Effect of parenteral lipid emulsion on preterm infant PUFAs and their downstream metabolites

Hiroki Suganuma; Carmel T Collins; Andrew J McPhee; Shalem Leemaqz; Ge Liu; Chad C Andersen; Dennis Bonney; Robert A Gibson

doi:10.1016/j.plefa.2020.102217

Effect of parenteral lipid emulsion on preterm infant PUFAs and their downstream metabolites

Prostaglandins Leukot Essent Fatty Acids. 2021 Jan:164:102217. doi: 10.1016/j.plefa.2020.102217. Epub 2020 Nov 18.

Authors

Hiroki Suganuma¹, Carmel T Collins², Andrew J McPhee³, Shalem Leemaqz⁴, Ge Liu⁵, Chad C Andersen⁶, Dennis Bonney⁶, Robert A Gibson⁷

Affiliations

¹ SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; Discipline of Paediatrics, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
² SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; Discipline of Paediatrics, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia. Electronic address: carmel.collins@sahmri.com.
³ SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; Neonatal Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia.
⁴ SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
⁵ SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; School of Agriculture Food and Wine, The University of Adelaide, PMB 1, Glen Osmond, Adelaide, South Australia 5064, Australia.
⁶ Neonatal Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia.
⁷ SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; School of Agriculture Food and Wine, The University of Adelaide, PMB 1, Glen Osmond, Adelaide, South Australia 5064, Australia. Electronic address: robert.gibson@adelaide.edu.au.

PMID: 33291053
DOI: 10.1016/j.plefa.2020.102217

Abstract

Objective: Oxylipins synthesized by oxidation of long-chain polyunsaturated fatty acids (LCPUFAs) are bioactive downstream lipid mediators. The aim of this study was to describe oxylipin levels in preterm infants born 30 to 33 weeks' gestation who were enrolled in a randomized controlled trial in which peripheral parenteral nutrition (P-PN), including lipid emulsion (containing soy, medium chain triglyceride, olive and fish oil), was compared with 10% glucose on growth during the transition to enteral feeds.

Methods: Of the 92 infants randomized to the P-PN study, the first 72 (P-PN n = 34, control n = 38) had blood taken for fatty acid analyses. P-PN infants received parenteral nutrition including 3% protein, 8% glucose and 17% SMOFlipid® lipid (containing soy, medium chain triglyceride, olive and fish oil), and control infants 10% glucose. Both groups commenced enteral feeds when clinically stable. 32 oxylipins and 5 free fatty acids were screened (using ultra-high-performance liquid chromatography-tandem mass spectrometry), and 5 total LCPUFA were measured (using gas chromatography), on study days 1 (baseline), 2, 4, 7, 14 and 21.

Results: Both total and free LA, ALA and EPA were significantly higher in the P-PN group compared with control over the first week of life. Whereas total AA was significantly lower and free DHA significantly higher over the same time period. All LA, ALA, EPA and four DHA derived oxylipins detected were significantly higher in the P-PN group compared with the control group during the first week of life, with three AA derived oxylipins significantly lower and one significantly higher.

Conclusions: Parenteral lipid emulsion resulted in a change in total and free fatty acids and related oxylipins with the profiles suggesting increased omega-6 driven inflammation. Further studies to investigate the association between the oxylipin levels and nutrition and to determine whether the oxylipin profiles influence the clinical outcome in preterm infants are warranted.

Keywords: Free fatty acids; Lipid emulsion; Oxylipin; Polyunsaturated fatty acids; Preterm infant.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Dietary Fats / administration & dosage*
Emulsions
Fatty Acids, Unsaturated / blood*
Female
Humans
Infant, Newborn
Infant, Premature / blood*
Male
Parenteral Nutrition*

Substances

Dietary Fats
Emulsions
Fatty Acids, Unsaturated