术前口服补充长链欧米伽-3脂肪酸可有益地改变肝脏、肠道黏膜和肿瘤组织中的磷脂脂肪酸模式。

Preoperative oral supplementation with long-chain Omega-3 fatty acids beneficially alters phospholipid fatty acid patterns in liver, gut mucosa, and tumor tissue.

作者信息

Senkal Metin, Haaker Rolf, Linseisen Jakob, Wolfram Günther, Homann Heinz-Herbert, Stehle Peter

机构信息

Department of Surgery, St. Josef Hospital, Ruhr University, Bochum, Germany.

出版信息

JPEN J Parenter Enteral Nutr. 2005 Jul-Aug;29(4):236-40. doi: 10.1177/0148607105029004236.

DOI:10.1177/0148607105029004236

PMID:15961678

Abstract

BACKGROUND

The uptake of omega-3 polyunsaturated fatty acids (PUFAs) into the liver, gut mucosa, and tumor tissue and plasma levels after preoperative administration of supplemented enteral nutrition was investigated in patients with malignancies of the upper gastrointestinal tract. The objective of the study was to evaluate the incorporation of preoperatively administrated PUFAs, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) into cell phospholipids.

METHODS

Patients undergoing major gastrointestinal surgery (n = 40) were prospectively randomized to receive a PUFA-supplemented liquid oral diet 5 days preoperatively or an isocaloric control diet. The planned diet intake was 1000 mL/d providing 3.7 g of PUFA. The diet was given in addition to the usual hospital diet. The phospholipid fractions in plasma were analyzed on the day of surgery. Tissue samples of liver, gut mucosa (small intestine), and tumor were taken during surgery and homogenized. EPA and DHA content was analyzed using liquid gas chromatography.

RESULTS

Both patient groups (PUFA group: n = 20; control group: n = 20) were similar in age, weight, and surgical procedures. As compared with the control group, the PUFA group had significantly increased levels of EPA in liver tissue (0.4 vs 1.3 weight %), gut mucosa (0.3 vs 1.0 weight %), and tumor tissue (0.3 vs 0.8 weight %). Also, the DHA levels in the PUFA group were significantly higher than the control group: liver tissue (4.1 vs 7.5 weight %), gut mucosa (2.1 vs 3.7 weight %) and tumor tissue (1.9 vs 4.2 weight %).

CONCLUSIONS

This study suggests that administration of PUFA-enriched diets leads to increased incorporation of EPA and DHA not only in liver and gut mucosa tissue, but also in tumor tissue in patients with solid gastrointestinal tumors. Thus, preoperative administration of oral PUFA-enriched diets could have an impact on the postoperative inflammatory response after major abdominal surgery.

摘要

背景

对上消化道恶性肿瘤患者术前补充肠内营养后，ω-3多不饱和脂肪酸（PUFAs）在肝脏、肠黏膜、肿瘤组织中的摄取情况以及血浆水平进行了研究。本研究的目的是评估术前给予的PUFAs、二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）在细胞磷脂中的掺入情况。

方法

对接受大型胃肠道手术的患者（n = 40）进行前瞻性随机分组，术前5天分别给予补充PUFA的液体口服饮食或等热量对照饮食。计划饮食摄入量为1000 mL/d，提供3.7 g的PUFA。该饮食在常规医院饮食基础上额外给予。手术当天分析血浆中的磷脂组分。手术期间采集肝脏、肠黏膜（小肠）和肿瘤的组织样本并匀浆。使用液相气相色谱法分析EPA和DHA含量。

结果

两组患者（PUFA组：n = 20；对照组：n = 20）在年龄、体重和手术方式方面相似。与对照组相比，PUFA组肝脏组织中EPA水平显著升高（0.4%对1.3%重量比）、肠黏膜中EPA水平显著升高（0.3%对1.0%重量比）、肿瘤组织中EPA水平显著升高（0.3%对0.8%重量比）。此外，PUFA组的DHA水平也显著高于对照组：肝脏组织（4.1%对7.5%重量比）、肠黏膜（2.1%对3.7%重量比）和肿瘤组织（1.9%对4.2%重量比）。