Effect of omega-3 polyunsaturated fatty acids to reverse biopsy-proven parenteral nutrition-associated liver disease in adults.

Abstract

BACKGROUND & AIMS:

Parenteral nutrition-associated liver disease (PNALD) complicates the treatment of patients with short bowel syndrome (SBS). Some studies have shown omega-3 polyunsaturated fatty acids (ω-3 PUFAs) have favorable effects in treating PNALD in children. We, therefore, investigate the effects of ω-3 PUFAs supplemented intravenous lipid emulsion (ILE) on PNALD in adults.

METHODS:

We performed an open-labeled study of a ω-3 PUFAs based ILE in 15 adults with SBS who developed cholestasis while receiving soybean oil-based ILE. Liver biopsies were performed before and after the initiation of ω-3 PUFAs to confirm the presence and improvement of cholestasis. Blood samples were collected every week for analysis of fatty acid composition and liver function.

RESULTS:

12 of the 15 patients had their direct bilirubin normalized within 4 weeks and our data demonstrated a significant decrease in both DB (P ≤ 0.001) and TB (P ≤ 0.001) after 4 weeks compared to baseline. There were ameliorations of liver function and fatty acid patterns in all patients and serial liver biopsy specimens showed progressive histologic improvement.

CONCLUSIONS:

Parenteral ω-3 PUFAs supplemented fat emulsions are safe and effective in the treatment of PNALD in adults.

• Authors: Ziwei Xu, Yousheng Li, Jian Wang, Bo Wu, Jieshou Li
• Journal: Clinical nutrition (Edinburgh, Scotland) (Clin Nutr) Vol. 31 Issue 2 Pg. 217-23 (Apr 2012) ISSN: 1532-1983 [Electronic] England
• PMID: 22035955 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Chemical References

• Fat Emulsions, Intravenous
• Fatty Acids, Omega-3
• Fish Oils
• Soybean Oil
• Bilirubin

Topics

• Adult
• Bilirubin (blood)
• Biopsy
• Cholestasis (complications, drug therapy)
• Fat Emulsions, Intravenous (administration & dosage)
• Fatty Acids, Omega-3 (administration & dosage)
• Female
• Fish Oils (administration & dosage)
• Humans
• Liver (pathology)
• Liver Diseases (complications, drug therapy)
• Liver Function Tests
• Male
• Middle Aged
• Parenteral Nutrition (adverse effects)
• Short Bowel Syndrome (complications, drug therapy)
• Soybean Oil (administration & dosage)
• Treatment Outcome
• Young Adult