¹Laboratory of Endocrinology, University Hospital, University of Antwerp, Antwerp, Belgium

²Nutrition Team, Department of Internal Medicine, Pharmacy, University Hospital, University of Antwerp, Antwerp, Belgium

³B Braun Melsungen AG, Germany

Correspondence to: B Manuel-y-Keenoy, University of Antwerp (UIA), Laboratory of Endocrinology, Universiteitsplein 1, B-2610 Wilrijk-Antwerp, Belgium. E-mail: begona@uia.ua.ac.be

Guarantors: B Manuel-y-Keenoy and I De Leeuw.

Contributors: LN and HDB selected and followed-up the patients and collected the clinical data. JV and SS were responsible for the biochemical analyses. IDL was the group leader and designed the clinical study. BMK carried out the data analysis and wrote the manuscript. KK was involved in the design of the clinical study and collaborated in the correction of the manuscript.

Objective: To compare the effects of a lipid emulsion containing medium-chain triglycerides (MCT) and supplemented with -tocopherol to a conventional long-chain triglyceride (LCT) emulsion.

Design: Randomised double blind study.

Setting: Department of Internal Medicine, Antwerp University Hospital.

Subjects and interventions: Twenty-four patients with an indication for total parenteral nutrition for a minimum of 10 days were randomly assigned to two groups: group E received as lipid source MCT/LCT (50/50) suplemented with 100 mg dl--tocopherol/day and group C received LCT. Blood samples were analysed at inclusion, after 4-6 and after 9-11 days.

Results: In group E, serum -tocopherol doubled from 11.4±6.9 at inclusion to 20.9±7.9 and to 23.8±8.8 µg/ml after 4 and 9 days, respectively, but did not change in group C (P=0.008). Production of thiobarbituric acid-reacting substances (TBARS) after 120 min incubation with copper decreased from 66±34 at inclusion to 29±25 nmol MDA/mg LDL and VLDL-cholesterol after 4 and to 42±17 after 9 days (P=0.022 when compared to group C, which underwent no significant changes). Velocity of production of fluorescent products decreased in group E but not in group C (P=0.026).

Conclusions: Supplementation of TPN containing MCT/LCT with 100 mg dl--tocopherol/day leads to a doubling in serum -tocopherol and to a decrease in the susceptibility of LDL and VLDL to peroxidation in vitro.

Sponsorship: This study was partly financed by B Braun Medical NVSA, Diegem, Belgium.

European Journal of Clinical Nutrition (2002) 56, 121-128. DOI: 10.1038/sj/ejcn/1601294

lipid peroxidation; total parenteral nutrition; vitamin E; -tocopherol; medium-chain triglycerides