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Effects of intravenous supplementation with α-tocopherol in patients receiving total parenteral nutrition containing medium- and long-chain triglycerides

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Abstract

Objective: To compare the effects of a lipid emulsion containing medium-chain triglycerides (MCT) and supplemented with α-tocopherol to a conventional long-chain triglyceride (LCT) emulsion.

Design: Randomised double blind study.

Setting: Department of Internal Medicine, Antwerp University Hospital.

Subjects and interventions: Twenty-four patients with an indication for total parenteral nutrition for a minimum of 10 days were randomly assigned to two groups: group E received as lipid source MCT/LCT (50/50) suplemented with 100 mg dl-α-tocopherol/day and group C received LCT. Blood samples were analysed at inclusion, after 4–6 and after 9–11 days.

Results: In group E, serum α-tocopherol doubled from 11.4±6.9 at inclusion to 20.9±7.9 and to 23.8±8.8 µg/ml after 4 and 9 days, respectively, but did not change in group C (P=0.008). Production of thiobarbituric acid-reacting substances (TBARS) after 120 min incubation with copper decreased from 66±34 at inclusion to 29±25 nmol MDA/mg LDL and VLDL-cholesterol after 4 and to 42±17 after 9 days (P=0.022 when compared to group C, which underwent no significant changes). Velocity of production of fluorescent products decreased in group E but not in group C (P=0.026).

Conclusions: Supplementation of TPN containing MCT/LCT with 100 mg dl-α-tocopherol/day leads to a doubling in serum α-tocopherol and to a decrease in the susceptibility of LDL and VLDL to peroxidation in vitro.

Sponsorship: This study was partly financed by B Braun Medical NVSA, Diegem, Belgium.

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Acknowledgements

The authors would like to thank the patients who participated in the study, M Vinckx and P Aerts for skilful technical assistance, the nursing staff of the Antwerp University Hospital and B Braun Medical NVSA, Belgium for partly financing the study.

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Author notes

  1. B Manuel-y-Keenoy and I De Leeuw: Guarantors: B Manuel-y-Keenoy and I De Leeuw.

  2. B Manuel-y-Keenoy, L Nonneman, H De Bosscher, J Vertommen, S Schrans, K Klütsch and I De Leeuw: Contributors: LN and HDB selected and followed-up the patients and collected the clinical data. JV and SS were responsible for the biochemical analyses. IDL was the group leader and designed the clinical study. BMK carried out the data analysis and wrote the manuscript. KK was involved in the design of the clinical study and collaborated in the correction of the manuscript.

Authors and Affiliations

  1. Laboratory of Endocrinology, University Hospital, University of Antwerp, Antwerp, Belgium

    B Manuel-y-Keenoy, J Vertommen, S Schrans & I De Leeuw

  2. Department of Internal Medicine, Nutrition Team, Pharmacy, University Hospital, University of Antwerp, Antwerp, Belgium

    B Manuel-y-Keenoy, L Nonneman, H De Bosscher & I De Leeuw

  3. B Braun Melsungen AG, Germany

    K Klütsch

Authors
  1. B Manuel-y-Keenoy
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  2. L Nonneman
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  3. H De Bosscher
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  5. S Schrans
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  6. K Klütsch
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  7. I De Leeuw
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Correspondence to B Manuel-y-Keenoy.

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Manuel-y-Keenoy, B., Nonneman, L., De Bosscher, H. et al. Effects of intravenous supplementation with α-tocopherol in patients receiving total parenteral nutrition containing medium- and long-chain triglycerides. Eur J Clin Nutr 56, 121–128 (2002). https://doi.org/10.1038/sj.ejcn.1601294

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  • DOI: https://doi.org/10.1038/sj.ejcn.1601294

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