vitamins and LDL-alpha-tocopherol levels only in the SMOF group.CONCLUSIONS: The lower increase of plasma liver enzymes and phospholipids/apo A1 ratio in the SMOF group suggest a better liver function than in the LIPOVEN group. This beneficial effect results in a higher liver mobilization and plasma levels of lipophilic antioxidants. They could, together with higher delivery of omega-3 fatty acids to peripheral tissues, contribute positively to survival rate of stressed patients.