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Intravenous intralipid 10% vs. 20%, hyperlipidemia, and increase in lipoprotein X in humans

Nutrition 8(3): 155-160

Intravenous intralipid 10% vs. 20%, hyperlipidemia, and increase in lipoprotein X in humans

To clarify mechanisms of hyperlipidaemia caused by infusion of Intralipid 10%, lipoprotein metabolism during intravenous Intralipid 10 and Intralipid 20% (which contains half the amount of egg yolk lecithin for the same content of triacylglycerol as Intralipid 10%) was compared. 10 patients (7 men, 3 women, 56.6+or-8.8 years old) receiving Intralipid 10% 20 ml/kg daily and 10 (8 men, 2 women; 52.8+or-15.1 years old) receiving Intralipid 20% 10 ml/kg daily were fed exclusively by total parenteral nutrition (TPN) providing amino acid 1.1 g and 30 kcal/kg daily for 4-6 weeks. Intravenous Intralipid 10% caused a marked increase in low-density lipoprotein (LDL), and increases in phospholipid and cholesterol, especially free cholesterol. The progressive increase in lipoprotein X (LpX) was in proportion with that of LDL or total lipid, whereas no increase in lipids, LDL, or LpX was observed during intravenous Intralipid 20%. A significant increase in apolipoproteins CIII and E with Intralipid 10% also caused a rise in LpX. With Intralipid 20%, however, alterations in apolipoproteins were not observed. Lecithin:cholesterol acyltransferase (LCAT) activity was significantly elevated with Intralipid 10 but not 20%. Disappearance of LpX after cessation of Intralipid 10% was relatively rapid, and the half-life was 24-60 h. From the findings, hyperlipidaemia with Intralipid 10% was caused almost exclusively by the increase in LpX. The excess lecithin may be responsible for the formation of an increase in LpX. It was observed that Intralipid 20% could be safely used without inducing hyperlipidaemia.

Accession: 002416304

PMID: 1525430

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