OBJECTIVES:Fat emulsions used in Australia for parenteral nutrition in preterm neonates have been based on either soybean oil or olive oil (OO). OO lipid Clinoleic has a high ratio of n-6 to n-3 fatty acids (9:1); this may not be ideal for long-chain polyunsaturated fatty acids supply. Newly available SMOFlipid has an appropriate ratio of n-6 to n-3 fatty acids (2.5:1). SMOFlipid also contains OO (25%), coconut oil (30%), and soybean oil (30%). The aims of the study were to evaluate the safety of the SMOFlipid and to test the hypothesis that SMOFlipid would lead to increased omega-3 long-chain polyunsaturated fatty acid levels and reduced oxidative stress as compared with Clinoleic in preterm neonates (<30 weeks). METHODS:Preterm neonates (23-30 weeks) were randomised to receive Clinoleic or SMOFlipid emulsion for 7 days. Investigators and outcome assessors were masked to allocation. Plasma F2-isoprostanes (lipid peroxidation marker), red blood cell fatty acids, and vitamin E were measured before and after the study. Blood culture positive sepsis and growth were monitored for safety. RESULTS:Thirty of 34 participants completed the study. Both emulsions were well tolerated without any adverse events. F2-isoprostane levels were reduced in the SMOFlipid group as compared with baseline. Eicosapentanoic acid and vitamin E levels were significantly increased in the SMOFlipid group. Oleic acid and linoleic acid levels were increased in both groups. No significant differences were noted in poststudy docosahexaenoic acid levels in both groups despite higher levels of docosahexaenoic acid in SMOFlipid. CONCLUSIONS:SMOFlipid was safe, well tolerated, and showed beneficial effect in terms of reduction of oxidative stress by reducing lipid peroxidation levels in high-risk preterm neonates.

译文

目的:在澳大利亚用于早产儿肠胃外营养的脂肪乳剂是基于大豆油或橄榄油(OO)的。 OO脂质亚油酸具有高比例的n-6与n-3脂肪酸(9:1);对于长链多不饱和脂肪酸供应来说,这可能不是理想的选择。新获得的SMOFlipid具有n-6与n-3脂肪酸的适当比例(2.5:1)。 SMOFlipid还包含OO(25%),椰子油(30%)和大豆油(30%)。这项研究的目的是评估SMOFlipid的安全性,并检验以下假设:与早产儿相比,SMOFlipid与亚油酸相比,会导致omega-3长链多不饱和脂肪酸水平升高和氧化应激降低, 。
方法:将早产新生儿(23-30周)随机接受7天的亚油性或SMOF脂质乳剂治疗。研究者和结果评估者被掩盖了分配。在研究之前和之后测量血浆F2-异前列腺素(脂质过氧化标记),红细胞脂肪酸和维生素E。监测血培养阳性败血症和生长的安全性。
结果:34名参与者中有30名完成了研究。两种乳液均具有良好的耐受性,没有任何不良事件。与基线相比,SMOFlipid组的F2-异前列腺素水平降低。 SMOF脂质组的二十碳五烯酸和维生素E水平显着升高。两组的油酸和亚油酸水平均升高。尽管SMOF脂质中的二十二碳六烯酸水平较高,但两组的研究后二十二碳六烯酸水平均无显着差异。
结论:SMOF脂质安全,耐受性好,并且通过降低高危早产儿的脂质过氧化水平,在减少氧化应激方面显示出有益的作用。

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