Biomaterial Database

Effect of total parenteral nutrition on biliary lipids in neonates. 1986

A Al-Rabeeah, and O G Thurston, and K Walker

To study the effect of total parenteral nutrition (TPN) on biliary lipids in critically ill neonates, biliary lipid concentrations were determined in 13 neonates before starting TPN, in 8 receiving TPN for up to 2 weeks and in 9 receiving TPN for up to 8 weeks. Bile was very dilute in the 13 neonates not receiving TPN owing to a low concentration of bile acids. In many the bile-acid concentration was below the critical micellar concentration, thus cholesterol in bile was not dissolved. The neonates receiving TPN for up to 2 weeks showed a marked increase in bile-acid content and had levels above the critical micellar concentration. This apparently beneficial effect of TPN disappeared after 2 weeks and neonates who received TPN for 3 to 8 weeks again had bile-acid levels below the critical micellar concentration. Three conclusions may be drawn from this study: (a) in the fasting state before TPN is begun, the cholesterol content of bile relative to phospholipid and bile acids increased in linear fashion during the fasting period; (b) short-term TPN of up to 2 weeks' duration was associated with an increased bile-acid content to levels at which cholesterol could be dissolved; (c) neonates on long-term TPN and no oral intake secrete extremely dilute bile with an insufficient concentration of bile-acid molecules to form micelles to dissolve cholesterol. This finding may explain some of the adverse hepatobiliary changes associated with long-term administration of TPN.

UI	MeSH Term	Description	Entries
D007231	Infant, Newborn	An infant during the first 28 days after birth.	Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008297	Male		Males
D010289	Parenteral Nutrition, Total	The delivery of nutrients for assimilation and utilization by a patient whose sole source of nutrients is via solutions administered intravenously, subcutaneously, or by some other non-alimentary route. The basic components of TPN solutions are protein hydrolysates or free amino acid mixtures, monosaccharides, and electrolytes. Components are selected for their ability to reverse catabolism, promote anabolism, and build structural proteins.	Hyperalimentation, Parenteral,Intravenous Hyperalimentation,Nutrition, Total Parenteral,Parenteral Hyperalimentation,Total Parenteral Nutrition,Hyperalimentation, Intravenous
D010743	Phospholipids	Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides see GLYCEROPHOSPHOLIPIDS) or sphingosine (SPHINGOLIPIDS). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system.	Phosphatides,Phospholipid
D002784	Cholesterol	The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils.	Epicholesterol
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001646	Bile	An emulsifying agent produced in the LIVER and secreted into the DUODENUM. Its composition includes BILE ACIDS AND SALTS; CHOLESTEROL; and ELECTROLYTES. It aids DIGESTION of fats in the duodenum.	Biliary Sludge,Sludge, Biliary
D001647	Bile Acids and Salts	Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones.	Bile Acid,Bile Salt,Bile Salts,Bile Acids,Acid, Bile,Acids, Bile,Salt, Bile,Salts, Bile