Ziwei Xu1, Yousheng Li, Jian Wang, Bo Wu, Jieshou Li. 1. Department of Surgery, Jinling Hospital, Nanjing University School of Medicine, 305 E Zhongshan Rd, Nanjing 210002, PR China.
Abstract
BACKGROUND & AIMS: Parenteral nutrition-associated liver disease (PNALD) complicates the treatment of patients with short bowel syndrome (SBS). Some studies have shown omega-3 polyunsaturated fatty acids (ω-3 PUFAs) have favorable effects in treating PNALD in children. We, therefore, investigate the effects of ω-3 PUFAs supplemented intravenous lipid emulsion (ILE) on PNALD in adults. METHODS: We performed an open-labeled study of a ω-3 PUFAs based ILE in 15 adults with SBS who developed cholestasis while receiving soybean oil-based ILE. Liver biopsies were performed before and after the initiation of ω-3 PUFAs to confirm the presence and improvement of cholestasis. Blood samples were collected every week for analysis of fatty acid composition and liver function. RESULTS: 12 of the 15 patients had their direct bilirubin normalized within 4 weeks and our data demonstrated a significant decrease in both DB (P ≤ 0.001) and TB (P ≤ 0.001) after 4 weeks compared to baseline. There were ameliorations of liver function and fatty acid patterns in all patients and serial liver biopsy specimens showed progressive histologic improvement. CONCLUSIONS: Parenteral ω-3 PUFAs supplemented fat emulsions are safe and effective in the treatment of PNALD in adults.
BACKGROUND & AIMS: Parenteral nutrition-associated liver disease (PNALD) complicates the treatment of patients with short bowel syndrome (SBS). Some studies have shown omega-3 polyunsaturated fatty acids (ω-3 PUFAs) have favorable effects in treating PNALD in children. We, therefore, investigate the effects of ω-3 PUFAs supplemented intravenous lipid emulsion (ILE) on PNALD in adults. METHODS: We performed an open-labeled study of a ω-3 PUFAs based ILE in 15 adults with SBS who developed cholestasis while receiving soybean oil-based ILE. Liver biopsies were performed before and after the initiation of ω-3 PUFAs to confirm the presence and improvement of cholestasis. Blood samples were collected every week for analysis of fatty acid composition and liver function. RESULTS: 12 of the 15 patients had their direct bilirubin normalized within 4 weeks and our data demonstrated a significant decrease in both DB (P ≤ 0.001) and TB (P ≤ 0.001) after 4 weeks compared to baseline. There were ameliorations of liver function and fatty acid patterns in all patients and serial liver biopsy specimens showed progressive histologic improvement. CONCLUSIONS: Parenteral ω-3 PUFAs supplemented fat emulsions are safe and effective in the treatment of PNALD in adults.
Authors: Mathias Plauth; William Bernal; Srinivasan Dasarathy; Manuela Merli; Lindsay D Plank; Tatjana Schütz; Stephan C Bischoff Journal: Clin Nutr Date: 2019-01-16 Impact factor: 7.324
Authors: Christina Belza; John C Wales; Glenda Courtney-Martin; Nicole de Silva; Yaron Avitzur; Paul W Wales Journal: JPEN J Parenter Enteral Nutr Date: 2019-08-25 Impact factor: 4.016
Authors: Maria B Badia-Tahull; Elisabet Leiva-Badosa; Ramon Jodar-Masanes; Josep Maria Ramon-Torrell; Josep Llop-Talaveron Journal: Nutr J Date: 2015-07-02 Impact factor: 3.271
Authors: Alfonso Pastor-Clerigues; Ezequiel Marti-Bonmati; Javier Milara; Patricia Almudever; Julio Cortijo Journal: PLoS One Date: 2014-12-12 Impact factor: 3.240