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.
Thirty two surgical patients with liver disease (hepatocelluar carcinoma 16, liver cirrhosis 8, obstructive jaundice 8) were studied. All of them were randomly divided into three groups for administration of different kinds of TPN during the postoperative period [group Ⅰ (TPN without fat emulsion), group Ⅱ (TPN with fat emulsion, 1g/kg body weight/day of fat), group Ⅲ (TPN with fat emulsion 2g/kg body weight/day of fat )]. Their liver function test, glucose, lipid metabolism were examined and compared during the period of TPN. Result: ①TB, ALT and AST decreased in group Ⅱ and group Ⅲ (Plt;0.05), but increased in group Ⅰ (Plt;0.05). ②The blood glucose and insulin levels were normal in group Ⅱ and groupⅢ, but showed hyperglycemia and hyperinsulinemia in group Ⅰ (Plt;0.05). ③The serum lipid, lipoprotein, apoliprotein level and LCAT activity returned to normal 6 days after operation in group Ⅱ (Plt;0.05), but not in group Ⅰ and groupⅢ (Plt;0.05). Conclusion: ①TPN with fat emulsion for surgical patients with liver disease can make more improvement on hepatic functions than TPN without fat emulsion. ②1g/kg body weight/day of fat dosage may be suitable for the patients during the period of postoperative TPN.
Objective To assess the efficacy and safety of fat emulsion (FE) for acute pancreatitis (AP).Methods We searched the electronic biological databases: Cochrane Controlled Trials Register (Issue 2, 2007), Medline(1996 to April 2007), EMBASE (1984 to April 2007), Chinese biological medical database (1978 to April 2007). We alsodid handsearching to identify other published and unpublished data. Data collection and undertaken by two reviewersaccording to the Cochrane Handbook for Reviews of Intervention. Randomized controlled trials (RCTs) or quasi-RCTscomparing FE versus glucose in the treatment of AP were collected. Pooled estimates of overall treatment effect werecalculated using the RevMan 4.2.10 according to available data from included studies. Otherwise, qualitative descriptiveanalysis was performed. Results In total, 10 clinic control trials finally (include 314 participant) met the eligible criteria. ① To long chain triglyceride (LCT), the comparison of overall mortality (relative risk, 0.73; 95%CI, 0.34 to 1.58; P=0.26) and complications (Pgt;0.05) showed no significant difference. One study reported LCT cannot reduce hospital stay (Pgt;0.1). The effects of LCT on cholesterol and triglyceride were inconsistent with respect to the course of treatment. ② However, there were no changes of the cholesterol and triglyceride levels secondary to the medium chain triglyceride and long chain triglyceride (MCT/LCT) (Pgt;0.05, respectively) according to one study. ③ No severe adverse events were reported.Conclusions The evidence currently available cannot conclude that FE is safe and effective, though LCT may decreasethe mortality of AP. Therefore, more high-quality trails are needed.
Objective To compare two ways of establishing hyperlipidemia model in rats with fat emulsion.Methods Thirty male SD rats were randomly divided into three groups， which fed with normal diet （normal control group）， low concentration fat emulsion （low concentration fat emulsion group）， and high concentration fat emulsion （high concentration fat emulsion group）， respectively. All the rats were sacrificed and tested for serum total cholesterol （TC）， triglyceride （TG）， high density lipoprotein-cholesterol （HDL-C）， and low density lipoprotein-cholesterol （LDL-C）in two weeks after establishment. Results The levels of TC， TG， HDL-C， and LDL-C in the high concentration fat emulsion group were significantly higher than those in the normal control group and the low concentration fat emulsion group （P＜0.05）；the levels of TC， TG， and HDL-C in the low concentration fat emulsion group didn’t significantly differ from normal control group （P＞0.05）. Conclusions High concentration fat emulsion can be used to establish hyperlipidemia model in SD rats， low concentration fat emulsion is not suitable for establishing hyperlipidemia model in SD rats.