Caliari S, Benini L, Sembenini C, Gregori B, Carnielli V, Vantini I
Division of Gastroenterologic Rehabilitation, University of Verona, Italy.
Scand J Gastroenterol. 1996 Jan;31(1):90-4. doi: 10.3109/00365529609031633.
The role of medium-chain triglycerides (MCTs) in the management of patients with pancreatic insufficiency is controversial. The aim of the study was to evaluate the absorption of MCTs in the presence of pancreatic insufficiency and the effect of pancreatic extracts on MCT absorption so as to clarify whether the replacement of usual dietary fats with MCTs is cost-effective.
Six patients with severe pancreatic steatorrhea were for 5 days fed a low-fat diet to which butter (long-chain triglycerides (LCTs)) or MCT oil was added, with and without pancreatic extracts, in a crossover design.
Fecal weight and nitrogen losses were the same during MCT and LCT intake. Steatorrhea was substantial during both periods but was significantly lower during MCT than LCT intake. Fecal weight and nitrogen and fat losses were reduced by pancreatic extracts in both diets. Steatorrhea was the same when MCTs and LCTs were consumed together with pancreatic extracts.
MCTs are absorbed better than LCTs in the presence of pancreatic insufficiency but require pancreatic extracts for optimal absorption. No advantage is to be expected from replacing usual dietary fats with MCTs if pancreatic supplements are used.
中链甘油三酯（MCTs）在胰腺功能不全患者管理中的作用存在争议。本研究的目的是评估胰腺功能不全时MCTs的吸收情况以及胰腺提取物对MCT吸收的影响，以阐明用MCTs替代常规膳食脂肪是否具有成本效益。
采用交叉设计，对6例严重胰腺性脂肪泻患者给予低脂饮食5天，饮食中分别添加黄油（长链甘油三酯（LCTs））或MCT油，同时添加或不添加胰腺提取物。
摄入MCT和LCT期间，粪便重量和氮损失相同。两个时期均有大量脂肪泻，但摄入MCT时明显低于摄入LCT时。两种饮食中，胰腺提取物均降低了粪便重量、氮和脂肪损失。同时摄入MCT和LCT并添加胰腺提取物时，脂肪泻情况相同。
在胰腺功能不全的情况下，MCTs的吸收优于LCTs，但需要胰腺提取物以实现最佳吸收。如果使用胰腺补充剂，用MCTs替代常规膳食脂肪并无益处。
