Parenteral Medium Chain Triglycerides in the Premature

早产儿肠外注射中链甘油三酯

• 批准号: 6367868
• 负责人: EBERHARD SCHMIDT-SOMMERFELD
• 金额: $ 7.15万
• 依托单位: LSU HEALTH SCIENCES CENTER
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-07-01 至 2003-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6367868
• 关键词: aminoacid metabolism; bioenergetics; blood tests; carnitine; catheterization; chemical chain length; chemical kinetics; clinical trials; combination therapy; developmental neurobiology; developmental nutrition; diet therapy; fatty acid metabolism; gas chromatography mass spectrometry; human subject; human therapy evaluation; ketone body; low birth weight infant human; nutrition related tag; parenteral feedings; patient oriented research; premature infant human; radiotracer; triglycerides

DESCRIPTION (provided by applicant): Very low birth weight infants who require total parenteral nutrition (TPN) due to enteral feeding intolerance have a limited capacity to utilize energy in the form of glucose and long-chain triglycerides (LCT). Achieving sufficient caloric intake for growth and a positive nitrogen balance is one of the big challenges in the care of these patients. In the proposed research, the incorporation of medium-chain triglycerides (MCT) as a readily available alternative source of energy into the TPN regimen will be explored. MCT-containing lipid emulsions are being studied in adults. No studies in premature infants have been reported in the U.S., yet their potential benefit may be greatest in this patient population. The scientific hypotheses of this proposal are: (1) MCT have a more pronounced ketogenic effect than LCT. This could be beneficial for brain development, but could also cause toxicity; and (2) MCT decrease the availability of free carnitine, resulting in an accumulation of short- and medium-chain acyl-coenzyme A and impairment of energy metabolism if exogenous carnitine is not supplied. The proposed experimental approaches are novel: The first hypothesis will be tested by determining rates of ketone body turnover and clearance in premature infants 26-32 weeks of gestation during infusion of a mixture of MCT and LCT (MCT/LCT) in comparison with a pure LCT emulsion, using stable isotope technology. The second hypothesis will be tested by measuring parameters of carnitine metabolism and evaluating the effect of L-carnitine supplementation on ketone body kinetics during MCT/LCT infusion. The long term goal is to determine whether the addition of MCT and L-carnitine to TPN will improve the nutrition of premature infants during a critical period of their lives.

描述（由申请人提供）：非常低的出生体重婴儿 由于肠内喂养不耐受而需要全肠胃外营养（TPN） 以葡萄糖形式使用能量的能力有限 长链甘油三酸酯（LCT）。实现足够的热量摄入量以增长 积极的氮平衡是护理的最大挑战之一 这些患者。在拟议的研究中，融合了中链 甘油三酸酯（MCT）作为随时可用的替代能源 将探索TPN方案。含MCT的脂质乳液正在 在成人中学习。没有报告过早产的研究 美国，但他们的潜在利益可能是该患者人群中最大的。 该提议的科学假设是：（1）MCT的明显 生酮效应比LCT。这可能对大脑发育有益，但是 也可能引起毒性； （2）MCT降低了自由的可用性 肉碱，导致短链和中链积累 如果外源性肉碱为 未提供。提出的实验方法是新颖的：第一个 假设将通过确定酮体周转率和 早产婴儿的清除在注入26-32周的妊娠26-32周 与纯LCT乳液相比，MCT和LCT（MCT/LCT）的混合物使用 稳定的同位素技术。第二个假设将通过测量来检验 肉碱代谢的参数和评估L-肉碱的作用 在MCT/LCT输注过程中补充酮体动力学。长期 目标是确定在TPN中添加MCT和L-肉碱是否会 在关键时期改善早产婴儿的营养 生命。