Open AccessA Comparison of Medium-Chain and Long-Chain Triglycerides in Surgical Patients
Author(s) -
Zhu-Ming Jiang,
Shiyuan Zhang,
Xiurong Wang,
Nai-fa Yang,
Yu Zhu,
Douglas W. Wilmore
Publication year - 1993
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-199302000-00012
Subject(s) - medicine , medium chain triglyceride , triglyceride , nitrogen balance , ketone bodies , parenteral nutrition , fat emulsion , emulsion , soybean oil , metabolism , endocrinology , surgery , biochemistry , cholesterol , nitrogen , chemistry , organic chemistry , pathology
Available lipid emulsions made from soybean or safflower oil are classified as long-chain triglycerides (LCT). In contrast, medium-chain triglyceride (MCT) emulsions have different physical properties and are metabolized by other biochemical pathways. To compare the differences between these two fat emulsions, the authors studied 12 surgical patients and 6 volunteers. These subjects were randomly assigned to receive parenteral nutrition with MCT or LCT emulsion. Measurement of arterial and venous concentration differences across the forearm demonstrated that muscle utilization was significantly improved with MCT administration. There was also a trend toward improved nitrogen balance in the MCT group, and less weight loss in the postoperative period also was observed in this group. During the fat clearance test, the serum ketone concentrations were significantly higher in the MCT than the LCT group. The improvement in nitrogen retention may be associated with increasing ketone and insulin levels. Fat emulsions containing 50% MCT are safe for use in parenteral nutrition and may provide an alternate fuel that improves protein metabolism.