Clinical nutrition

Effect of a fish oil-based lipid emulsion on intestinal failure-associated liver disease in children

European Journal of Clinical Nutrition volume 72, pages1364–1372(2018)Cite this article

Subjects

Abstract

Background/Objectives

The aim of this study was to assess the effects of a fish oil-based lipid emulsion on intestinal failure-associated liver disease (IFALD) in children.

Subjects/Methods

From January 2014 through June 2017, we enrolled 32 children with IF on long-term parenteral nutrition (PN). When the levels of any three of seven liver indicators (TBA, alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase, gamma glutamyl transferase (γ-GT), total bilirubin (TB), or direct bilirubin (DB)) were two times higher than normal levels, we switched a 50:50 mix of soybean oil and medium-chain triglycerides (MCT) lipid emulsion (with an average dose of 1.30 g/kg/day) to a fish oil-based lipid emulsion (1 g/kg/day) and measured liver function in the children. Meanwhile, inflammation and oxidative stress-related markers were also measured.

Results

The average fish oil therapy duration was 26 ± 21 days, and the median duration of PN support was 84 days. With fish oil therapy, levels of TBA, ALT, AST, γ-GT, TB, and DB all significantly decreased. Enteral nutrition was introduced following fish oil resulting in higher energy intake (99.88 ± 31.06 kcal/kg/day) compared with before fish oil (67.90 ± 27.31 kcal/kg/day, P = 0.001). No significant difference was found in average PN energy (P = 0.147). In addition, levels of inflammatory indicators like tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), and white blood cell (WBC) significantly decreased.

Conclusions

Fish oil therapy alleviates IFALD in children.

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Funding

Funding

This work was supported by the Shanghai Pujiang Program [grant number 17PJD026]; Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition (14DZ2272400); Shanghai Municipal Commission of Health and Family Planning (2013ZYJB0017); Science and Technology Commission of Shanghai Municipality (14411950400/14411950401); and the National Natural Science Foundation of China-Key Program (81630039).

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Author notes

  1. Tian Zhang and Nan Wang contributed equally to this work.

Affiliations

  1. Department of Pediatric Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Tian Zhang & Wei Cai

  2. Shanghai Institute of Pediatric Research, Shanghai, China

    Tian Zhang, Nan Wang, Weihui Yan, Lina Lu, Yijing Tao, Ying Wang & Wei Cai

  3. Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China

    Tian Zhang, Nan Wang, Weihui Yan, Lina Lu, Yijing Tao, Ying Wang & Wei Cai

  4. Department of Clinical Nutrition, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Nan Wang, Weihui Yan, Lina Lu, Yijing Tao & Ying Wang

  5. Department of Pharmacy, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Fang Li

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  1. Tian Zhang
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Zhang, T., Wang, N., Yan, W. et al. Effect of a fish oil-based lipid emulsion on intestinal failure-associated liver disease in children. Eur J Clin Nutr 72, 1364–1372 (2018). https://doi.org/10.1038/s41430-018-0096-z

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