Abstract
The effect of TPN with intravenous fat (IVF) on Low Density Lipoproteins (LDL) and LDL, assessed by gradient gel electrophoresis and electron microscopy (EM), and apo AI levels was examined in 22 acutely ill newborns. Blood samples were taken oefore IVF, on maximal IVF (2.5 g/kg/d) and on full enteral feedings. Before start of IVF most infants (73%), as seen on age, had a normal HDL subclass distribution with 2-3 major peaks, which increased with IVF. Apo AI levels also increased with IVF and further on enteral feedings (73±10, 93±16, 126±29 g/dl). In contrast to this group, the remaining 27% of the infants showed an abnormal HDL subclass distribution with very little material within but large HDL particles outside the normal HDL region, a profile very similar of Lecithin:Cholesterol-acyltransferase (LCAT) deficiency. This was associated with discoidal particles on EM and very low apo AI (32+11g/dl). The abnormal HDL profile improved with IVF, the discoidal particles diminished and apo AI rose significantly (59±19, 100±30 g/dl), as did LCAT mass (1.2, 1.6, 2.6 μml). In opposite to these striking changes, LDL distribution did not change with IVF or enteral nutrition in the individual patient, nor was there a profound difference between the infants.
Conclusion: TPE/IVF improves HDL morphology, probably by stimulating increased liver synthesis of apo AI and LCAT, whereas LDL subclass distribution is not influenced.
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Genzel-Boroviczeny, O., Forte, T. & D'Harlingue, A. 62 HIGH DENSITY LIPOPROTEIN (HOD SUBCLASS DISTRIBUTION AND APOPROTEIN AI (APO AI) LEVEL IMPROVE IN NEWBORNS ON TOTAL PARENTERAL NUTRITION (TPN). Pediatr Res 28, 287 (1990). https://doi.org/10.1203/00006450-199009000-00086
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DOI: https://doi.org/10.1203/00006450-199009000-00086