Blanco Cynthia, Chang Weili, Bhatt Abhay J, Gerday Erick, Talati Ajay J, Dereddy Narendra, Singh Rachana, Ryan Erika, Senterre Thibault
Division of Neonatology, University of Texas Health Science Center, San Antonio, Texas, USA.
Division of Neonatology, East Carolina University Health Medical Center, Greenville, North Carolina, USA.
J Pediatr Gastroenterol Nutr. 2025 Aug;81(2):314-323. doi: 10.1002/jpn3.70072. Epub 2025 May 25.
There is a concern that decreasing soybean oil (SO) content in intravenous lipid emulsions (ILEs) may increase the risk for essential fatty acid deficiency (EFAD). This study evaluates the risk of EFAD in pediatric patients who were expected to require parenteral nutrition for at least 7 days with an 80% olive oil/20% SO ILE (OO/SO group) versus a 100% SO ILE (SO group).
This randomized, double-blind, controlled, multicenter study evaluated 101 pediatric patients including 94 preterm infants. The primary outcome was the incidence of EFAD, including the analysis of the plasma fatty acid (FA) profiles and genetic polymorphism in the FA desaturase genes in patients with extreme arachidonic acid values.
Treatment duration was 10.3 ± 7.8 and 11.3 ± 9.4 days in the OO/SO and SO groups respectively. No EFAD was observed. Linoleic acid values increased in both groups but to a lesser extent in the OO/SO group. Arachidonic acid values remained stable within the two groups. The changes in mead acid value were opposite in the two groups, demonstrating an increase in the OO/SO group and a decrease in the SO group, leading to similar changes in the triene:tetraene ratio (T:T). Genetic polymorphisms were frequently observed in patients presenting extreme arachidonic acid values in both groups.
The use of an 80% OO/20% SO ILE is well tolerated, safe, and does not increase the risk of EFAD in pediatric patients. The assessment of EFAD should not only consider the T:T but also the complete FA profile and genetic polymorphisms.
Trial Identification Number and URL: NCT04555044, https://clinicaltrials.gov/study/NCT04555044?term=NCT04555044&rank=1.
人们担心静脉脂质乳剂（ILEs）中大豆油（SO）含量的降低可能会增加必需脂肪酸缺乏（EFAD）的风险。本研究评估了预计需要肠外营养至少7天的儿科患者中，使用80%橄榄油/20%大豆油ILEs（OO/SO组）与100%大豆油ILEs（SO组）相比发生EFAD的风险。
这项随机、双盲、对照、多中心研究评估了101名儿科患者，其中包括94名早产儿。主要结局是EFAD的发生率，包括对花生四烯酸值极低的患者进行血浆脂肪酸（FA）谱分析和FA去饱和酶基因的基因多态性分析。
OO/SO组和SO组的治疗持续时间分别为10.3±7.8天和11.3±9.4天。未观察到EFAD。两组的亚油酸值均升高，但OO/SO组升高幅度较小。两组内花生四烯酸值保持稳定。两组中廿碳三烯酸值的变化相反，OO/SO组升高而SO组降低，导致三烯:四烯比值（T:T）出现相似变化。两组中花生四烯酸值极低的患者经常观察到基因多态性。
使用80%橄榄油/20%大豆油ILEs耐受性良好、安全，不会增加儿科患者发生EFAD的风险。对EFAD的评估不仅应考虑T:T，还应考虑完整的FA谱和基因多态性。
试验识别号和网址：NCT04555044，https://clinicaltrials.gov/study/NCT04555044?term=NCT04555044&rank=1 。
