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P.39

KINETIC CHHRACTERIZMTION OF n FAT EMULSION CONTRININQ LONO-CHRIN nND NEDIUH-CHnIN TRISLYCERIDES. ternal Medicinm, Medical

~.Jul~;d~A~e;;;;rdt (Department of In- Aca emu

He studied the elimination kinetics of Lipofundin= MCT 10 %, con- taining 50 % of its fat as medium-chain triglycerides (MCT), in uounq healthy persons (9 males, 9 females). Both an intrauenous fat toloran- oe test CIVFTT; 0.1 2 fat/kg) and a six-hours lasting infusion (0.1 u fat/kglhour) were performed in the same probands. For comparison, in these probands an IVFTT with Lipofundin n S 10 % tonlu long-chain trigluoerides - LCT) has been carried out.

Fractional elimination rates k P for Lipofundin= MCT 10 % were 7.29 + 2.73 %/min for males and 11.59 + 3.38 x/min for females. kn- ualues for LipofunditF 8 10 % were higher, showed the same sex dif- ference and were signifioantlu oorrelated with those of the flCT-oon- taininu emulsion. Evidently, both the type of fat used and the emulsi- fier (MCT-emulsion: egg phospholipid; LCT-emulsion: soya phosphatide) influence the elimination uelocitu.

During the infusion tests, light scattering intensity reaohes maximum levels after one hour and thereafter decreases continuously. Trigluoe- ride conoentrations slowly increase till 2-3 hours and then sliplhtlU decrease. The mean levels were below 2.5 mmol/l, the highest OonGen- tration euer obserued in one male proband amounted to 2.98 mmol/l. f1f- ter the end of the infusion triglycerides went dowr and reaohed ini- tial ualues after two hours. There was a significant correlation be- tween k=-Values of the IVFTT and the increments of trigluoerides du- ring the infusion.

The fast elimination of LipofundiW HCT 10 X has also been dooumen- ted by measuring free fatty acids, beta-hydroxybuturate, and gluoerol. In oonolusion, our results do not point to a siunificant accumulation of the fat emulsion tested.

CLEARANCE RATES OF MCT-AND LCT-EMULSIONS IN DIABETICS

M.Wicklmayr,K.Rett,C.Mickan,B.Schwiegelshohn,G.Dietze,H.Mehnert (IIIrd Med.Dept.Krankenhaus Schwabing und Forschergruppe Diabetes)

MCT-emulsions have been successfully used in parenteral nutrition for several years. There are no negative side effects as compared to con- ventional LCT-emufsions,in contrast,the oxidation- and clearance-rates of MCT were shown to be higher than those of LCT. However, the clinical relevance of this finding is questionable, since TG-levels during par- enteral nutrition are quite similar with MCT and LCT. Therefore,the present study was performed in order to evaluate whether MCT may have some ad- vantage in cases of slightly disturbed lipid metabolism. 7 moderately overweiht non insulin dependent diabetics(D,age 61.3f3.Oyea-sj weight 72.5'2.9 kg;height 167.8*2.3 cm) who were under poor metabolic control(fasting blood glucose 8.3850.65 mM,TG 2,1*0.3 mM) received in random order at two different days an intravenous infusion of a 10% MCT/ LCT- or a 10% LCT-emulsion,respectively for 3 hnurs(O.i5g/kgBW*h.Venous blood samples were taken twice during a basal period,every hour during the lipid infusion and l5,30,45,60 and 90 min.after it was stopped.As control, the same experiment was performed in 5 healthy,young volunteers (C). As expected,due to the different molecular weight TG-levels were higher after 3 hours of ~CT(C:3.6*O.g,D:6.9*0.8 mM) as compared to LCT(C:2.4*0.4,D:5.7 *0.5 mM).Plotted semilogarithmically,TG-levels decreased in a mono- exponential way after the infusion was stopped.Half life value was longer in diabetics as cmmpared to controls and in both groups in every subject longer with LCT compared to MCT(D:MCT 70.7f5.6,LCT 103.7'6.1;C:MCT 43.oi1.2, LCT 68.2t3.8 min). The data suggest that MCT-emulsions should be preferred in patients with disturbed carbohydrate and lipid metabolism,if parenteral nutrition with fat is necessary.

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