Medium-chain-triglyceride lipid emulsion: metabolism and tissue distribution

Johnson, Robert C.; Young, S. K.; Cotter, Richard; Li, Lin; Rowe, W.B.

doi:10.1093/ajcn/52.3.502

Cited by 80 publications

(46 citation statements)

References 19 publications

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“…The ®nding of a better utilisation of LCT emulsion in cancer patients then suggests that LCT are better substrates for lipid storage than MCTaLCT. In fact MCTaLCT are preffered substrates for lipid oxidation (Lutz et al,1989;Johnson et al, 1990). However, lipid oxidation is reduced by insulinaglucose infusion (see results).…”

Section: Discussionmentioning

confidence: 91%

Increased lipid utilization in weight losing and weight stable cancer patients with normal body weight

et al. 1999

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Objective: Cachexia and weight loss are frequently seen in cancer patients. We investigated lipid metabolism to elucidate a metabolic basis for adequate nutrition of cancer patients. Design: Lipid metabolism was assessed by indirect calorimetry and triglyceride clearance rates after randomised injection of a lipid bolus (long-chain triglycerides (LCT) or medium-chain triglycerides (MCT) during an euglycemic clamp protocol in cancer patients. Setting: Rudolf-Virchow Krankenhaus, Berlin, Germany. Subjects: Eighteen patients were included. Twelve patients had upper gastrointestinal cancer: a weight stable cancer group (Caws, n 6) with a body mass index (BMI) of 22.9 AE 1.7 kgam 2 and a weight losing cancer group (Cawl, n 6) with a mean weight loss of 7.4 AE 3.1 kg or 11% of the initial body weight during the previous three months (present BM1 21.8 AE 0.8 kgam 2 ). The data were compared with six control patients with benign gastrointestinal diseases (BMI 25.0 AE 0.8 kgam 2 ). Main outcome: Cancer patients had an increased basal lipid oxidation rate that was more pronounced in Cawl ( 92% vs 42% in Caws; P`0.01 and 0.05 vs controls, respectively). Utilisation of LCT was increased in cancer patients, this was most pronounced in Cawl ( 150 vs 65% in Caws; P`0.01 and 0.05, respectively). Metabolically, there were no differences in the utilisation of LCT and MCTaLCT containing lipid emulsions. Conclusions: Cancer patients have an increased lipid oxidation and an enhanced utilisation of exogeneous lipids. This is most pronounced in Cawl. To prevent further weight loss or to increase body weight, they should increase their fat intake. In contrast, fat-reduced or prudent diets seem to be inadequate for the nutrition of cancer patients.

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Section: Discussionmentioning

confidence: 91%

Increased lipid utilization in weight losing and weight stable cancer patients with normal body weight

et al. 1999

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“…2, excess acetyl-CoA is also expected to enhance the activity of the malate-citrate shuttle, which transports citrate from mitochondria to the cytosol and transfers reducing equivalents from the cytosol to mitochondria. However, experiments with 14 C-labeled MCT administered intravenously to rats demonstrated that the majority of MCT was retained in the liver and about 90% of the MCT was converted to carbon dioxide within 24 h (Bach and Babayan 1982;Johnson et al 1990). The effect of MCT therapy on citrin deficiency may not occur via enhancement of the malate-citrate shuttle, but via a supply of acetyl-CoA, FADH 2 and NADH to hepatic cells as energy sources.…”

Section: Resultsmentioning

confidence: 99%

Treatment with Lactose (Galactose)-Restricted and Medium-Chain Triglyceride-Supplemented Formula for Neonatal Intrahepatic Cholestasis Caused by Citrin Deficiency

et al. 2011

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Citrin plays a role in the transfer of NADHreducing equivalent from cytosol to mitochondria as part of the malate-aspartate shuttle in liver. Citrin deficiency may cause an impairment of glycolysis due to an increase in the cytosolic NADH/NAD ratio leading to an energy shortage in the liver. Mutations of the SLC25A13 gene are responsible for neonatal intrahepatic cholestasis (NICCD) and adult-onset type II citrullinemia (CTLN2). Most patients with NICCD show a resolution of symptoms within the first year of life, but some patients present with severe symptoms and require liver transplantation. We treated four patients including three siblings with NICCD by lactose (galactose)-restricted and medium-chain triglyceride (MCT)-supplemented formula. This formula rapidly improved the clinical condition and laboratory findings. Early treatment was more effective and did not require long-term administration. Lactose (galactose)-restriction can avoid further increase in the cytosolic NADH/NAD ratio in the liver and MCT supplementation can provide energy to hepatic cells by producing an excess of acetyl-CoA in mitochondria. Early treatment with lactose (galactose)-restricted and MCT-supplemented formula is recommended for patients with NICCD and possibly for patients with CTLN2.

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“…These characteristics are thought to be responsible for the different rates of fat oxidation for MCT versus LCT. In addition, MCT have been shown to undergo increased oxidation in both animal studies [16,17] and human studies [18 -20]. These reports of increased oxidative capacity have made MCT appealing as a possible adjunct for the treatment of obesity; however, MCT have also been shown to have deleterious effects on the blood lipid profile, causing their use to be less desirable.…”

Section: Introductionmentioning

confidence: 99%

Effects of a medium chain triglyceride oil mixture and α-lipoic acid diet on body composition, antioxidant status, and plasma lipid levels in the Golden Syrian hamster

Wollin

Wang

Kubow

et al. 2004

The Journal of Nutritional Biochemistry

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The objective of this study was to examine the effects of the antioxidant ␣-lipoic acid (ALP) versus a medium chain triglyceride oil mixture (MCTo), which was designed to increase energy expenditure and to improve lipid profiles containing medium chain triglycerides, phytosterols, and omega-3 fatty acids in the form of flaxseed oil. A total of 48 hamsters were fed a) hypercholesterolemic (HC) control, b) HC MCTo, c) HC ALP, or d) HC MCTo/ALP diet for 4 weeks. No differences were observed on food intake, body weight, total body water, lean and fat mass, and tissue thiobarbituric acid reactive substances (TBARS). ALP alone had no effect on total cholesterol (TC); however, MCTo feeding increased TC with (P Ͻ 0.03) and without (P Ͻ 0.003) ALP when compared with control. ALP increased HDL levels compared with control (P Ͻ 0.04) and MCTo/ALP (P Ͻ 0.007) groups. MCTo, with (P Ͻ 0.0001) or without (P Ͻ 0.006) ALP, increased non-HDL cholesterol levels versus control. The non-HDL:HDL cholesterol ratio was decreased by ALP compared with MCTo (45%) and MCTo/ALP (68%) (P Ͻ 0.0001), a similar trend was seen when compared with the HC control (22%) group (P Ͻ 0.14). Triglyceride levels were not altered by any dietary treatment. Liver and heart tissue reduced glutathione (GSH) was increased (P Ͻ 0.05) by all three treatments when compared with control. Both tissues showed an increase (P Ͻ 0.05) in oxidized glutathione (GSSG) when fed ALP as compared with other treatments. Hamsters fed ALP had a lower (P Ͻ 0.05) GSH/GSSG ratio compared with other treatment groups. In conclusion, MCTo feeding does not elicit beneficial effects on circulating plasma lipids and measures of body composition. In addition, our results do not clearly support an improvement in oxidative status through supplementation of ALP. However, our results do support the existence of beneficial effects of ALP on circulating lipoprotein content in the hamster.

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Medium-chain-triglyceride lipid emulsion: metabolism and tissue distribution

Cited by 80 publications

References 19 publications

Increased lipid utilization in weight losing and weight stable cancer patients with normal body weight

Increased lipid utilization in weight losing and weight stable cancer patients with normal body weight

Treatment with Lactose (Galactose)-Restricted and Medium-Chain Triglyceride-Supplemented Formula for Neonatal Intrahepatic Cholestasis Caused by Citrin Deficiency

Effects of a medium chain triglyceride oil mixture and α-lipoic acid diet on body composition, antioxidant status, and plasma lipid levels in the Golden Syrian hamster

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