不同浓度的脂肪乳剂对血脂代谢影响的研究

为观察３０％Ｉｎｔｒａｌｉｐｉｄ与２０％Ｉｎｔｒａｌｉｐｉｄ两种脂肪乳剂对血脂代谢的影响。作者以４０例外科非应激与无代谢异常患者为对象，随机分为３０％组与２０％组，分别经外周静脉给予等热量的３０％Ｉｎｔｒａｌｉｐｉｄ及２０％Ｉｎｔｒａｌｉｐｉｄ，连续使用３天。于实验前后检测外周静脉血甘油三酯、总胆固醇、异常脂蛋白及载脂蛋白的变化。结果显示：两组研究前后血甘油三酯水平均无明显变化。２０％组血胆固醇、异常脂蛋白及载脂蛋白Ｂ水平于输注后显著升高，而３０％组则略有下降。作者认为，决定脂肪乳剂影响血脂代谢的因素并不是其甘油三酯含量而是其磷脂／甘油三酯含量比。选择具有较低磷脂／甘油三酯比的脂肪乳剂对减少高脂血症的发生有重要意义。     

中长链脂肪乳和长链脂肪乳对肝脏外科病人术后的影响

目的：观察两种没碳链脂肪乳剂地肝脏外科病人术后自然病程的影响。方法：直脏外科病人２５例，随机分为两组，长链脂肪乳剂组和中／长链脂肪乳剂组。ＬＣＴ组脂肪乳剂为２０％Ｉｎｔｒａｌｉｐｉｄ，ＭＣＴ组为２０％Ｌｉｐｏｆｕｎｄｉｎ连续观察１周。在术前、术后１、４、７天测定肝功能、血脂、血及尿液中肉毒碱（ＣＮＴ）以及激素的变化，结果：两组对肝脏酶学无明显影响；胆红素在ＰＯＤＩ明显升高，但ＣＭＴ组随后显著下降，     

中,长链脂肪乳剂对肝硬变门脉高压术后脂蛋白,肝功能及胆红素代谢 …

选择肝硬变门脉高压病人１５例，随机分为两组：长链脂肪乳剂组（ｎ＝８，简称ＬＣＴ组），中／长链脂肪乳剂组（ｎ＝７，简称ＭＣＴ组）。两组供氮每天每千克体重０．１５￣０．２ｇ，非蛋白质热卡为每天每千克体重２０￣２５ｋｃｌ。ＬＣＴ组脂肪能源由２０％－Ｉｎｔｒａｌｉｐｉｄ提供，ＭＣＴ组由２０％－Ｌｉｐｏｆｕｎｄｉｎ ＭＣＴ／ＬＣＴ提供。糖脂供能比为２：１。在术前、术后１、４、７天，测定肝、肾功能及胆红素血脂     

中、长链脂肪乳剂对肝硬变门脉高压手术前后脂肪廓清的影响

选择肝硬变门脉高压病人１５例,随机分为两组：长链肪乳剂组,中／长链脂肪乳剂组。ＬＣＴ旨肪有源由２０％－Ｉｎｔｒａｌｉｐｉｄ提供,ＭＣＴ组由２０％－ＬｉｐｏｆｕｎｄｉｎＭＣＴ／ＬＣＴ组成,糖脂供热比为２：１,全部营养素配制成全营养混合液（ＴＮＡ）,连续观察１周,在术前、术后１天、７天作脂肪廓清试验（ＶＦＴＴ）。经高效液相色谱ＨＰＬＣ）测定注射后５、３０、６０及９０分钟时亚油酸、亚麻酸、辛酸及癸酸的含     

不同碳链脂肪乳剂对肝脏外科患者脂肪及肝脏能量代谢的影响

目的 观察两种不同碳链脂肪乳剂对肝脏外科患者术后脂肪及肝脏能量代谢的影响。方法 选择肝脏外科患者25例,随机分为2组;给予肠外营养,长链脂肪乳剂组（LCT组）12例,中／长链脂肪乳剂组（MCT组）13例。LCT组脂肪乳剂为20％英脱利匹特（Intralipid),MCT组为２０％为保肪宁（Lipofundin),连续观察１周。在术前,术后１d、7d作脂肪廓清实验（IVFTT）,并测定血及尿液中肉毒碱（CNT）以及动脉血酮体浓度及比率（AKBR）的变化。结果 MCT组清除率为LCT组的1倍,半衰期为LCT组的1／2;术后血CNT明显升高,尿排出减少,术后7d时,LCT组血CNT高于NCT组,尿CNT低于MCT组,P＜0．05;血AKBR术后1d明显下降,随后MCT组逐渐回升,在术后7d时,MCT组明显高于LCT组,P＜0．01。结论 MCT组体内清除迅速,对CNT依赖较小,并对肝脏能量代谢有保护作用。提示MCT乳剂可能是肝脏外科患者更为理想的脂肪能源。     

胆道术后并发急性肾衰的营养治疗(附7例报告)

报告７例胆道术后并发急性肾衰（ＡＲＦ）、氮质血症病人实施肠外营养（ＰＮ）治疗的体会。全组病例均用含８种必需氨基酸（ＥＡＡ）的肾安，７％Ｖａｍｉｎ和氨复命等提供氮源，并以２０％和１０％Ｉｎｔｒａｌｉｐｉｄ及适量葡萄糖作为主要能源，按“全合一”营养混和液行ＰＮ治疗，疗效满意。作者认为：①针对不同原因ＡＲＦ的ＰＮ治疗，应供给足够能量和较最小需要量稍高的ＥＡＡ，使体内潴留的尿素氮转而用于合成非必需氨基酸（ＮＥＡＡ），进而再被用于合成蛋白质，以减少蛋白质分解，降低氮质血症；②ＡＲＦ时，在有限的输液量中，２０％Ｉｎｔｒａｌｉｐｉｄ不失为一种低容量、高热卡的有效制剂，应予推崇。     

脂肪乳剂建立大鼠高脂血症模型的研究

目的 用两种不同浓度脂肪乳剂按灌胃法建立大鼠高脂血症模型,并对其血脂水平进行评价,为建立合适的高脂血症动物模型提供依据.方法 将30只150～180 g健康雄性SD大鼠随机分为正常对照组、低浓度脂肪乳剂组及高浓度脂肪乳剂组,每组10只.分别饲以基础饲料、低浓度配方脂肪乳剂(20％猪油、6％胆固醇、0.2％丙基硫氧嘧啶、2％胆酸钠及10％吐温-80)及高浓度配方脂肪乳剂(30％猪油、10％胆固醇、1％丙基硫氧嘧啶、5％胆酸钠及20％吐温-80).2周后处死大鼠,测定血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)水平.结果 高浓度脂肪乳剂组血清TC、TG、HDL-C及LDL-C水平与正常对照组及低浓度脂肪乳剂组比较均升高(P＜0.05),低浓度脂肪乳剂组血清TC、TG及HDL-C水平与正常对照组比较差异无统计学意义(P＞0.05).结论 高浓度脂肪乳剂可以成功建立SD大鼠高脂血症模型,低浓度脂肪乳剂不适合用于建立SD大鼠高脂血症模型.     

术后输注不同浓度脂肪乳剂对脂代谢影响的临床研究

目的:前瞻性研究术后短期应用不含脂肪乳剂的肠外营养(PN)和含10%及20%Intralipid的PN对行中等以上普外科手术患者血脂代谢的影响.方法:53例患者随机分成对照组、10%Intralipid组及20%Intralipid组,术后均接受5天静脉PN支持.结果:术后10%组血总胆固醇(Tcho)及低密度脂蛋白胆固醇(LDL-ch)明显高于20%组及对照组,增加的胆固醇以游离胆固醇(Fcho)为主,异常脂蛋白(LPX)及磷脂也均高于20%组及对照组,相关性分析发现血磷脂与LPX、Tcho密切相关.结论:脂肪乳剂中磷脂/甘油三脂(PL/TG)比值过高所产生的过剩磷脂是导致术后短期PN血Tcho蓄积的主要原因,其中LPX的形成起了重要的作用.与10%Intralipid相比,20%Intralipid对机体脂代谢影响较小,更适合于临床使用     

中长链混合脂肪乳剂对梗阻性黄疸患者肝脏及脂代谢的影响

作者将恶性梗阻性黄疸患者１３例，随机分为长链脂肪乳（ＬＣＴ，Ａ组）和中长链脂肪乳（ＭＣＴ／ＬＣＴ，Ｂ组）两组，围手术期给予不同脂肪乳剂（ＬＣＴ、ＭＣＴ／ＬＣＴ）的营养支持（ＰＮ）１０日。结果显示：ＭＣＴ组术后及ＰＮ期间血ＣＨ、ＴＧ及ＬＤＬ逐渐下降，ＨＤＬ升高，Ｐ＜０．０５。两组血胆红素于引流术后明显下降，ＩＢｉｌ在ＭＣＴ组下降更为明显，术后６天已达正常，且与ＬＣＴ组比较Ｐ＜０．０１。两组血糖、肝酶、血浆蛋白与氮平衡变化趋势相同，手术前、后合并血糖升高，需补充适量胰岛素；引流后肝酶逐渐下降，ＰＡＢ、ＴＲＦ于ＰＮ期间逐渐升高，术后负氮平衡于术后４天后得到纠正。结论：梗阻性黄疸引流术后双能源ＰＮ支持１０日，含ＭＣＴ脂肪乳剂对血脂代谢及胆红素生成影响更小，并达到与ＬＣＴ同样的节氮效应。     

中,长链脂肪乳剂对肝 硬变家兔胆红素代谢及肝功能的影响

目的：研究长链脂肪乳剂和中长／链混合脂肪乳剂二种不同肠外营养液支持下，观察血中游离脂肪酸浓度变化对胆红素和肝功能的影响。方法：２１只新西兰大 白哆经结扎胆总管制成胆源性肝硬化动物模型，随机分为三组：正常对照组（ｎ＝６）；肝硬化肠外营养ＰＮ－ＬＣＴ组（ｎ＝１０）；肝硬化肠外营养ＰＮ－ＭＣＴ／ＬＣＴ组（ｎ＝１１），两组的ＰＮ液所含热量及氮量均相等。在ＰＮ的第１、７天，用高效液相色谱（ＨＰＬＣ）测定ＰＮ     

The lowering effect of probucol on plasma lipoprotein and proteinuria in puromycin aminonucleoside-induced nephrotic rats

Hyperlipidemia associated with nephrotic syndrome was treated with probucol and the changes in plasma lipoprotein lipid concentration and urinary protein excretion were examined in puromycin aminonucleoside-induced nephrotic rats. Rats made nephrotic exhibited severe hyperlipidemia with increases in all major lipoprotein fractions. Probucol treatment of nephrotic rats significantly lowered plasma triglyceride (TG), cholesterol (Ch) phospholipid (PL) and apoprotein B associated with very-low-density and low-density lipoprotein and Ch and PL in high-density lipoprotein (HDL). Malondialdehyde (MDA) associated with the lipoproteins was significantly elevated in nephrotic rats and probucol treatment also lowered MDA concentration in all major lipoproteins. In control rats probucol moderately, but significantly, reduced plasma TG and HDL-Ch concentrations. Proteinuria associated with nephrosis was decreased significantly by treatment with probucol. Probucol treatment did not affect blood urea nitrogen and plasma creatinine levels. A significant positive correlation existed between the amount of protein excreted in urine and the plasma lipid concentrations in all nephrotic rats, suggesting that the hypolipidemic effect of probucol may attenuate proteinuria associated with nephrosis. These results suggest that probucol may be a favorable treatment for hyperlipidemia associated with nephrotic syndrome.     

Nonalcoholic fatty gallbladder disease: The influence of diet in lean and obese mice

The obesity epidemic has contributed to an increased prevalence of gallstones and a higher percentage of chronic acalculous cholecystitis. Obesity is associated with Type II diabetes and hyperlipidemia in murine models. In addition, we have previously demonstrated that serum glucose, insulin, cholesterol, and triglycerides correlated with gallbladder contractility in murine models. However, the relative role of in sulin resistance and gallbladder fat infiltration in this phenomenon remain unclear. Therefore, we tested the hypothesis that gallbladder wall lipids are related to obesity and diet and are inversely correlated with gallbladder contractility. One hundred lean control (C7BL/6J) and 36 obese leptin-deficient (Lep^ob) 8-week-old female mice were fed either a chow diet or a 1.0% cholesterol, 15% butterfat (high-lipid) diet for four weeks. Pooled gallbladders were then analyzed for free fatty acids (FFA), phospholipids (PL), total cholesterol (TC), and triglycerides (TG). Cholesterol/phospholipid ratios were then calculated. The Lepob mice fed a chow diet had significantly higher (P<0.01) gallbladder lipids than the three other groups. The lean mice that were fed a high-lipid diet had increased (P<0.05) gallbladder TC compared to the lean mice on a chow diet. In addition, the cholesterol/phospholipid ratio was significantly in creased (P<0.01) in the lean mice fed a high-lipid diet compared to the other three groups. Finally, the high-lipid diet decreased gallbladder FFA (P<0.01), PL (P=0.08), and TC (P<0.05) in Lep^ob mice. These data suggest that (1) obese mice have increased gallbladder lipids; (2) a high-cholesterol, high-fat diet increases gallbladder lipids and the cholesterol/phospholipid ratio in lean mice; but (3) de creases gallbladder fatty acids, phospholipids, and cholesterol in obese mice. Prior studies have docu mented similarly decreased gallbladder response to neurotransmitters in obese mice on a chow diet, as well as lean and obese mice on a high-lipid diet. Therefore, we conclude that leptin-deficient obesity and/or a high-fat diet causes nonalcoholic fatty gallbladder disease, which is manifested by diminished gallbladder contractility. Presented at the 2005 American Hepato-Pancreato-Biliary Association Congress, Hollywood, Florida, April 14–17, 2005. Supported by NIH grant R-01 DK44279.     

Effect of intravenous administration of fat emulsion to depancreatized dogs

Sixteen mongrel dogs were depancreatized and controlled with intravenous hyperalimentation that included fat emulsion (Intralipid) for four weeks. Plasma lipids, fat tolerance test, PHLA, and presence of fatty liver were investigated. Dogs were divided into three groups (A, B, and C) for the purpose of studying the effect of fat emulsion. Groups A(n = 6) and B(n = 5) were given fat emulsion 1g/kg/day and 2g/kg/day respectively. Group C(n = 5) was not given fat emulsion. Group B had increased plasma total cholesterol and phospholipid. Group A had a slight increase of TG only. Group C had decreased plasma total cholesterol and phospholipid, and became hypoglycemic sometimes. The ability to clear fat emulsion expressed as (K2) decreased significantly after the 14th day in group B only. LPL, determined by the PHLA test in groups B and C only, did not change significantly. It seemed that fat emulsion was utilized in part as FFA and ketone bodies. Infusion of fat emulsion did not lead to fatty liver when insulin was administered continuously. For the depancreatized condition, it appeared that fat emulsion could be useful when blood sugar was controlled with insulin.     

Treatment of nephrotic hyperlipoproteinemia with gemfibrozil

Hypercholesterolemia is a known complication of the nephrotic syndrome. Patients with persistent proteinuria and prolonged hypercholesterolemia are probably at increased risk for cardiovascular disease. Until recently there has been no safe and effective treatment for this disorder. The effects of gemfibrozil on plasma lipids and lipoproteins in hypercholesterolemic patients with the nephrotic syndrome were therefore studied. Eleven patients with the nephrotic syndrome were studied in a randomized, double-blind placebo-controlled trial with six-week treatment periods. Gemfibrozil 600 mg or placebo was administered twice a day. There was a third unblinded period in which seven patients received gemfibrozil plus the bile acid-binding resin, colestipol, 10 grams twice a day. Gemfibrozil treatment produced a marked reduction in plasma triglyceride (51%, P = 0.001) and a 15% decrease in plasma total cholesterol (P = 0.003). Low density lipoprotein cholesterol decreased 13% (P greater than 0.05), high density lipoprotein cholesterol increased 18% (P = 0.006) and the ratio of low density lipoprotein to high density lipoprotein cholesterol fell 26% (P = 0.01). Apolipoprotein A-l was unchanged while apolipoprotein B decreased 26% (P = 0.006). Four patients were unable to complete period 3 because of gastrointestinal symptoms. The remaining patients had further improvement in plasma lipids and lipoproteins with the combined therapy: total cholesterol further decreased 26%, triglycerides decreased 17%, low-density lipoprotein cholesterol decreased 36%, high-density lipoprotein to high-density lipoprotein cholesterol fell 33%. Gemfibrozil improved lipid and lipoprotein cardiovascular risk factors without major toxicity. Persistent elevations in total plasma and low-density lipoprotein cholesterol during gemfibrozil treatment, however, indicate the need for individualized drug therapy.     

Fat metabolism during total parenteral nutrition: a biochemical and ultra-structural study

Background : Before the introduction of Intralipid in 1961, the incidence of adverse reactions to intravenous fat emulsions was quite common. Concurrent with hyperlipidaemia, multiple organ dysfunction could occur, but the most prominent symptoms were high fever and anaemia, and the reaction was called “the fat overloading syndrome”. Although the reports are quite rare today the reaction does still appear, and we have observed that some patients develop severe fever during or after incidental retention of exogenous fat in the blood during total parenteral nutrition (TPN). The pathophysiological background to these adverse reactions, as well as the final destiny and the effects of the retained exogenous fat particles, are largely unknown. These questions initiated the present study, which focuses on two factors of importance for the clearance of infused fat from the circulation: the lipoprotein lipase (LPL) system and the reticluloendo-thelial system. Methods : An introductory analysis of the clinical course of a head-injured patient suffering from fat intolerance during TPN implied that observed adverse reactions could be due to influence on macrophages by retained exogenous fat particles. Results : During infusion of lipid emulsions, cholesterol and phospholipids accumulated in non-high-density lipoproteins, while high-density lipoproteins were enriched in triglycerides. Triglycerides also accumulated in hepatic tissue, and the activity of hepatic lipase decreased. Although lipoprotein lipase activity in the heart was up-regulated and serum levels of triglycerides were normal, suggesting that the total elimination rate of triglycerides was not impaired, ultra-structural investigations indicated that Kupffer cells were involved in clearing exogenous lipids from the blood during the infusion of long-chain triglycerides. Furthermore, the Kupffer cells were activated, according to morphological criteria. When high doses of fat were given intravenously, the Kupffer cells were grossly distended by fat vacuoles, and serum levels of lactate dehydrogenase increased. During treatment with fat emulsions containing medium-chain triglycerides and long-chain triglycerides in equal amounts, the alterations in lipid transport were less pronounced, and signs of Kupffer cell activation were weaker than during infusion with long-chain triglycerides only. Conclusion : The experimental studies showed that infusion of exogenous fat particles interfered with the regulation of lipid transport, and there were signs of increased demands on various aspects of lipid metabolism. Although the capacity of the LPL was sufficient in most situations in healthy rats, the Kupffer cells seemed to be involved in the clearance of exogenous lipids. The present investigations identified one factor, LCT fat emulsion, which was necessary for the appearance of fat vacuoles in the Kupffer cells during TPN. To some extent, the experimental findings may be related to clinical observations of a head-injured patient who developed signs of acute, severe macrophage activation with haemophago-cytosis during and after accumulation of exogenous fat in the blood after treatment with intravenous fat emulsions. The condition was considered to be a consequence of impaired lipid elimination and altered macrophage function during clearance of fat from the blood, a consideration supported by the morphological changes of rat Kupffer cells after TPN in the present study.     

脂蛋白脂酶,肝脂酶及载脂蛋白在兔胆囊结石中的变化及作用

目的研究脂蛋白脂酶,肝脂酶及载脂蛋白在兔胆囊结石中的变化及作用。方法采用日本杂交大耳兔５０只,随机分为对照组,１周组、２周组、３周组和４周组为实验组,实验组饲以１．２％高胆固醇膳食诱以胆囊结石,测定各组脂蛋白脂酶、肝脂酶、血清载脂蛋白和脂质的动态变化,脂蛋白脂酶和肝脂酶采用比色法测定,血清载脂蛋白采用圆周免疫扩散法测定,血清脂质采用酶法测定。结果随着高胆固醇膳食进食时间延长,２周组、３周组和４周组分别有４／１０,６／１０和７／１０只动物出现胆囊结石;肝素化血清中脂蛋白脂酶和肝脂酶活性增加,以３周组和４周组升高明显（与对照组比较,Ｐ＜０．０５）;血清载脂蛋白ａｐｏＢ１００,ａｐｏＣⅡ,ａｐｏＣⅢ明显增加（与对照组比较,Ｐ＜０．０５）,ａｐｏＡＩ在４周组时降低（与对照组比较,Ｐ＜０．０５）;血清总胆固醇,甘油三酯,磷脂,低密度脂蛋白胆固醇和极低密度脂蛋白胆固醇逐渐明显升高（与对照组比较Ｐ＜０．０５）,高密度脂蛋白胆固醇及其亚组份有降低趋势,但与对照组比较差异无显著性（Ｐ＜０．０５）。结论高胆固醇膳食后,脂蛋白脂酶和肝脂酶活性增强,血清载脂蛋白和酯质代谢异常变化,促进了胆囊结石形成。     

Effects of omega-3 fish oils on plasma lipids, lipoprotein composition, and postheparin lipoprotein lipase in women with IDDM

Because the apparent reduction in cardiovascular risk noted in nondiabetic populations that ingest diets rich in marine lipids containing omega-3 fatty acids is believed to result in part from their capacity to modify the composition and physicochemical behavior of lipoproteins, we sought to determine whether dietary supplementation with marine lipids might favorably affect lipoprotein composition in insulin-dependent diabetes mellitus (IDDM). Eight normolipidemic IDDM women (mean +/- SD age 29.8 +/- 4.7 yr) were studied before and 3 mo after receiving a marine-lipid concentrate (Super-EPA) containing 6 g omega-3 fatty acids and a total of 12 mg of cholesterol daily. Weight, insulin requirements, and glycosylated hemoglobin remained stable. After treatment, mean +/- SD plasma triglyceride (TG) levels fell (before, 81.7 +/- 22 mg/dl; after, 69.19 +/- 17; P less than 0.025). High-density lipoprotein2 (HDL2) cholesterol (before, 10.98 +/- 5.45 mg/dl; after, 18.43 +/- 7.93; P less than 0.01), its major apolipoprotein A-I (apoAI), and the major phospholipids (sphingomyelin and lecithin) all rose significantly. ApoB and plasma and low-density lipoprotein cholesterol levels and HDL3 composition were unchanged. Postheparin hepatic and lipoprotein lipase activities were unaffected by marine lipids. These data indicate that women with IDDM experience apparently beneficial effects on TG and HDL2 from dietary supplementation with omega-3 fatty acids administered in a low-cholesterol-containing oil without adversely affecting overall diabetes management. If these changes in lipoprotein concentration and composition prove to have antiatherogenic consequences and are free of long-term toxicity, these agents may have a role in the therapy of IDDM patients.     

Apolipoprotein B-containing lipoproteins in renal failure: the relation to mode of dialysis

BACKGROUND: The aim of this study was to establish whether there is a differential effect of mode of dialysis, hemodialysis (HD), or continuous ambulatory peritoneal dialysis (CAPD) on the dyslipidemia of renal failure. METHODS: The lipoprotein profile was determined in 61 non-diabetic patients on chronic HD (N = 30) and CAPD treatment (N = 31), and in a control group of 27 healthy subjects. The analysis included the measurement of individual apolipoprotein (apo) A- and apo B-containing lipoproteins (LPs) separated by sequential immunoaffinity chromatography. Apo A-containing lipoproteins include lipoprotein A-I with apo A-I and lipoprotein A-I:A-II with apo A-I and apo A-II as the main protein constituents, whereas apo B-containing lipoproteins comprise simple cholesterol-rich lipoprotein B (LP-B), with apo B as the only protein moiety and complex triglyceride (TG)-rich lipoprotein B complex (LP-Bc) particles with apo B, apo A-II, apo C, and/or apo E as the protein constituents. RESULTS: CAPD patients had significantly higher concentrations of total cholesterol (6.8 vs. 5.1 mmol/liter), low-density lipoprotein (LDL) cholesterol (4.6 vs. 3.2 mmol/liter), TG (2.3 vs. 1.5 mmol/liter), apo B (155.3 vs. 105.7 mg/dl), LP-B (136.0 vs. 91.9 mg/dl), and LP-Bc (19.3 vs. 13.8 mg/dl) than HD patients. Both HD and CAPD patients had significantly higher TG, VLDL cholesterol, apo C-III, and apo E and significantly lower high-density lipoprotein cholesterol, apo A-II, and lipoprotein A-I:A-II levels than control subjects. The distribution of apo C-III in high-density lipoprotein and VLDL-LDL was altered in CAPD patients in comparison with control subjects. This suggests that the removal of TG-rich lipoproteins is less efficient in patients on CAPD. Normotriglyceridemic (NTG; TG < or = 1.7 mmol/liter, 150 mg/dl) CAPD patients had significantly higher levels of TC, LDL cholesterol, apo B, and LP-B than NTG-HD patients. There was little difference in the LP-Bc levels between NTG-CAPD, NTG-HD, and controls. Similarly, hypertriglyceridemic (HTG) CAPD patients had significantly higher TC, LDL cholesterol, apo B, and LP-B levels than HTG-HD patients. The LP-Bc levels were significantly increased in HTG-HD and HTG-CAPD patients compared with controls, but the slightly higher levels in the CAPD patients did not differ significantly from the HD group. CONCLUSION: CAPD and HD patients have a lipoprotein profile characteristic of renal failure. Patients on long-term CAPD have higher levels of cholesterol-rich apo B-containing lipoproteins unrelated to TG levels. Many patients on CAPD also have a substantial elevation of the plasma concentrations of TG-rich LPs. The clinical significance of increased levels of potentially atherogenic LP-B during CAPD remains to be investigated.     

Effect of intravenously administered fat emulsion on liver function in totally depancreatized dogs

Total Pancreatectomy was performed under nembutal anesthesia in 16 adult mongrel dogs after a 24-hour fast, and the depancreatized dogs were given parenteral nutrition containing fat emulsion. Serum lipids, intravenous fat tolerance and post-heparin lipolytic activity were determined and liver biopsy was done to demonstrate the presence or absence of fatty liver. The animals were divided into three groups: group A (n = 6) received fat emulsion 1 g/kg/day; group B (n = 5), fat emulsion 2 g/kg/day; and group C (n = 5), no fat emulsion. Blood levels of cholesterol and phospholipid were increased in group B, while only a mild elevation of the blood triglyceride (TG) level was noted in group A. In group C, cholesterol and phospholipid levels were decreased, and hypoglycemia was liable to occur. The rate of disappearance of blood fat (K2) was decreased two weeks after surgery in group B, but there were no significant change in the other two groups. These findings suggest that if insulin is present, the administration of fat emulsion will not cause fatty liver.