Balık Yağı İçeren veya Zeytinyağından Zengin Parenteral Lipid Emülsiyonu Alan Prematüre Yenidoğanların Karaciğer Fonksiyon Testlerinin Değerlendirilmesi

Abstract

Amaç: Çalışmada balık yağı içeren veya zeytinyağından zengin lipid parenteral emülsiyonu alan çok düşük doğum ağırlıklı prematüre yenidoğanların karaciğer fonksiyon testleri, kolesterol ve trigliserit düzeylerinin incelenmesi amaçlandı.Gereç ve Yöntemler: Bu retrospektif çalışma Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi yenidoğan yoğun bakım ünitesinde yapıldı. 01.01.2015 – 31.12.2015 tarihleri arasında hastanemizde doğan, gestasyon haftası 25 – 32 hafta ve doğum ağırlığı 1500 gr’dan küçük olan prematüre yenidoğanların dosyaları incelendi. On gün ve daha fazla parenteral nütrisyon alan ve postnatal 28. gününde yaşayan olgular çalışmaya alındı. Olgular almış oldukları parenteral lipid emülsiyonuna göre (balık yağı içeren; SMOFlipid®, zeytinyağından zengin; ClinOleic®) iki gruba ayrıldı. Üçüncü hafta içerisindeki alanın aminotransferaz, aspartat aminotransferaz, total ve direkt bilirubin, protein, albümin, kalsiyum, fosfor, alkalen fosfataz, kolesterol ve trigliserit düzeyleri kaydedildi ve lipid emülsiyonu türüne göre karşılaştırıldı. Sonuçlar n (%) ve ortanca (çeyrekler arası aralık) olarak sunuldu.Bulgular: Çalışma grubunu 76 prematüre yenidoğan oluşturdu (SMOFlipid grubu: 37 olgu ve ClinOleic grubu: 39 olgu). İki gruptaki olguların gestasyon haftası [hafta; SMOFlipid grubu: 28 (27 – 30), ClinOleic grubu: 28 (27 – 29); p=0.477] ve doğum ağırlığı [gram; SMOFlipid grubu: 1080 (840 – 1290), ClinOleic grubu: 850 (1000 – 1230); p=0.454] benzer idi. Parenteral nütrisyon tedavisi süresi iki grupta farklı saptanmadı [gün; SMOFlipid grubu: 11 (10 – 14), ClinOleic grubu: 12 (10 – 19); p=0.217]. Serum alanin aminotransferaz [U/L; SMOFlipid grubu: 9 (7 – 11), ClinOleic grubu: 10 (7 – 12); p=0.742] ve aspartat aminotransferaz [U/L; SMOFlipid grubu: 24 (18 – 28), ClinOleic grubu: 25 (20 – 31); p=0.365] dahil olmak üzere karaciğer fonksiyon testleri, kolesterol ve trigliserit düzeyleri iki grupta benzer bulundu. Kolestaz SMOFlipid grubunda bir olguda (%3) ve ClinOleic grubunda üç olguda (%8) gelişti, p: 0.330.Sonuç: Bu çalışmada prematüre yenidoğanların parenteral nütrisyon tedavisinde balık yağı içeren veya zeytinyağından zengin lipid emülsiyonların kullanılmasının karaciğer fonksiyon testlerini farklı etkilemedikleri saptandı.

Keywords

• İntavenöz lipid emülsiyonu, Karaciğer fonksiyon testi, Omega-3 yağ asiti, Parenteral beslenme, Prematüre yenidoğan

Evaluation of Liver Function Tests in Preterm Infants Receiving Parenteral Lipid Emulsions Based on Fish Oil or Olive Oil

Abstract

Objective: We aimed to compare the serum liver function tests, cholesterol and triglyceride levels in preterm infants receiving parenteral lipid emulsions based on fish oil or olive oil.Material and Methods: This retrospective study was performed at Etlik Zübeyde Hanım Women’s Health Training Hospital, Ankara. We reviewed charts of inborn infants, with a gestational age between 25 and 32 weeks and birth weight <1500 grams, who were admitted to the neonatal intensive care unit between 01.01.2015 and 31.12.2015. Infants who received parenteral nutrition ≥ 10 days and were alive on the 28th day were included and grouped regarding the type of lipid emulsion (fish-oil; SMOFlipid®, olive oil; ClinOleic®). The levels of serum alanine transaminase, aspartate transaminase, total and direct bilirubin, protein, albumin, calcium, phosphorus, alkaline phosphatase, cholesterol, and triglyceride at the third postnatal week were recorded and compared between the groups. Results are presented as n (%) and median (interquartile range) where appropriate.Results: 76 preterm neonates (SMOFlipid group: n=37 and ClinOleic group: n=39) were included. The gestational age [weeks; SMOFlipid group: 28 (27–30), ClinOleic group: 28 (27–29); p=0.477] and birth weight [gram; SMOFlipid group: 1080 (840–1290), ClinOleic group: 850 (1000–1230); p:0.454] were similar in the groups. The duration of parenteral nutrition was comparable [days; SMOFlipid group: 11 (10–14), ClinOleicgroup: 12 (10–19); p=0.217]. The serum alanine transaminase [U/L; SMOFlipid group: 9 (7–11), ClinOleic group: 10 (7–12); p=0.742] and aspartate transaminase [U/L; SMOFlipid group: 24 (18–28), ClinOleic group: 25 (20–31); p=0.365] as well as other biochemical tests were similar between two groups. Cholestasis occurred in four infants [ClinOleic group: 3 (8%), SMOFlipid group: 1 (3%), p=0.330].Conclusion: It was demonstrated that liver function tests and levels of cholesterol and triglyceride were not affected in infants who had received parenteral lipid emulsions based on fish oil or olive oil

Keywords

• Intravenous fat emulsion, Liver Function Tests, Omega-3 fatty acids, Parenteral nutrition, Premature infants

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