Article: article from journal or magazin.
Metabolic effects of parenteral nutrition enriched with n-3 polyunsaturated fatty acids in critically ill patients
Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't --- Old month value: Aug
BACKGROUND & AIMS: n-3 fatty acids are expected to downregulate the inflammatory responses, and hence may decrease insulin resistance. On the other hand, n-3 fatty acid supplementation has been reported to increase glycemia in type 2 diabetes. We therefore assessed the effect of n-3 fatty acids delivered with parenteral nutrition on glucose metabolism in surgical intensive care patients. METHODS: Twenty-four surgical intensive care patients were randomized to receive parenteral nutrition providing 1.25 times their fasting energy expenditure, with 0.25 g of either an n-3 fatty acid enriched-or a soy bean-lipid emulsion. Energy metabolism, glucose production, gluconeogenesis and hepatic de novo lipogenesis were evaluated after 4 days. RESULTS: Total energy expenditure was significantly lower in patients receiving n-3 fatty acids (0.015+/-0.001 vs. 0.019+/-0.001 kcal/kg/min with soy bean lipids (P<0.05)). Glucose oxidation, lipid oxidation, glucose production, gluconeogenesis, hepatic de novo lipogenesis, plasma glucose, insulin and glucagon concentrations did not differ (all P>0.05) in the 2 groups. CONCLUSIONS: n-3 fatty acids were well tolerated in this group of severely ill patients. They decreased total energy expenditure without adverse metabolic effects.
Adult Aged Blood Glucose/*metabolism Critical Care/methods Critical Illness/*therapy Energy Metabolism/*drug effects/physiology Fat Emulsions, Intravenous/analysis Fatty Acids, Omega-3/*administration & dosage Female Food, Fortified Glucagon/blood Gluconeogenesis/drug effects Humans Hydrocortisone/blood Insulin Resistance Intensive Care Units Lipid Metabolism/drug effects Liver/metabolism Male Middle Aged *Parenteral Nutrition, Total
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