Druml W, Fischer M, Sertl S, Schneeweiss B, Lenz K, Widhalm K
1st Medical and Pediatric University Clinic, University of Vienna, Austria.
Am J Clin Nutr. 1992 Feb;55(2):468-72. doi: 10.1093/ajcn/55.2.468.
Elimination and hydrolysis of fat emulsions containing long-chain (LCT; Intralipid) or long- and medium-chain triglycerides (MCT; Lipofundin MCT) were compared in seven patients with acute renal failure (ARF) and six healthy control subjects. In control subjects, clearance of MCT was slightly higher than that of LCT (1.93 +/- 0.34 vs 1.55 +/- 0.3 mL.kg body wt-1.min-1, P less than 0.05). The rise in plasma triglycerides was similar and the release of free fatty acids was higher during MCT (P less than 0.02). In ARF, clearance of both LCT and MCT was equally reduced (0.53 +/- 0.12 vs 0.59 +/- 0.14 mL.kg body wt-1.min-1, P less than 0.01 vs control subjects). Again, the rise in triglycerides was comparable. Free fatty acid release was higher during MCT but lower than in control subjects. Plasma concentrations of glucose and lactate were not affected in control subjects but increased during both LCT and MCT in ARF. Thus elimination of both LCT and MCT is profoundly decreased in ARF. The impaired lipolysis in ARF cannot be circumvented by the use of MCT.
在7例急性肾衰竭（ARF）患者和6名健康对照受试者中，比较了含长链（LCT；英脱利匹特）或长链与中链甘油三酯（MCT；力保肪宁MCT）的脂肪乳剂的清除率和水解情况。在对照受试者中，MCT的清除率略高于LCT（1.93±0.34对1.55±0.3 mL·kg体重-1·min-1，P<0.05）。血浆甘油三酯的升高相似，而MCT期间游离脂肪酸的释放更高（P<0.02）。在ARF中，LCT和MCT的清除率均同样降低（0.53±0.12对0.59±0.14 mL·kg体重-1·min-1，与对照受试者相比P<0.01）。同样，甘油三酯的升高相当。MCT期间游离脂肪酸的释放更高，但低于对照受试者。对照受试者的血浆葡萄糖和乳酸浓度未受影响，但在ARF中LCT和MCT期间均升高。因此，ARF中LCT和MCT的清除率均显著降低。ARF中脂解受损不能通过使用MCT来规避。
