Chiarla C, Giovannini I, Boldrini G, Castagneto M
Università Cattolica del Sacro Cuore-Roma.
Minerva Gastroenterol Dietol. 1997 Dec;43(4):197-208.
Medium Chain Triglycerides (MCT) are lipids which are commonly present in nature, for instance in milk and in some vegetable oils. The MCT molecule is composed of glycerol esterified with saturated linear-chain fatty acids containing 6 to 12 carbon atoms (MCFA: Medium Chain Fatty Acids: C(6:0), esanoic acid; C(8:0), octanoic acid; C(10:0), decanoic acid; C(12:0), dodecanoic acid). MCT for clinical use are currently obtained from vegetable fat through industrial processing. The large interest for MCT in clinical nutrition is due to unique physico-chemical, biochemical and metabolic features, which characterize MCT compared to conventional lipids (LCT: Long Chain Triglycerides). In particular, MCT represent a source of rapidly, fully available and ''high density'' energy, which makes their use very advantageous and suitable in a wide range of clinical situations, from the premature newborn to the adult patient. In addition to the MCT oil, known to physicians and nutritionists since the 1950s, and to the many commercially available MCT-containing compounds for oral-enteral use, in the last years it has become possible also to administer MCT-containing emulsions in parenteral nutrition. This has allowed to improve further knowledge of the effects of MCT, expanding the indications for use, often as a ''first-choice'' substrate in different types of critically ill patients.
中链甘油三酯(MCT)是自然界中常见的脂质,例如存在于牛奶和某些植物油中。MCT分子由甘油与含有6至12个碳原子的饱和直链脂肪酸酯化而成(中链脂肪酸:C(6:0),己酸;C(8:0),辛酸;C(10:0),癸酸;C(12:0),月桂酸)。目前临床使用的MCT是通过工业加工从植物脂肪中获得的。MCT在临床营养中备受关注,是因为其具有独特的物理化学、生物化学和代谢特性,与传统脂质(长链甘油三酯,LCT)相比,这些特性是MCT所特有的。特别是,MCT是一种快速、完全可用且“高密度”的能量来源,这使得它们在从早产儿到成年患者的广泛临床情况下使用非常有利且合适。除了自20世纪50年代以来医生和营养学家就已知的MCT油,以及许多市售的口服肠内用含MCT化合物外,近年来在肠外营养中也可以使用含MCT的乳剂。这使得人们能够进一步了解MCT的作用,扩大其使用适应症,在不同类型的重症患者中,MCT常作为“首选”底物。