An experimental study of blood clearance, tissue distribution and safety of high dose intravenous fish oilmedium chain triglycerides lipid emulsion in mice / 中华临床营养杂志

Objective To evaluate the blood clearance,tissue uptake and distribution as well as safety of high dose-40 mg intravenous fish oil/'medium chain triglycerides (FO/MCT:2 ∶ 8,wt/wt) lipid emulsions iu mice by measuriug the contents of triglycerides (TG) and free fatty acids (FFA) level in blood.Methods FO/MCT emulsions were radiolabeled with nondegradable [3H] cholesteryl ether to trace core particle metabolism in C57BL/6J mice following a bolus injection.For high dose,TG was 40 mg,100 times of low dose.Blood samples were obtained within 25 min to analyze TG and FFA concentrations;extracted organs were used to measure the tissue distribution of lipid emulsions.Results No animal in either group died,and no fat overload syndrome evidence was found after high dose injection.Compared with low dose,high dose injection increased the plasma TG and FFA concentrations rapidly;the emulsions were cleared significantly slower during 25 min after administration in mice;blood has a higher uptake ratio in organs,but heart has a lower one;there was no significant difference in liver and lung uptake ratio between the two groups.Conclusions High dose injection of FO/MCT is not fatal in mice.The animals only experience hypertriglyceridemia and high level of free fatty acids during a significant slower blood clearance period compared to low dose.Although blood clearance is slower,the blood uptake rate increases for further metabolism and clearance.Heart and lung functions are not affected as a lower cardiac and pulmonary uptake;blood uptakes more emulsions to further metabolize.FO/MCT may not induce fat overload syndrome in mice when administered with a super high dose.

Preparation and Physical Stability Evaluation of Palm Oil-Based Nanoemulsion as a Drug Delivery System for Propofol / Jurnal Sains Kesihatan Malaysia

The objective of this study was to develop a formulation for propofol injection at various concentrations (1 and 2%)using palm oil-based nanoemulsion as the carrier. The nanoemulsions were characterised by globule size distribution(Dv 90 value), zeta potential, pH and viscosity determination. The physicochemical stability and accelerated stabilityof the formulations were also evaluated. Stability studies were performed for 6 months at 4, 16, 25 and 40oC storagetemperatures. The propofol content was analysed by HPLC study. The characterisation result of propofol nanoemulsion 1and 2% showed good globule size distributions in Dv 90 values of 284 ± 1.15 nm and 304 ± 1.20 nm and also stable zetapotential values of-43.37 ± 0.96 mV and -40.97 ± 1.36 mV, respectively. Accelerated test showed that the formulationshave excellent stability with no physical changes observed after centrifugation, autoclaving at 121oC for 15 mins, shakingfor 12 hours and thermal cycling test. The stability studies indicated that propofol emulsion show good stability for 6months when stored at 4 ± 1oC and 16 ± 1oC based on Dv 90 values, zeta potential, and pH readings. No changes inpropofol concentrations were observed after 6 months storage. Overall, propofol in palm oil-based nanoemulsions ascarrier was found to be stable and can be used as an alternative anaesthetic inje

Efficacy of Virgin Coconut Oil supplemented-milk feeding in augmenting weight gain among very low birth weight preterm infants: A meta-analysis

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Nutritional status is crucial in neonatal survival, especially among the Very Low Birthweight (VLBW) preterm infants. They have low nutrient reserves with increased metabolic needs and immature gut system. Several studies have proven the efficacy of medium-chain triglycerides (MCT) as a good source of calories among pre-term infants. However, such is not commercially available. Virgin coconut oil (VCO) has the most concentrated content of MCT's, hence a possible source of MCT.</p><p style="text-align: justify;"><strong>OBJECTIVES:</strong> This review aims to determine the efficacy of VCO-supplementation to milk feeding in augmenting weight gain among very low birth weight preterm infants.</p><p style="text-align: justify;"><strong>METHODS:</strong> Pubmed (1975-September 2016), Cochrane Central Register of Controlled Trials (The Cochrane Library, September 2016), HERDIN (1966 -September 2016), Google Scholar (September 2016), and https://clinicaltrials.gov (last searched September 2016) were thoroughly searched. Manual search in reference and citation lists of the eligible studies and list of abstracts from the Philippine Pediatric Society was also reviewed. Only randomized controlled trials comparing VCO-supplemented milk versus standard care in weight gain among very low birth weight preterm infants were included. The author reviewed each study's quality and extracted data on weight gain. Weighted mean differences with 95% confidence intervals were reported. Risk of biases among studies were also evaluated.</p><p style="text-align: justify;"><strong>RESULTS:</strong> Three randomized controlled trials involving 290 infants were included. All trials were of good quality with relatively low heterogeneity (39%), and low risk of biases. Overall, infants receiving VCO-supplemented milk feeding had statistically significant weight gain compared to those given non-fortified milk (mean difference 5.31, 95% CI: 3.83 to 11.93).</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> Virgin coconut oil is effective in augmenting weight gain among very low birth weight preterm infants.</p><p style="text-align: justify;"><strong>RECOMMENDATIONS:</strong> Small trials were used in this review, and a single multicenter randomized controlled trial would be ideal to further establish these findings.</p>

Effects of structured triglyceride and medium and long chain triglyceride on postoperative efficacies of elderly patients (≥ 70 years old) after total gastrectomy for gastric cancer / 中华消化外科杂志

Objective To investigate the effects of structured triglyceride and long chain triglyceride/medium chain triglyceride (LCT/MCT) on postoperative efficacies of elderly patients (≥70 years old) after total gastrectomy for gastric cancer.Methods The retrospective cohort study was conducted.The clinical data of 42 elderly patients who underwent total gastrectomy for gastric cancer in the Jiangsu Cancer Hospital between Sepember 2014 and September 2015 were collected.Twenty-two patients using structured triglyceride in postoperative parenteral nutrition and 20 using LCT/MCT in postoperative parenteral nutrition were allocated into the case and control groups,respectively.All the patients underwent total gastrectomy + Roux-en-Y esophagojejunostomy.Patients in the case and control groups received respectively 20％ structured triglyceride and 20％ LCT/MCT.Observation indicators:(1) postoperative recovery situation:time of gut exsufflation,changes of body mass at postoperative 5 days,postoperative anastomotic leakage and abdominal infection;(2) test of liver function indexes:aspartate transaminase (AST),alanine transaminase (ALT),total bilirubin (TBil),direct bilirubin (DBil) of liver function in fasting peripheral blood were tested at preoperative day 1 and at postoperative day 1 and 5;(3) test of nutritional indexes:serum total protein (TP),albumin (Alb) and prealbumin in fasting peripheral blood were tested at preoperative day 1 and at postoperative day 1 and 5;(4) test of immunological indexes:levels of IgG and IgA,CD3,CD4 and ratios of CD3/CD8 in fasting peripheral blood were tested at preoperative day 1 and at postoperative day 1 and 5.Measurement data with normal distribution were represented as x ±s.Repeated measures data were evaluated with the repeated measures ANOVA.Count data were analyzed using the chi-square test and Fisher exact probability.Results (1) Postoperative recovery situation:there was no special adverse reaction during support treatment of parenteral nutrition.Time of gut exsufflation,changes of body mass at postoperative 5 days,incidences of postoperative anastomotic leakage and abdominal infection were (46 ± 12)hours,(60±8) kg,0,0 in the case group and (50 ±14) hours,(58±9)kg,0,1 in the control group,respectively,with no statistically significant difference between the 2 groups (t =0.86,0.65,P＞0.05).(2) Test of liver function indexes:levels of AST and ALT from preoperation to postoperative day 5 were respectively from (24±9) U/L to (22±6)U/L,from (31±12)U/L to (20±8)U/L in the case group and from (23±8) U/L to (30± 10) U/L,from (30 ± 9) U/L to (32 ± 7) U/L in the control group,respectively,with statistically significant differences between the 2 groups (F =92.87,87.92,P＜0.05).Levels of TBil and DBil from postoperative day 1 to postoperative day 5 were respectively from (21±4) μmol/L to (19±4) μmol/L,from (7.0±2.0) μmol/L to (6.0±2.0)μmol/L in the case group and from (19±3) μmol/L to (20±4)μmol/L,from (7.0±2.0)μmol/L to (8.0±3.0)μmol/L in the control group,respectively,with no statistically significant difference between the 2 groups (F =1.48,0.81,P ＞ 0.05).(3) Test of nutritional indexes:levels of serum TP and Alb from postoperative day 1 to postoperative day 5 were respectively from (52±6)g/L to (56±5)g/L,from (34±3)g/L to (37±4) g/L in the case group and from (53±7)g/L to (52±4)g/L,from (33±3) g/L to (31± 3)g/L in the control group,respectively,with no statistically significant difference in changing trends between the 2 groups (F=0.47,0.54,P ＞ 0.05).Levels of prealbumin from postoperative day 1 to postoperative day 5 were respectively from (230±32)mg/L to (245±30)mg/L in the case group and from (228±28)mg/L to (222±26) mg/L in the control group,respectively,with a statistically significant difference in changing trend between the 2 groups (F=16.81,P＜0.05).(4) Test of immunological indexes:levels of IgG and IgA,CD3,CD4 and ratios of CD4/CD8 from postoperative day 1 to postoperative day 5 were respectively from (12±4) g/L,(2.20±0.20)g/L,52％±4％,30％±4％,1.30±0.20 to (18±5)g/L,(2.80±0.30)g/L,59％±4％,33％±4％,1.50±0.20 in the case group and from (12±3)g/L,(2.10±0.10)g/L,52％±4％,27％±4％,1.30±0.10 to (13±4)g/L,(2.30±0.20) g/L,51％±4％,26％ ±4％,1.20±0.20 in the control group,respectively,with statistically significant differences in changing trends between the 2 groups (F=25.07,29.42,33.53,22.19,33.47,P＜0.05).Conclusions The short-term usage of structured triglyceride or LCT/MCT in early period after operation can effectively improve postoperative recovery of elderly patients with gastric cancer,with a small impact on liver function.Structured triglyceride can improve immunologic function and nutrition status more effectively.

The effect of medium chain triglyceride on blood lipid and expression of leptin in myocardium of rats fed with high fat diet / 中国中西医结合急救杂志

Objective To investigate the effects of medium-chain triglyceride (MCT) on levels of blood lipids and leptin in myocardium tissue.Methods Thirty-two male Sprague-Dawley (SD) rats aged 4 weeks were divided into control group [n = 8, given normal diet prepared by American Nutrition Society (AIN93)], common high fat diet group [HFD group (n = 16), given 23% lard+ 5% corn oil], MCT group (n = 8, given 23% MCT+ 5% corn oil) by random number table, after 8 weeks of feeding, the HFD group was further randomly subdivided into HFD group fed with diet as before and (HFD+ MCT) group whose diet was replaced bythe diet in MCT group, each subgroup 8 rats, and all the rats continued to be fed for further 8 weeks. The rats' diet intake and the changes of their body weight were observed weekly. After total 16 weeks, the rat tail venous blood was collected, the levels of triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) in serum were measured; The expression of leptin mRNA in rat myocardium was measured by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR), and the contents of leptin in myocardium tissue and serum were measured by enzyme-linked immunosorbent assay (ELISA).Results Compared with the control group, the difference in daily food intake quantity of any one of the high fat diet groups was not statistically significant (allP > 0.05); the final body weight, blood lipid level , the level of leptin mRNA expression in myocardium, contents of leptin in myocardium and serum in the HFD, MCT, and HFD+ MCT groups were all significantly higher, the increase was the most pronounced in the HFD group [body weight (g): 395±13 vs. 326±10, TG (mmol/L): 2.01±0.06 vs. 1.46±0.07, TC (mmol/L): 2.67±0.12 vs. 1.62±0.06, LDL-C (mmol/L): 1.72±0.12 vs. 1.10±0.07, HDL-C (mmol/L): 2.07±0.03 vs. 1.56±0.05, mRNA espression (gray value): 0.357±0.023 vs. 0.202±0.004, leptin in myocardium (pg/mg): 19.30±2.81 vs. 11.50±1.40, leptin in serum (μg/L): 14.63±4.50 vs. 8.21±2.98, allP < 0.05], and the least increase was in the MCT group [respectively was (363±9) g, (1.65±0.07) mmol/L, (2.30±0.06) mmol/L, (1.38±0.05) mmol/L, (1.85±0.04) mmol/L, 0.255±0.005 (gray value), (14.44±1.87) pg/mg, (10.56±2.20)μg/L].Conclusion The high fat diet can significantly increase the body weight, blood lipid level and the contents of leptin in rat myocardium and serum, and MCT can alleviate the above effects of high fat diet to a certain degree, thus it has the potential of cardiovascular protection.

Preparation and evaluation of a phospholipid-based injectable gel for the long term delivery of leuprolide acetaterrh

A phospholipid-based injectable gel was developed for the sustained delivery of leuprolide acetate (LA). The gel system was prepared using biocompatible materials (SPME), including soya phosphatidyl choline (SPC), medium chain triglyceride (MCT) and ethanol. The system displayed a sol state with low viscosity in vitro and underwent in situ gelation in vivo after subcutaneous injection. An in vitro release study was performed using a dialysis setup with different release media containing different percentages of ethanol. The stability of LA in the SPME system was investigated under different temperatures and in the presence of various antioxidants. In vivo studies in male rats were performed to elucidate the pharmacokinetic profiles and pharmacodynamic efficacy. A sustained release of LA for 28 days was observed without obvious initial burst in vivo. The pharmacodynamic study showed that once-a-month injection of LA-loaded SPME (SPME-LA) led to comparable suppression effects on the serum testosterone level as observed in LA solution except for the onset time. These findings demonstrate excellent potential for this novel SPME system as a sustained release delivery system for LA.

Formation mechanism of Pickering emulsions induced by self-assembly of medium chain triglycerides and α-cyclodextrin / 药学学报

In this study, the Pickering emulsions were prepared using medium chain triglycerides (MCT) and α-cyclodextrin (α-CD) and the formation mechanism was studied by means of several physicochemical techniques. The MCT/α-CD microparticles, which stabilized the emulsions, were characterized by the measurement of interfacial tension and the contact angle (θow), powder X ray diffraction (XRD), scanning electron microscope (SEM), high performance liquid chromatography (HPLC), differential interference microscope (DIM), Cryo-scanning electron microscopy (Cryo-SEM). The physical stability of emulsions with different α-CD content in the continuous aqueous phase was investigated by determination of the droplet size and sedimentation rate, combined with the observation of droplet morphologies by the inverted phase contrast microscope. As a result, it was observed that the amphiphilic supramolecule of MCT and α-CD were indeed formed. Furthermore, MCT/α-CD microparticles formed by the aggregation of MCT/α-CD supramolecule absorbed at the oil/water interface, and then forming a membrane structure to stabilize emulsion. In addition, the average θow for the MCT/α-CD microparticles was (46.1±3.4)° which stabilized O/W emulsion. When the content of α-CD was increased in the continuous phase, there were more microparticles formed at the oil/water interface and in the continuous aqueous phase, which resulted in smaller particle size of droplet and higher viscosity of the continuous phase. In summary, the study suggest that α-CD/MCT/water emulsions were of O/W Pickering emulsions and the physical stability was better for emulsions with higher content of α-CD in the continuous phase.

Thermic Effect of Food, Macronutrient Oxidation Rate and Satiety of Medium-chain Triglyceride / 대한지역사회영양학회지

OBJECTIVES: The objective of this study was to evaluate the thermic effects, the macronutrient oxidation rates and the satiety of medium-chain triglycerides (MCT). METHODS: The thermic effects of two meals containing MCT or long-chain triglycerides (LCT) were compared in ten healthy men (mean age 24.4 +/- 2.9 years). Energy content of the meal was 30% of resting metabolic rate of each subject. Metabolic rate and macronutrient oxidation rate were measured before the meals and for 6 hours after the meals by indirect calorimetry. Satiety was estimated by using visual analogue scales (VAS) at 8 times (before the meal and for 6 hours after meal). RESULTS: Total thermic effect of MCT meal (42.8 kcal, 8.0% of energy intake) was significantly higher than that (26.8 kcal, 5.1% of energy intake) of the LCT meal. Mean postprandial oxygen consumption was also significantly different between the two types of meals (MCT meal: 0.29 +/- 0.35 L/min, LCT meal: 0.28 +/- 0.27 L/min). There were no significant differences in total postprandial carbohydrate and fat oxidation rates between the two meals. However, from 30 to 120 minutes after consumption of meals, the fat oxidation rate of MCT meal was significantly higher than that of the LCT meal. Comparison of satiety values (hunger, fullness and appetite) between the two meals showed that MCT meal maintained satiety for a longer time than the LCT meal. CONCLUSIONS: This study showed the possibility that long-term substitution of MCT for LCT would produce weight loss if energy intake remained constant.

Medium-Chain Triglyceride Activated Brown Adipose Tissue and Induced Reduction of Fat Mass in C57BL/6J Mice Fed High-fat Diet / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate activation of brown adipose tissue (BAT) stimulated by medium-chain triglyceride (MCT).</p><p><b>METHODS</b>30 Male C57BL/6J obese mice induced by fed high fat diet (HFD) were divided into 2 groups, and fed another HFD with 2% MCT or long-chain triglyceride (LCT) respectively for 12 weeks. Body weight, blood biochemical variables, interscapular brown fat tissue (IBAT) mass, expressions of mRNA and protein of beta 3-adrenergic receptors (β3-AR), uncoupling protein-1 (UCP1), hormone sensitive lipase (HSL), protein kinase A (PKA), and adipose triglyceride lipase (ATGL) in IBAT were measured.</p><p><b>RESULTS</b>Significant decrease in body weight and body fat mass was observed in MCT group as compared with LCT group (P<0.05) after 12 weeks. Greater increases in IBAT mass was observed in MCT group than in LCT group (P<0.05). Blood TG, TC, LDL-C in MCT group were decreased significantly, meanwhile blood HDL-C, ratio of HDL-C/LDL-C and norepinephrine were increased markedly. Expressions of mRNA and protein of β3-AR, UCP1, PKA, HSL, ATGL in BAT were greater in MCT group than in LCT group (P<0.05).</p><p><b>CONCLUSION</b>Our results suggest that MCT stimulated the activation of BAT, possible via norepinephrine pathway, which might partially contribute to reduction of the body fat mass in obese mice fed high fat diet.</p>

Lipoprotein Lipase Deficiency in an Infant.

Patients with isolated hypertriglyceridemia usually present with recurrent abdominal pain, pancreatitis, eruptive xanthomas, lipemia retinalis and hepatosplenomegaly. We describe the diagnosis and treatment of an infant with severe hypertriglyceridemia. The child was found to be heterozygous for two novel mutations in the lipoprotein lipase gene.

Effects of medium chain triglyceride on insulin resistance in type 2 diabetes mellitus / 中华临床营养杂志

etary oil with MCT can improve insulin resistance.

Spontaneous Chylothorax in Children / 소아알레르기및호흡기학회지

PURPOSE: The purpose of this study was to review the cases of spontaneous chylothorax and its diagnosis, treatment, outcome, and complications. METHODS: We retrospectively reviewed the medical records of 10 patients who were diagnosed as spontaneous chylothorax in Seoul National University Children's Hospital between January 1990 and August 2001. We reviewed demographic data, pleural fluid analysis, treatment modalities, complications, and outcomes. RESULTS: Spontaneous chylothorax was identified in 10 patients including 5 infants with congenital origin. Chylothorax was noted in left(3 cases), right(2 cases) and bilatelly in five cases. Three of five infants with congenital chylothorax were born with hydrops fetalis and two were born prematurely. Pleural fluid laboratory findings were as follows: WBC>1,000/microliter, lymphocytes 92.8+/-9.9%, protein 3.9+/-2.7 g/dL, triglyceride 994+/-825 mg/dL, cholesterol 46.6+/-26.7 mg/dL. All cases were treated initially with a combination of repeated thoracenteses and/or pleural drains, total parenteral nutrition, medium-chain triglyceride based formula or low fat diet. Seven cases responded to conservative treatment. One infant underwent successful thoracic duct ligation. Chylothorax persisted in 2 cases. There was an initial response to steroid treatment in 1 infant who was considered Noonan syndrome, but chylous effusion increased during the tapering of steroid. CONCLUSION: Conservative treatment was successful in 70% of the patients. A precise diagnosis, proper treatment, and prevention and treatment of complications are important in the management of chylothorax. Familiarity with the therapeutic options and appropriate timing for surgical intervention will be required.

Effects of Early Enteral Feeding Containing MCT/LCT on Improving Protein Catabolism of Burned Patients / 中国医师杂志

Objectives To compare the effects of different early enteral nutrition formula on improving metabolic status of burned patients. Methods Thirty cases of burned patients with total burn surface area (TBSA) more than 30% were randomly divided into two groups:⑴Group F, enteral feeding with Fresubin 750MCT containing MCT/LCT as fat source, ⑵Group N, enteral feeding with Nutrison containing only LCT as fat source. All of the thirty patients received isocaloric, isonitrogenous and isolipidic enteral feeding with intragstric tube and enteral feeding pump, within 24h of postburn. Plasma insulin, glucagons, tumor necrosis factor (TNF) and 3-methylhistidine in urine were measured on day 1,4,7and 10 days of postburn. Results The results showed that the patients of group F had an increased blood concentration of insulin and the ratio of insulin/ glucagons, a decreased plasma concentration of TNF, and a reduced excretion of 3-methylhistidine in urine as compared with the patients of group N. Conclusions An enteral compound diet containing MCT/LCT in the early enteral feeding in burned patients can improve the metabolic status of burned patients more effectively.

Effects of early enteral feeding containing medium and long-chain triglyceride on improving protein catabolism of burned patients / 肠外与肠内营养

Obfectives:The purpose of the present study was to compare the effects of different early enteral nutrition formula (containing either MCT/LCT or LCT only) on improving nutritional status of burned patients. Methods:This was a prospective,randomized,single blind and controlled study.Thirty cases of burned patients injured by varous causes with total burn surface area (TBSA) more than 30% were collected and randomized into two groups:①Group F:enteral feeding with Fresubin 750 MCT containing MCT/LCT as fat source,②Group N:enteral feeding with Nutrison,containing only LCT as fat source.All of the thirty patients received isocaloric,isonitrogenous,and isolipidic enteral feeding,with intragastric tube and enteral feeding pump,started within 24 h postburn.The several parameters were observed on postburn day(PBD) 1,4,7 and 10,such as serum concentrations of transferrin and prealbumin and plasma concentrations of prostaglandin E 2(PGE 2) and insulin.Nitrogen in urine per day and excretion of 3 methylhistidine in urine on day 1,7 and 10 postburn were determined. Results:The results showed that the patients of F group had an increased blood concentration of transferrin,prealbumin and insulin,and a decreased plasma concentration of PGE 2.Excretion of nitrogen and 3 methylhistidine in urine was also markedly reduced in patients fed with nutrients containing MCT/LCT compared with LCT. Conclusions :We have shown that an enteral diet containing MCT/LCT can improve the nutrition status of burned patients more effectively.