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Clin Nutr. 2012 Apr;31(2):217-23. doi: 10.1016/j.clnu.2011.10.001. Epub 2011 Oct 27.

Effect of omega-3 polyunsaturated fatty acids to reverse biopsy-proven parenteral nutrition-associated liver disease in adults.

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1
Department of Surgery, Jinling Hospital, Nanjing University School of Medicine, 305 E Zhongshan Rd, Nanjing 210002, PR China.

Abstract

BACKGROUND & AIMS:

Parenteral nutrition-associated liver disease (PNALD) complicates the treatment of patients with short bowel syndrome (SBS). Some studies have shown omega-3 polyunsaturated fatty acids (ω-3 PUFAs) have favorable effects in treating PNALD in children. We, therefore, investigate the effects of ω-3 PUFAs supplemented intravenous lipid emulsion (ILE) on PNALD in adults.

METHODS:

We performed an open-labeled study of a ω-3 PUFAs based ILE in 15 adults with SBS who developed cholestasis while receiving soybean oil-based ILE. Liver biopsies were performed before and after the initiation of ω-3 PUFAs to confirm the presence and improvement of cholestasis. Blood samples were collected every week for analysis of fatty acid composition and liver function.

RESULTS:

12 of the 15 patients had their direct bilirubin normalized within 4 weeks and our data demonstrated a significant decrease in both DB (P ≤ 0.001) and TB (P ≤ 0.001) after 4 weeks compared to baseline. There were ameliorations of liver function and fatty acid patterns in all patients and serial liver biopsy specimens showed progressive histologic improvement.

CONCLUSIONS:

Parenteral ω-3 PUFAs supplemented fat emulsions are safe and effective in the treatment of PNALD in adults.

PMID:
22035955
DOI:
10.1016/j.clnu.2011.10.001
[Indexed for MEDLINE]
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