Abstract
To examine changes in fatty acid composition of serum lipids, sixteen patients with gastric cancer were maintained on total parenteral nutrition (TPN) or intravenous feeding immediately after total gastrectomy. Subjects receiving no fat showed decreases in linoleic acid, linolenic acid and arachidonic acid and increases in palmitoleic acid and oleic acid, whereas those receiving fat emulsion showed no detectable changes. Decrease in the linoleic acid content was greater in subjects on a higher carbohydrate intake, but less in those on a higher fat intake. Multiple regression analysis of the relationships among carbohydrate intake (X1) and fat intake (X2) and changes in the linoelic acid percentage of total serum fatty acids (Y) in each case yielded an equation: Y=−4.75 X1+69.0 X2−27.9 (R=0.885, p<0.05). Approximately 1 g/kg/day of fat provided in 40–50 kcal/kg/day of nonprotein energy intake was estimated to prevent decrease in the linoleic acid content in the serum fatty acid pattern during the postoperative catabolic stage.
Similar content being viewed by others
References
Dudrick SJ, Wilmore DW, Vars HM, Rhoads JE. Long-term total parenteral nutrition with growth, development, and positive nitrogen balance. Surgery 1968; 64: 134–142.
Collins FD, Sinclair AJ, Royle JP, Coats DA, Naynard AT, Leonard RF. Plasma lipids in human linoleic acid deficiency. Nutr Metab 1971; 13: 150–167.
Caldwell MD, Jonsson HT, Othersen HB. Essential fatty acid deficiency in an infant receiving prolonged parenteral alimentation. J Pediatr 1972; 81: 894–898.
Paulsrud JR, Pensler L, Whitten CF, Stewart S, Holman RT. Essential fatty acid deficiency in infants induced by fat free intravenous feeding. Am J Clin Nutr 1972; 25: 897–904.
Richardson TJ, Sogoutas D. Essential fatty acid deficiency in four adult patients during total parenteral nutrition. Am J Clin Nutr 1975; 28: 258–263.
Tashiro T, Ogawa H, Yokoyama H, Mashima Y, Iwasaki I. The effect of fat emulsion on essential fatty acid deficiency during intravenous hyperalimentation in pediatric patients. J Pediatr Surg 1975; 10: 203–213.
Wene JD, Connor WE, DenBesten L. The development of essential fatty acid deficiency in healthy men fed fat-free diets intravenously and orally. J Clin Invest 1975; 56: 127–134.
Stegnik LD, Freeman JB, Wispe J, Connor WE. Absence of the biochemical symptoms of essential fatty acid in surgical patients undergoing protein sparing therapy. Am J Clin Nutr 1977; 30: 388–393.
Goodgame JT, Lwory SF, Brennan MF. Essential fatty acid deficiency in total parenteral nutrition. Time course of development and suggestions for therapy. Surgery 1978; 84: 271–277.
Nube M, Bos LP, Boomgoard DM, Hekkens WT. Energy intake and the appearance of 5,8,11-eicosatrienoic acid in serum lipids during parenteral nutrition without fat. JPEN 1982; 6: 134–139.
Folch J, Less M, Sloano-Stanlay GH. A simple method for the isolation and purification of total lipid from animal tissues. J Biol Chem 1957; 226: 497–509.
Metaclfe LD, Schmitz JL. The rapid preparation of fatty acid esters for gas chromatographic analysis. Anal Chem 1961; 33: 363–364.
MacCarthy MC, Cottam GL, Turner WW. Essential fatty acid deficiency in critically ill surgical patients. Am J Surg 1981; 142: 747–751.
O'neill JA, Caldwell MD, Meny HC. Essential fatty acid deficiency in surgical patients. Ann Surg 1977; 185: 535–542.
Wilmore DW, Moylan JA, Helmkamp GM, Pruitt BA. Clinical evaluation of a 10 per cent intravenous fat emulsion for parenteral nutrition in thermally injured patients. Ann Surg 1973; 178: 503–513.
Jelen S, Tempel G, Lohniger A, Blumel G. Changes in essential fatty acids in plasma lipid fraction of traumatized patients. JPEN 1983; 7: 142–145.
Riella MC, Broviac JW, Wells M, Scribner BH. Essential fatty acid deficiency in human adults during total parenteral nutrition. Ann Inter Med 1975; 83: 786–789.
Flemming CR, Smith LM, Hodges RE. Essential fatty acid deficiency in adults receiving total parenteral nutrition. Am J Clin Nutr 1976; 29: 976–983.
Holman RT, Johnson S. Changes in essential fatty acid profile of serum phospholipids in human diseases. Prog Lipid Res 1982; 20: 67–73.
Holman RT. The ratio of trienoic: tetraenoic acids in tissue lipids as a measure of essential fatty acid requirement. J Nutr 1960; 7: 405–410.
Barr LH, Dunn GD, Brennan MF. Essential fatty acid deficiency during total parenteral nutrition. Ann Surg 1981; 193: 304–311.
Wolfram G, Eckart J, Walther B, Zollner N. Factors influencing essential fatty acid requirement in total parenteral nutrition (TPN). JPEN 1978; 2: 634–639.
Stein TP, Buzby GP, Hargrovell WC, Leskiw MJ, Mullen J. Essential fatty acid deficiency in patients receiving simultaneous parenteral and oral nutrition. JPEN 1980; 4: 343–345.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Okuno, M., Nagayama, M., Ikehara, T. et al. Serum fatty acid concentrations in patients on postoperative parenteral nutrition with and without fat. The Japanese Journal of Surgery 16, 118–125 (1986). https://doi.org/10.1007/BF02471081
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02471081