Protein metabolism during total parenteral nutrition (TPN) in injured rats using medium-chain triglycerides

Maíz, Alberto; Yamazaki, Kazuma; Sobrado, Javier; Babayan, Vigen K.; Moldawer, Lyle L.; Bistrian, Bruce R.; Blackburn, George L.

doi:10.1016/0026-0495(84)90243-9

Cited by 67 publications

(16 citation statements)

References 27 publications

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“…We suppose that the better nitrogen balance with MCT/LCT may be related to the rapid metabolism of MCT with production of non-esterified fatty acids and ketones as an energy source. An improved nitrogen balance has also been reported in injured rats receiving lipid containing MCT [23] . In the present study, the concentration of serum non-esterified fatty acids in the MCT/LCT group was significantly higher than that in the LCT group.…”

Section: Discussionmentioning

confidence: 75%

Effect of an Enteral Diet Containing Medium-Chain Triglyceride on Protein Metabolism in Septic Rats.

Handa

Mizuguchi

Hayashi

et al. 1997

J. Clin. Biochem. Nutr.

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SummaryWe studied the effects of an enterally administered diet containing medium-chain triglycerides (MCT) on protein metabolism in septic Wistar rats and compared them with those of a long-chain triglycerides (LCT). The sepsis was induced by cecal ligation and puncture. The rats were divided into two groups. One group was fed a diet containing a MCT and LCT mixture (MCT/LCT), and the other was fed one containing LCT, as 10% of total energy. The diets also contained protein, dextrin, vitamins, and electrolytes. The experimental diets were via an intraduodenal catheter for 6 days. The MCT/LCT group showed a higher nitrogen balance after 3 days of the feeding and a higher liver protein content compared with the LCT group on the last day. Furthermore, the concentrations of serum total protein and albumin in the MCT/LCT group were higher than those in the LCT group. These results indicate that the enteral diet containing MCT combined with LCT may be advantageous to protein metabolism in septic rats over the diet with LCT alone. require a supplement of energy sufficient to compensate for the deficit. Generally fats are a more effective energy source than carbohydrates or proteins because of their high caloric value. However the utilization of fats, in particular long-chain triglycerides (LCT), might be impaired in sepsis [4,5], because the level of carnitine, which is essential for oxidation of LCT, is decreased in blood [6] and tissues [7] in the septic state.On the other hand, medium-chain triglycerides (MCT) are different from LCT in their metabolism, for MCT can be used as an energy source without carnitine in the liver and other organs [8] . Therefore, MCT may be preferred for septic patients over LCT as the energy source [9,10] . However, as MCT are exclusively saturated fatty acids, an essential unsaturated fatty acid such as linoleic acid must be supplemented by blending with LCT for the nutritional requirement of the patients. Several investigators reported that a mixture of intravenously injected MCT/LCT was more advantageous as an energy source under seriously stressful conditions than LCT or glucose [11][12][13]. However, effects of enteral administration of MCT/LCT in sepsis have rarely been reported.Recently, enteral nutrition was reported to be advantageous for patients with intestine dysfunction and immuno suppression [14][15][16]. We also reported beneficial effects of enteral diet containing fat as about 10% of total calories on septic rats [17]. In the present study, we investigated the efficacy of the enteral liquid diet containing 10% MCT/LCT compared with one having LCT as fat on protein metabolism in septic rats, because the accelerated breakdown of body protein in sepsis can cause serious clinical problems [18].

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Section: Discussionmentioning

confidence: 75%

Effect of an Enteral Diet Containing Medium-Chain Triglyceride on Protein Metabolism in Septic Rats.

Handa

Mizuguchi

Hayashi

et al. 1997

J. Clin. Biochem. Nutr.

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“…A new form of lipid includes tailor-made structured lipids, 28,103,105,112,[125][126][127][138][139][140][141][142][143][144] whlCh involved the process of transesterifying MCT with LCT having linoleic and/or linolenic fatty acids. On the basis of the defined molar ratios of the MCT and the LCT, one can obtain a structured lipid with the desired combinations.…”

Section: Structured Lipidsmentioning

confidence: 99%

Invited Review: Selection of Optimal Lipid Sources in Enteral and Parenteral Nutrition

Gottschlich¹

1992

Nut in Clin Prac

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The manipulation of dietary fat intake can affect the response to disease, injury, and infection. These effects include enhancement or inhibition of immune function, altered susceptibility to cardiovascular disease, promotion or maintenance of gut integrity, and prevention of total parenteral nutrition-induced hepatic dysfunction. These effects may occur as a result of changes in the fatty acid composition of biomembranes or changes in concentrations of lipid moieties such as prostaglandins or leukotrienes. Those fats that have been shown to affect physiologic function include long-chain, medium-chain, and short-chain fatty acids and omega-3 and omega-6 fatty acids. Currently available enteral and parenteral products used for nutrition support contain widely varied amounts of these different fatty acids. Therefore, the selection of the most appropriate product or nutrition support regimen for an individual patient requires an understanding of the metabolism of these different fat substrates, their therapeutic indications, and the contraindications and controversies that surround their use. This article reviews these issues and also focuses on several alternate lipid sources such as short-chain fatty acids, medium-chain fatty acids, omega-3 fatty acids, and blended and structured lipids.

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“…3,4,8,12,17 Therefore, we conducted a blind, randomized, parallelgroups study that compared LCT emulsions' (Intralipid 20%, Kabipharmacia AB, Stockholm, Sweden) and structured triglycerides' fat emulsions (73403 Kabipharmacia AB). The effects of these emulsions on the levels of triglycerides, glucose, and other metabolisms; urea excretion; clinical parameters; Apache II score; nitrogen balance; and urinary excretion of 3-methylhistidine (U-3-MH) were investigated.…”

Section: )mentioning

confidence: 99%

Structured Versus Long‐Chain Triglycerides: A Safety, Tolerance, and Efficacy Randomized Study in Colorectal Surgical Patients

Bellantone

Bossola

Carriero

et al. 1999

J Parenter Enteral Nutr

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Protein metabolism during total parenteral nutrition (TPN) in injured rats using medium-chain triglycerides

Cited by 67 publications

References 27 publications

Effect of an Enteral Diet Containing Medium-Chain Triglyceride on Protein Metabolism in Septic Rats.

Effect of an Enteral Diet Containing Medium-Chain Triglyceride on Protein Metabolism in Septic Rats.

Invited Review: Selection of Optimal Lipid Sources in Enteral and Parenteral Nutrition

Structured Versus Long‐Chain Triglycerides: A Safety, Tolerance, and Efficacy Randomized Study in Colorectal Surgical Patients

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