Abstract
Objective: To compare the effects of a lipid emulsion containing medium-chain triglycerides (MCT) and supplemented with α-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-α-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 α-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-α-tocopherol/day leads to a doubling in serum α-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.
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Acknowledgements
The authors would like to thank the patients who participated in the study, M Vinckx and P Aerts for skilful technical assistance, the nursing staff of the Antwerp University Hospital and B Braun Medical NVSA, Belgium for partly financing the study.
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Manuel-y-Keenoy, B., Nonneman, L., De Bosscher, H. et al. Effects of intravenous supplementation with α-tocopherol in patients receiving total parenteral nutrition containing medium- and long-chain triglycerides. Eur J Clin Nutr 56, 121–128 (2002). https://doi.org/10.1038/sj.ejcn.1601294
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DOI: https://doi.org/10.1038/sj.ejcn.1601294
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