Plasma clearance and lipaemic index of lipid emulsion used for lipid emulsion treatment

I read with interest the article entitled âDoes the use of fish-oil based lipid emulsion in the clinical setting of total parenteral nutrition (TPN) and lipid rescue therapy interfere with common laboratory analytes on Roche Cobas 6000?â recently published in the Annals of Clinical Biochemistry. Tan and Wong describe that initial administration alone (1.5 mL/kg, 20% SMOFlipid emulsion) followed by 15 mL/kg/hr for 5 min, pharmacokinetically produced a lipemic index of 660 (660 mg/dL) and 1220 (1220 mg/dL), respectively, which causes interference with aspartate aminotransferase (AST) and alanine aminotransferase (ALT) because of the lipemic threshold for AST and ALT measurement. However, the in vivo plasma clearance of lipid emulsion should be considered to determine the plasma concentration of lipid emulsion. Lipid emulsion containing triglyceride, which is equivalent to natural chylomicron, bypasses the gastrointestinal tract and directly enters into the blood stream. Lipoprotein lipase hydrolyzes lipid emulsion chylomicron to non-essential fatty acids. Medium-chain triglycerides with a relatively short carbon chain are hydrolyzed at least 2-fold higher by lipoprotein lipase than long-chain triglycerides. Thus, the half-life of triglyceride in the SMOFlipid comprising 30% soybean oil, 30% medium-chain triglyceride, 25% olive oil, and 15% fish oil, is lower than that of triglyceride in lipid emulsion with 100% long-chain fatty acid. Depending on the plasma concentration of triglyceride induced by lipid emulsion treatment, low or high concentration of triglyceride hydrolyzed by lipoprotein lipase using first or zero order kinetics, respectively, produces plasma clearance of triglyceride and subsequently induces decreased plasma concentration of triglyceride.

• Publication year

  2021

• Venue

  Annals of Clinical Biochemistry

• Publication date

  2021-01-12

• Fields of study

  Medicine

• Identifiers
  DOI 10.1177/0004563221990686PMID 33435698
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Does the use of fish oil-based lipid emulsion in the clinical setting of total parenteral nutrition and lipid rescue therapy interfere with common laboratory analytes on Roche Cobas 6000?

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