Tian Zhang1,2,3, Nan Wang2,3,4, Weihui Yan2,3,4, Lina Lu2,3,4, Yijing Tao2,3,4, Fang Li5, Ying Wang6,7,8, Wei Cai9,10,11. 1. Department of Pediatric Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. 2. Shanghai Institute of Pediatric Research, Shanghai, China. 3. Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China. 4. Department of Clinical Nutrition, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. 5. Department of Pharmacy, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. 6. Shanghai Institute of Pediatric Research, Shanghai, China. wangying02@xinhuamed.com.cn. 7. Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China. wangying02@xinhuamed.com.cn. 8. Department of Clinical Nutrition, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. wangying02@xinhuamed.com.cn. 9. Department of Pediatric Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. caiw204@sjtu.edu.cn. 10. Shanghai Institute of Pediatric Research, Shanghai, China. caiw204@sjtu.edu.cn. 11. Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China. caiw204@sjtu.edu.cn.
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.
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 tumornecrosis factor-alpha (TNF-α), C-reactive protein (CRP), and white blood cell (WBC) significantly decreased. CONCLUSIONS: Fish oil therapy alleviates IFALD in children.
Authors: Vit Kosek; Marie Heczkova; Frantisek Novak; Eva Meisnerova; Olga Novákova; Jaroslav Zelenka; Kamila Bechynska; Nikola Vrzacova; Jiri Suttnar; Alzbeta Hlavackova; Helena Dankova; Miriam Bratova; Nikola Daskova; Hana Malinska; Olena Oliyarnyk; Petr Wohl; Hana Bastova; Jana Hajslova; Monika Cahova Journal: Nutrients Date: 2020-08-06 Impact factor: 5.717