Potential for Omega-3 Fatty Acids to Protect against the Adverse Effect of Phytosterols: Comparing Laboratory Outcomes in Adult Patients on Home Parenteral Nutrition Including Different Lipid Emulsions
Sylwia Osowska,
Marek Kunecki,
Jacek Sobocki,
Joanna Tokarczyk,
Krystyna Majewska,
Magdalena Burkacka,
Marek Radkowski,
Magdalena Makarewicz-Wujec,
Helena L. Fisk,
Sultan Mashnafi,
Sabine Baumgartner,
Jogchum Plat,
Philip C. Calder
Affiliations
Sylwia Osowska
Applied Pharmacy Department, Warsaw Medical University, 02-097 Warsaw, Poland
Marek Kunecki
Centre of Clinical Nutrition, Pirogow Hospital, 90-531 Lodz, Poland
Jacek Sobocki
Department of General Surgery and Clinical Nutrition, Centre for Postgraduate Medical Education, 00-416 Warsaw, Poland
Joanna Tokarczyk
Centre of Clinical Nutrition, Pirogow Hospital, 90-531 Lodz, Poland
Krystyna Majewska
Department of General Surgery and Clinical Nutrition, Centre for Postgraduate Medical Education, 00-416 Warsaw, Poland
Magdalena Burkacka
Centre of Clinical Nutrition, Pirogow Hospital, 90-531 Lodz, Poland
Marek Radkowski
Department of Immunopathology, Warsaw Medical University, 02-097 Warsaw, Poland
Magdalena Makarewicz-Wujec
Institute of Pharmaceutical Care, University of Economics and Human Sciences, 01-043 Warsaw, Poland
Helena L. Fisk
School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
Sultan Mashnafi
Department of Nutrition and Movement Sciences, NUTRIM School of Translational Research in Metabolism, Maastricht University, 6200 MD Maastricht, The Netherlands
Sabine Baumgartner
Department of Nutrition and Movement Sciences, NUTRIM School of Translational Research in Metabolism, Maastricht University, 6200 MD Maastricht, The Netherlands
Jogchum Plat
Department of Nutrition and Movement Sciences, NUTRIM School of Translational Research in Metabolism, Maastricht University, 6200 MD Maastricht, The Netherlands
Philip C. Calder
School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
Background: the effect on liver function markers and inflammation of the different content of phytosterols in lipid emulsions (LEs) used in the parenteral nutrition (PN) regimen of adult home PN (HPN) patients is not clear. Methods: plasma phytosterol and cytokine concentrations, fatty acid composition, liver function markers, and triglycerides were measured in 58 adult HPN patients receiving one of three different LEs (soybean oil-based: Intralipid; olive oil-based: ClinOleic; containing fish oil: SMOFLipid). Results: patients receiving Intralipid had higher plasma campesterol and stigmasterol concentrations than those receiving ClinOleic or SMOFLipid. Plasma sterol concentrations were not different between patients receiving ClinOleic and SMOFLipid. Differences in plasma fatty acids reflected the fatty acid composition of the LEs. Markers of liver function did not differ among the three groups. Blood triglycerides were higher with ClinOleic than with Intralipid or SMOFLipid. Total bilirubin correlated positively with the plasma concentrations of two of the phytosterols, ALT correlated positively with one, AST with one, and GGT with three. Conclusions: liver function markers correlate with plasma plant sterol concentrations in adult HPN patients. Adult HPN patients receiving SMOFLipid are more likely to have liver function markers and triglycerides within the normal range than those receiving ClinOleic or Intralipid. The omega-3 fatty acids in SMOFLipid may act to mitigate the adverse effects of plant sterols on liver function.
