Effect of Supplementing Medium Chain Triglycerides with Linoleic Acid-Rich Monoglycerides on Severely Disturbed Serum Lipid Fatty Acid Patterns in Patients with Cystic Fibrosis

Abstract

7 patients with cystic fibrosis, having serum lipids with fatty acid compositions (FACs) skewed in the direction of essential fatty acid deficiency, were given a mixture of medium chain triglycerides (MCTs) with linoleic acid-rich monoglycerides (LAMs) as food fat (about 1–1.25 g/kg body weight/day). Blood was sampled before and after a short period (4–11 days) of experimental fat feeding. The FACs of the serum triglycerides (TGs), cholesterol esters (CEs) and phospholipids (PLs) were determined before and after dietary treatment. Dietary treatment resulted in a significant increase of the previously reduced fraction of linoleic acid in all lipid classes. In TGs, the increase in the fraction of linoleic acid was accompanied by a reduction of the previously increased fraction of palmitoleic acid to normal values, by a reduction in the fraction of oleic acid to subnormal values and by an increase in the fraction of stearic acid which, however, remained normal. In PLs, the increase in the fraction of linoleic acid was accompanied by an increase in the fraction of dihomogammalinoleic acid which remained normal, however. In CEs, concomitant with the increase of the previously reduced linoleic acid fraction, there was a reduction of previously elevated palmitoleic and oleic fractions, the latter to a normal value. Thus, supplementing a MCT-containing diet with LAMs in cystic fibrosis patients results in a considerable amelioration of the previously disturbed FACs of the major serum lipid classes.

De novo fatty acid biosynthesis and elongation in very long‐chain acyl‐CoA dehydrogenase‐deficient mice supplemented with odd or even medium‐chain fatty acids

“…A great amount of literature describes several positive effects of MCFAs as compared with long-chain species for the treatment of different disorders such as chyluria, chylothorax and cystic fibrosis, as well as for absorption disorders and coeliac diseases [2][3][4][5][33][34][35]. With special regard to even-chain MCTs, oil containing these is widely applied as a recommended therapy for the treatment of LCFA oxidation disorders [15,16] as it passively crosses mitochondrial membranes and enters the fatty acid oxidation cycle, supplying it with the required energy.…”

Monoacylglycerol Form of Omega-3s Improves Its Bioavailability in Humans Compared to Other Forms

“…Indeed, it has been suggested that this type of persistent malabsorption is not only due to insufficient enzymes but also due to incomplete intraluminal solubilization or reduced enterocyte uptake, or both [33,35,36]. Studies suggest that OM3 LC-PUFA may be anti-inflammatory and a benefit for cystic fibrosis patients, and that the MAG form exhibits a higher degree of efficient absorption than the TAG form [20][21][22][23]28,33,35,36].…”

“…Recent studies evaluating the bioavailability of MAG containing EPA/DHA have found that this carrier exhibits a high degree of efficient absorption [23,28,32]. Also, studies have reported that FAs at the sn-2 position are more efficiently absorbed by the intestine.…”

“…Therefore, it is recommended to include sources of OM3-long chain polyunsaturated fatty acids (LC-PUFAs), such as fatty fish, in one's diet in order to obtain the desired health benefits [15,[17][18][19]. Several bioavailability studies have been devoted to the actions of different sources of LC-PUFAs (e.g., fatty fish versus supplements) or different carriers (e.g., triacylglycerol (TAG), MAG, ethyl ester, FFA, and phospholipids) [5,6,12,[20][21][22][23]. During the digestion of the ethyl ester carrier, the ethyl group is hydrolyzed by lipases, and the resulting fatty acid (FA) is then converted back into a TAG molecule ( Figure 1) before being transported by the lymphatic system [24,25].…”

Essential Fatty Acid Deficiency in Cystic Fibrosis

“…After a case report of reversal of pancreatic insufficiency in a newborn with CF receiving Intralipid ® in 1974 [26], many authors reported about short-term LA supplementation with varying results [27][28][29]. A long-term study (3 years) resulted in improvements in liver and renal functions [30,31].…”