Nutrition
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Comparative Study
Intravenous intralipid 10% vs. 20%, hyperlipidemia, and increase in lipoprotein X in humans.
To clarify the mechanisms of hyperlipidemia caused by infusion of Intralipid 10%, we compared lipoprotein metabolism during intravenous Intralipid 10% and Intralipid 20%, which contains only half the amount of egg yolk lecithin for the same content of triglyceride as Intralipid 10%. Ten patients receiving 20 ml.kg-1.day-1 of Intralipid 10% and 10 receiving 10 ml.kg-1.day-1 of Intralipid 20% were fed exclusively by total parenteral nutrition (TPN) providing 1.1 g amino acid and 30 kcal.kg-1.day-1 for 4-6 wk. Intravenous Intralipid 10% caused a marked increase in low-density lipoprotein (LDL), together with increases in phospholipid and cholesterol, especially free cholesterol. ⋯ From these findings, the hyperlipidemia with Intralipid 10% was caused almost exclusively by the increase in lipoprotein X. The excess lecithin may be responsible for the formation of and increase in lipoprotein X. Furthermore, it was revealed that Intralipid 20% could be safely used without inducing hyperlipidemia.
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A new gamma-linolenic acid-enriched fat emulsion (PFE 4501) was given for 13 mo as part of a home parenteral nutrition regimen to a 28-yr-old patient with cystic fibrosis. Blood biochemistry, hematological data, and fatty acid profile were followed. No side effects were reported, and pulmonary function tests remained stable. gamma-Linolenic acid appears to be safe for clinical use and may benefit patients with derangements in essential fatty acid metabolism. The potential role of a gamma-linolenic acid-enriched intravenous fat emulsion is discussed.