Phytosterol determination in lipid emulsions for parenteral nutrition

Farm Hosp. 2018 May 1;42(3):116-119. doi: 10.7399/fh.10954.

Abstract

Objective: The presence of phytosterols in vegetal lipid emulsions has been associated with alterations of liver function tests. Determination of phytosterols content, currently undeclared, would allow the development of strategies to prevent or treat these alterations.

Method: 3-4 non-consecutive batches of 6 lipid emulsions from different providers (Clinoleic, Intralipid, Lipofundina, Lipoplus, Omegaven and Smoflipid) were analyzed. Differences in total phytosterol assay between providers and batches were statistically studied by a one-way ANOVA and Kruskal-Wallis non-parametric approximation and post hoc Scheffé test (p < 0.05)Results: The absence of phytosterols was confirmed in Omegaven, emulsion based on fish oil. The highest assay of phytosterols (422.4 ± 130.5 μg/mL) has been related with the highest percentage of soya bean oil in Intralipid. In the remaining emulsions, concentrations were from 120 to 210 μg/mL related to the percentage of soya bean oil. Statistically significant differences of phytosterol content in lipid emulsions were observed among different providers (F = 23.59; p = 0.000) as well as among non-consecutive batches. Clinolenic (F = 23.59; p = 0.000), Intralipid (F = 978.25; p = 0.000), Lipofundina TCL/TCM (F = 5.43; p = 0.045), Lipoplus (F = 123.53; p = 0.000) and Smoflipid (16.78; p = 0.000). Except for Lipofundina TCL/TCM, the differences between batches were marked.

Conclusions: Lipid emulsions, registered on Spanish pharmaceutical market, contain variable quantities of phytosterols dependent on commercial brand and batch.

Objetivo: La presencia de fitoesteroles en emulsiones lipídicas de origen vegetal se ha relacionado con la aparición de alteraciones de los parámetros de la función hepática. El objetivo es determinar la presencia de fitoesteroles en las emulsiones registradas en el mercado farmacéutico.Método: Se analizaron tres-cuatro lotes no consecutivos de seis marcas distintas de emulsiones lipídicas (Clinoleic®, Intralipid®, Lipofundina®, Lipoplus®, Omegaven® y Smoflipid®) y las diferencias en contenido de fitoesteroles totales entre marcas y entre lotes se estudiaron estadísticamente (ANOVA de un factor, aproximación no paramétrica de Kruskal-Wallis y análisis post hoc Scheffé; p < 0,05).Resultados: Se encontró ausencia de fitoesteroles en el preparado Omegaven® con aceite de pescado. El contenido más alto de fitoesteroles (422,4 ± 130,5 μg/mL) coincidió con el porcentaje más alto de aceite de soja (Intralipid®). En el resto de las emulsiones se detectaron concentraciones de fitoesteroles entre 120 y 210 μg/mL, relacionadas con el contenido de aceite de soja. Se observaron diferencias estadísticamente significativas entre todas las marcas de emulsiones lipídicas (F = 42,97; p = 0,000) y entre lotes no consecutivos. Clinolenic® (F = 23,59; p = 0,000); Intralipid® (F = 978,25; p = 0,000); Lipofundina® TCL/TCM (F = 5,43; p = 0,045); Lipoplus ® (F = 123,53; p = 0,000),; y Smoflipid® (16,78; p = 0,000). Excepto en el caso de la Lipofundina® TCL/TCM las diferencias entre lotes fueron marcadas.Conclusiones: Las emulsiones lipídicas registradas en el mercado farmacéutico español contienen cantidades variables de fitoesteroles en función e la marca comercial y el lote. La determinación del contenido de fitoesteroles, actualmente no declarados, permitiría desarrollar estrategias para prevenir o tratar la aparición de estas alteraciones.

MeSH terms

  • Chromatography, High Pressure Liquid
  • Drug Compounding
  • Emulsions
  • Fat Emulsions, Intravenous / analysis*
  • Fish Oils / analysis
  • Parenteral Nutrition / methods*
  • Phospholipids
  • Phytosterols / analysis*
  • Plant Oils
  • Prospective Studies
  • Soybean Oil
  • Triglycerides

Substances

  • ClinOleic
  • Emulsions
  • Fat Emulsions, Intravenous
  • Fish Oils
  • Phospholipids
  • Phytosterols
  • Plant Oils
  • Triglycerides
  • fish oil triglycerides
  • soybean oil, phospholipid emulsion
  • Soybean Oil