Wene J D, Connor W E, DenBesten L
J Clin Invest. 1975 Jul;56(1):127-34. doi: 10.1172/JCI108061.
The hypothesis that clinical and biochemical essential fatty acid deficiency (EFA) might occur from the feeding of eucaloric, fat-free diets was tested in two experiments in healthy men. In Study I, eight men were given fat-free, eucaloric diets containing 80% of calories as glucose and 20% as amino acid hydrolysates by a constant drip over a 24-h period. The diets were fed in succession for periods of 2 wk each, either through a superior vena cava catheter or via a nasogastric tube. EFA deficiency was detected by decreases in linoleic acid and by the appearance of 5, 8, 11-eicosatrienoic acid in lipid fractions of plasma. Linoleic acid decreased significantly during 2 wk of the fat-free diet given intravenously from 48.8 to 9.8% (percent of total fatty acids) in cholesterol esters, from 21.2 to 3.2% in phospholipids, from 9.6 to 2.0% in free fatty acids, and from 14.1 to 2.6% in triglycerides. Eicosatrienoic acid, normally undetectable, appeared 0.6% in cholesterol esters, 2.5% in phospholipids, 0.2% in free fatty acids, and 2.3% in triglycerides. EFA deficiency occurred similarly during the nasogastric feeding. In Study II a subject received the same diet continuously by the nasogastric route for 10 days followed by a 24-h fast. He was then given the fat-free diet intermittently in three meals per day for 3 days. Finally, he was repleted with a diet containing 2.6% linoleic acid. By the 3rd day of the continuous nasogastric feeding, linoleic acid had fallen significantly and eicosatrienoic acid had appeared in plasma lipid fractions as in Study I. These findings were accentuated by day 10. Adipose tissue fatty acid composition did not change. Free fatty acid outflow from adipose tissue was presumably suppressed during the 10 days of continuous feeding. With increased free fatty acid outflow during fasting and intermittent feeding, linoleic acid rose and eicosatrienoic acid decreased. After 13 days of repletion with dietary linoleic acid, the EFA deficiency readily develops when fat-free diets containing glucose are given intravenously or orally as constant 24-h infusions. These diets are similar to the hyperalimentation formulas now being used clinically.
关于在健康男性中进行的两项实验，检验了以下假说：即通过给予等热量的无脂饮食可能会发生临床和生化必需脂肪酸缺乏（EFA）。在研究I中，八名男性通过在24小时内持续滴注给予无脂、等热量饮食，其中80%的热量来自葡萄糖，20%来自氨基酸水解物。这些饮食每次连续喂食2周，要么通过上腔静脉导管，要么通过鼻胃管。通过血浆脂质部分中亚油酸的减少以及5,8,11-二十碳三烯酸的出现来检测EFA缺乏。在静脉给予无脂饮食的2周内，胆固醇酯中亚油酸从48.8%显著降至9.8%（占总脂肪酸的百分比），磷脂中从21.2%降至3.2%，游离脂肪酸中从9.6%降至2.0%，甘油三酯中从14.1%降至2.6%。正常情况下无法检测到的二十碳三烯酸出现在胆固醇酯中为0.6%，磷脂中为2.5%，游离脂肪酸中为0.2%，甘油三酯中为2.3%。通过鼻胃管喂食时也同样出现了EFA缺乏。在研究II中，一名受试者通过鼻胃途径连续10天接受相同饮食，随后禁食24小时。然后他每天分三餐间歇性地给予无脂饮食，持续3天。最后，给他补充含有2.6%亚油酸的饮食。到连续鼻胃管喂食的第3天，亚油酸显著下降，并且如研究I中那样，血浆脂质部分中出现了二十碳三烯酸。到第10天这些发现更加明显。脂肪组织脂肪酸组成没有变化。在连续喂食的10天期间，脂肪组织中游离脂肪酸的流出可能受到抑制。随着禁食和间歇性喂食期间游离脂肪酸流出增加，亚油酸上升，二十碳三烯酸下降。在用膳食亚油酸补充13天后，当静脉内或口服给予含葡萄糖的无脂饮食作为24小时持续输注时，EFA缺乏很容易出现。这些饮食类似于目前临床上使用的胃肠外营养配方。
