Functional lipidomics in patients on home parenteral nutrition: Effect of lipid emulsions

Table 1 Characteristics of the study groups

	OO-IVLE	SMOF-IVLE	No-IVLE	HC	P value (4 groups)	P value (OO vs SMOF)
Demographic, anthropometric and disease characteristics
N of subjects (M/F)	15 (8/7)	8 (3/5)	8 (2/6)	42 (19/23)	0.4051
Age (yr) median (range)	56 (19-78)	44 (19-73)	56 (29-64)	46 (16-78)	0.4051
BMI (kg/m2) median (range)	22 (12-25)	20 (17-23)	21 (16-29)	22 (17-26)	0.1407
Cause of CIF n (%)					0.0791
SBS	9 (60)	5 (62)	8 (100)
Fistulas	-	2 (25)	-
Dysmotility	5 (33)	1 (12)	-
Mucosal disease	1 (7)	-	-
Primary disease n (%)					0.0037
Mesenteric ischemia	6 (40)	1 (12)	1 (12)			0.0627
CIPO	5 (32)	1 (12)	4 (50)
Crohn’s disease	1 (7)	3 (36)	3 (38)
Others	3 (21)	3 (36)
Home parenteral nutrition schedule and oral feeding characteristics
HPN schedule: median (range)
Duration (mo)	65 (2-261)	29 (5-53)	17 (6-278)		0.2765	-
Current duration (mo)	26 (2-96)	7 (5-14)	7 (2-19)		0.0620	0.5682
Infusions (n/wk)	7 (3.5-7)	7 (2-7)	7 (2-7)		0.8028
Lipids (n inf/wk)	7 (3.5-7)	7 (2-7)	-		-	0.6946
(g/inf)	48 (26-60)	45 (28-56)	-		-	0.8601
(g/kg of BW/inf)	0.79 (0.38-1.10)	0.86 (0.43-1.20)	-		-	0.6260
(g/wk)	210 (100-406)	203 (180-350)	-		-	0.8210
Glucose (g/inf)	169 (84-350)	198 (115-375)	150 (36-265)		0.3370	-
(g/kg of BW/inf)	3.3 (1.4-5.5)	3.8 (2.4-5.8)	2.3 (0.9-5.0)		0.5959	-
(g/wk)	1014 (300-2450)	1382 (473-2625)	1050 (300-1855)		0.4265	-
Amino acids (g/inf)	50 (24-106)	61 (50-100)	29 (0-72)		0.0553	0.2070
Energy (Kcal/inf)	1400 (739-2104)	1544 (837-2180)	700 (144-1345)		0.0117	0.4578
(Kcal/BEE × 100)1	99% (26%-149%)	122% (59%-147%)	54% (7%-116%)		0.0568	0.4114
Oral feeding: median (range)
Intake (Kcal/d)	1510 (0-2657)	1071 (0-2827)	1834 (930-2965)		0.1114	-
Fat Absorption (% ingested)	38 (0-88)	27 (0-68)	71 (21-95)		0.1816	-

¹Calculated by: [(Kcal/infusion × weekly frequency of infusions/7)/basal energy expenditure (BEE)] × 100. IVLE: Intravenous lipid emulsion; OO-IVLE group: Patients receiving a PN admixture containing Clinoleic 20%; SMOF-IVLE group: Patients receiving a PN admixture containing SMOF lipid ^®20%; No-IVLE group: Patients receiving PN without IVLE; HC: Healthy controls; BMI: Body mass index; CIF: Chronic intestinal failure; BW: Body weight; SBS: Short bowel syndrome; CIPO: Chronic Intestinal Pseudo-obstruction; HPN: Home Parenteral Nutrition; Current duration: Duration of current parenteral nutrition admixture prescription.

Table 2 Fatty acid profile of the intravenous lipid emulsions and of the red blood cell membrane in the study groups

Fatty acids, % total FAs	OO-IVLE	SMOF-IVLE	OO-IVLE group	SMOF-IVLE group	No-IVLE group	HC group	P value
Palmitic (16:0)	12.8	14.1	26.2 (23.1-30.6)	28.1 (24.8-30.6)	28.1 (26.1-29.4)	26.6 (20.3-29.6)	0.040
Stearic (18:0)	3.7	4.4	16.7 (14.3-18.3)	16.8 (15.9-18.3)	16.1 (14.2-16.7)	18.1 (13.4-20.7)	< 0.001
Palmitoleic (16:1)	0	0	0.5 (0.4-0.9)	0.5 (0.2-0.8)	1.0 (0.3-1.8)	0.4 (0.2-0.7)	< 0.001
Oleic (18:1; 9c)	61.8	43.3	18.9 (17.8-23.5)	18.6 (17.3-19.9)	18.9 (16.6-22.5)	17.1 (14.2-22.2)	< 0.001
Vaccenic (18:1; 11c)	2.3	2.5	1.9 (1.6-2.7)	1.7 (1.5-2.3)	2.2 (1.7-3.3)	1.4 (0.9-2.6)	< 0.001
Linoleic (18:2; n-6)	17.7	26.9	8.7 (5.5-10.4)	9.2 (7.2-10.9)	7.7 (3.9-9.6)	11.6 (8.8-14.4)	< 0.001
DGLA (20:3; n-6)	0	0	2.2 (1.5-3.9)	1.9 (1.1-2.1)	2.2 (1.5-2.9)	2.0 (1.5-2.8)	0.049
Arachidonic (20:4; n-6)	0	0	18.3 (10.0-21.1)	12.2 (10.7-14.4)	19.2 (18.4-20.3)	16.8 (13.1-21.4)	< 0.001
Alfa-linoleic (18:3; n-3)	1.7	2.4	< 0.01	< 0.01	< 0.01	< 0.01
EPA (20:5; n-3)	0	3.4	0.6 (0.4-4.5)	3.2 (2.1-5.0)	0.5 (0.4-1.0)	0.7 (0.2-6.0)	< 0.001
DHA (22:6; n-3)	0	3	4.8 (3.4-8.4)	7.6 (6.2-10.4)	3.9 (3.0-4.7)	5.2 (2.3-8.4)	< 0.001
trans-Oleic	0	0	0.1 (0.1-0.2)	0.1 (0.0-0.2)	0.2 (0.0-0.2)	0.1 (0.0-0.2)	0.275
5-8-trans-Arachidonic	0	0	0.1 (0.1-0.2)	0.1 (0.0-0.2)	0.2 (0.0-0.1)	0.1 (0.0-0.3)	0.109
Total SFAs	16.5	18.5	43.5 (41.1-46.4)	44.9 (40.7-47.4)	44.0 (40.8-45.6)	44.3 (37.7-50.1)	0.786
Total MUFAs	65.1	45.8	21.5 (20.7-25.6)	20.9 (19.7-21.9)	21.9 (20.7-27.1)	19.5 (15.8-24.8)	0.001
Total PUFAs	19.4	35.7	34.4 (30.6-37.1)	33.7 (31.0-39.2)	33.8 (28.9-35.7)	35.7 (24.4-39.2)	0.937

The amount of each fatty acid was calculated as a percentage of the total fatty acid content (relative%). Data are expressed as medians (ranges); IVLE: Intravenous lipid emulsion; RBCs: Red blood cells; OO-IVLE: Clinoleic 20%; SMOF-IVLE: SMOF lipid ^®20%; DGLA: Dihomo-γ-linoleic acid; EPA: Eicosapentaenoic acid; DHA: Docosahexaenoic acid; FAs: Fatty acids; SFAs: Saturated fatty acids; MUFAs: Monounsaturated fatty acids; PUFAs: Polyunsaturated fatty acids; n6-PUFAs: Omega 6-PUFAs; n3-PUFAs: Omega 3-PUFAs; OO-IVLE group: Patients receiving a PN admixture containing Clinoleic 20%; SMOF-IVLE group: Patients receiving a PN admixture containing SMOF lipid ^®20%; No-IVLE group: Patients receiving PN without IVLE; HC group: Healthy controls.