A PROSPECTIVE CLINICAL STUDY ON POSTOPERATIVE LIPID METABOLISM WITH DIFFERENT FAT EMULSIONS_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

Gu Yan ¹ , Wu Zhaohan ¹ , Zheng Yunhong. ²

Department of Surgery, Zhongshan Hospital, Shanghai Medical University, Shanghai 200032;

Corresponding author：

Keywords：

Fat emulsion; Postoperation; Lipid metabolism

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To investigate prospectively the short-term effect of different fat emulsions on plasma lipids and lipoproteins and to clarify the underlying mechanisms. Fifty six surgical patients were randomized to received intravenously either a 10%. Intralipid, a 20% Intralipid or no fat emulsions for 5 days postoperatively as part of a standard parenteral nutrition regimen. Serum lipids and lipoproteins were measured prior to and after the 5-day infusion period. Results: Intravenous administration of 10% Intralipid caused a marked increase of total cholesterol (Tcho), free cholesterol (Fcho), Low-density lipoprotein cholesterol (LDL-ch), phospholipid and lipoprotein X (LPX). Quantification of LPX revealed that its increase was proportionate to that of phospholipid and Tcho. Conclusion: Exogenous phospholipids when using fat emulsions with a high phospholipid/triglyceride (PL/TG) ratio play an impressive role in the formation of LPX and consequently are capable of inducing hypercholesterolemia after only a few days. Therefore, 20% Intralipid should be preferred to the corresponding 10% Intralipid for its low PL/TG ratio.

Citation： Gu Yan,Wu Zhaohan,Zheng Yunhong.. A PROSPECTIVE CLINICAL STUDY ON POSTOPERATIVE LIPID METABOLISM WITH DIFFERENT FAT EMULSIONS. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 1999, 6(2): 92-95. doi: Copy

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8.	Hajri T, Ferezon J, Lutton C, et al. Effects of intravenous infusions of commercial fat emulsion on rat plasma lipoproteins: phospholipids in excess are the main precursors of lipoproteinXlike particles. Biochim Biophys Acta, 1990; 1047(2)∶121.
9.	Williams KJ, Scanu AM. Uptake of endogenous cholesterol by a synthetic lipoprotein. Biochim Biophys Acta, 1986; 875(2)∶183.
10.	Weinberg RB, Singh KK. Shortterm parenteral nutrition with glucose and intralipid: effects on serum lipids and lipoproteins. Am J Clin Nutr, 1989; 49(5)∶794.
11.	Tashiro T, Mashima Y, Yamamori H, et al. Increased lipoprotein X causes hyperlipidemia during intravenous administration of 10% fat emulsion in man. JPEN, 1991; 15(5)∶546.
12.	Breckenridge WC. The catabolism of very low density lipoproteins. Can J Biochem Cell Biol, 1985; 63(6)∶890.

1. Talafant E, Tovarek J. Rapid colorimetric methods for quantitative LPX determination without electrophresis. Clin Chim Acta, 1978; 88(2)∶215.
2. Zohrab WJ, McHattie JD, Jeejeebhoy KN, et al. Fat emulsion for I.V. administration: intralipid. Rx Bull, 1973; 4(1)∶45.
3. Roulet M, Wiesel PH, Pilet M, et al. Effect of intravenously infused egg phospholipids on lipid and lipoprotein metabolism in postoperative trauma. JPEN, 1993; 17(2)∶107.
4. Meguid MM, Kurzer M, Hayashi RJ, et al. Shorttime effect of fat emulsion on serum lipids in postoperative patient. JPEN, 1989; 13(1)∶77.
5. Zohrab WB, McHattie JD, Jeejeebhoy KN, et al. Total parenteral nutrition with lipid. Gastroenterology, 1973; 64(4)∶583.
6. Judd RH, Freund H, Deckelbaum RJ. Human plasma lipoproteins and total parenteral nutrition with intravenous fat emulsion. JPEN, 1984; 8(54)∶552.
7. Carpentier YA. Intravascular metabolism of fat emulsions. Clin Nutr, 1989; 8(2)∶115.
8. Hajri T, Ferezon J, Lutton C, et al. Effects of intravenous infusions of commercial fat emulsion on rat plasma lipoproteins: phospholipids in excess are the main precursors of lipoproteinXlike particles. Biochim Biophys Acta, 1990; 1047(2)∶121.
9. Williams KJ, Scanu AM. Uptake of endogenous cholesterol by a synthetic lipoprotein. Biochim Biophys Acta, 1986; 875(2)∶183.
10. Weinberg RB, Singh KK. Shortterm parenteral nutrition with glucose and intralipid: effects on serum lipids and lipoproteins. Am J Clin Nutr, 1989; 49(5)∶794.
11. Tashiro T, Mashima Y, Yamamori H, et al. Increased lipoprotein X causes hyperlipidemia during intravenous administration of 10% fat emulsion in man. JPEN, 1991; 15(5)∶546.
12. Breckenridge WC. The catabolism of very low density lipoproteins. Can J Biochem Cell Biol, 1985; 63(6)∶890.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

A PROSPECTIVE CLINICAL STUDY ON POSTOPERATIVE LIPID METABOLISM WITH DIFFERENT FAT EMULSIONS

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