Munakata Mitsutoshi, Nishikawa Masazumi, Togashi Noriko, Nio Eiko, Kobayashi Yasuko, Omura Kiyoshi, Haginoya Kazuhiro, Tanaka Soichiro, Abe Takuya, Hishinuma Takanori, Chida Nobukazu, Tsuchiya Shigeru, Onuma Akira
Division of Pediatric Neurology, Takuto Rehabilitation Center for Children, Sendai, Japan.
Tohoku J Exp Med. 2009 Jan;217(1):23-8. doi: 10.1620/tjem.217.23.
Currently, various formulas with different fatty acid compositions are used for enteral nutrition (EN). All formulas contain various concentrations of essential fatty acids: linoleic acid (LA) and alpha-linolenic acid (ALA); LA is biotransformed into arachidonic acid (AA) and ALA into eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in vivo. Some formulas contain preformed EPA and DHA. However, the effects of the differences in the fatty acid composition on the fatty acid status of patients receiving long-term EN is not clear. We measured serum fatty acid concentrations in 50 patients with neurological diseases receiving long-term EN. The data were then compared retrospectively with reference to the fatty acid compositions of the formulas used. All of the patients received almost their entire nutritional intake via EN for at least 1 year. Blood samples were obtained just before injecting the EN solution. Among the formulas that did not include EPA or DHA, formulas with low ALA concentrations were associated with low serum EPA and DHA. Conversely, the ALA-enriched formulas with reduced LA concentrations significantly increased EPA and DHA levels, although the levels remained lower than the control values. With the formula containing EPA and DHA, the EPA and DHA levels reached control values. Therefore, the fatty acid composition of the EN formulas affected the fatty acid status of patients receiving long-term EN. Formulas containing preformed EPA and DHA with suitable amounts of essential fatty acids may benefit these patients.
目前，不同脂肪酸组成的各种配方用于肠内营养（EN）。所有配方都含有不同浓度的必需脂肪酸：亚油酸（LA）和α-亚麻酸（ALA）；LA在体内可生物转化为花生四烯酸（AA），ALA则转化为二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）。一些配方含有预先形成的EPA和DHA。然而，脂肪酸组成差异对长期接受EN患者脂肪酸状态的影响尚不清楚。我们测量了50例接受长期EN的神经系统疾病患者的血清脂肪酸浓度。然后根据所使用配方的脂肪酸组成对数据进行回顾性比较。所有患者通过EN摄入几乎全部营养至少1年。在即将注入EN溶液之前采集血样。在不包含EPA或DHA的配方中，ALA浓度低的配方与血清EPA和DHA水平低相关。相反，LA浓度降低的富含ALA的配方显著提高了EPA和DHA水平，尽管仍低于对照值。使用含有EPA和DHA的配方时，EPA和DHA水平达到了对照值。因此，EN配方的脂肪酸组成影响了长期接受EN患者的脂肪酸状态。含有适量必需脂肪酸的预先形成的EPA和DHA的配方可能使这些患者受益。
