Table 4.
Effects of olive oil-based intravenous lipid emulsions on plasma cholesterol and triglyceride levels.
| Study | Population | Intervention and Control (n) (Lipid Dose) | Duration | Outcomes |
|---|---|---|---|---|
| Animal studies | ||||
| Harvey et al., 2014 [5] | Guinea pigs | OO SO FO SMOF |
6 h infusion 10 d infusion |
During 6 h infusion, TG increased significantly in all groups; however, greatest increase in SO group During chronic administration (10 d), TG was significantly lower in SO, OO, and FO lipids compared with SMOF and control diet groups (p < 0.05) |
| Adult studies | ||||
| García-de-Lorenzo et al., 2005 [35] | Severe burns | OO (n = 11) (1.3 g/kg/day) MCT/LCT (n = 11) (1.3 g/kg/day) |
6 day | TG increased from baseline significantly in both groups and TC increased from baseline significantly in OO group. Between-group differences were not significant TC levels remained within normal ranges * for most patients |
| Gultekin et al., 2014 [69] | Sepsis or septic shock | OO (n = 16) (1.3 g/kg/day) OO + FO {90%/10%} (n = 16) (1.3 g/kg/day) |
5 day | No difference from baseline to final measurement for TC, TG, LDL, or VLDL in both groups. HDL significantly decreased from baseline to final measurement in the OO group (p < 0.05) In OO group, TC and TG were within normal ranges * at baseline and final measurement |
| Huschak et al., 2005 [70] | Trauma | OO (n = 18) (0.8 g/kg/day) SO (n = 15) (0.5 g/kg/day) |
14 day | No difference between groups in TG A significant difference in lipid dose delivered was observed between the groups (p < 0.001) |
| Olthof et al., 2013 [36] | Long-term PN | OO (n = 20) (NR) Healthy controls (n = 21) |
≥6 months | TG levels were significantly higher in the PN group; however, TG levels were within normal ranges (as specified in the article) for both groups |
| Onar et al., 2011 [38] | Abdominal surgery (oncology) | OO (n = 10) (0.75 g/kg/day) SO (n = 10) (0.75 g/kg/day) |
7 day | TC, LDL, VLDL, and HDL decreased from baseline in the OO group, no significant difference between groups All values were within normal ranges * |
| Pálová et al., 2008 [73] | Malnourished ≥10% decreased bodyweight | OO (n = 11) (NR) SO (n = 10) (NR) |
14 day | TG deteriorated† in 1/11 patients in OO group vs. 7/10 in SO group (p < 0.01) |
| Piper et al., 2009 [74] | Abdominal or major maxillofacial surgery (oncology) | OO (n = 22) (NR) SMOF (n = 22) (NR) |
5 day | TG increased from baseline in both groups, and the increase was greater in the OO group. TG levels remained mostly within normal range * Significant between-group differences at Day 2 (p < 0.03) and Day 5 (p < 0.01) |
| Puiggròs et al., 2009 [71] | Abdominal surgery | OO (n = 7) (1.1–1.2 g/kg/day) SO (n = 7) (1.1–1.2 g/kg/day) MCT/LCT {50%/50%} (n = 7) (1.1–1.2 g/kg/day) MCT/LCT {36%/64%} (n = 7) (1.1–1.2 g/kg/day) |
5 day | No change from baseline in TC, HDL, LDL, or TG in OO group, all values within normal ranges. No difference between groups for any of these measures |
| Reimund et al., 2005 [39] | Long-term PN | OO (n = 14) (31% of calories) | 3 months | No change from baseline in TC, HDL, LDL, or TG in OO group No difference between groups for any of these measures Baseline and 3-month values within normal ranges for all measures |
| Siqueira et al., 2011 [24] | Healthy volunteers | OO (NR) SO (NR) Lipid-free PN Saline |
24-h infusion of each intervention (random order) ‡ | TG significantly increased from baseline in OO and SO groups compared with saline No difference between OO and SO groups in TC, HDL, or LDL between groups All values were within normal range * |
| Pediatric studies | ||||
| Goulet et al., 1999 [51] | Long-term PN | OO (n = 9) (1.92 g/kg/day) SO (n = 9) (1.69 g/kg/day) |
Mean >30 months | TC, HDL, LDL, and TG decreased in OO group and increased in SO group Differences between groups not significant except for TC and LDL |
| Hartman et al., 2009 [62] | Bone marrow transplant | OO (n = 15) (1.1 g/kg/day) MCT/LCT (n = 13) (1.1 g/kg/day) |
14 day | TC decreased from baseline in both groups; however, the decrease was significantly greater in the OO group (p = 0.017). TG decreased from baseline in both groups, but the difference between groups was not significant TC remained within normal ranges in both groups, TG was above normal range * at baseline and decreased to within normal range in the OO group. TG remained within normal ranges in MCT/LCT group |
| Kurvinen et al., 2011 [75] | Intestinal failure | OO (n = 11) (0.9 g/kg/day) Normal controls (n = 20) |
3 months | TC was significantly lower in the OO group; however, TC remained within normal range * in both groups |
| Preterm neonate studies | ||||
| Demirel et al., 2012 [41] | ≤32 week | OO (n = 20) (up to 3 g/kg/day) SO (n = 20) (up to 3 g/kg/day) |
14 day | TC and TG within normal ranges * in both groups. No significant differences between groups except for VLDL, which was significantly higher in the OO group (p < 0.05), baseline levels NR |
| Koksal et al., 2011 [43] | ≤34 week | OO (n = 32) (up to 3 g/kg/day) SO (n = 32) (up to 3 g/kg/day) |
7 day | TC, VLDL, and TG increased, no significant difference between groups. All measures were within normal ranges * |
| Pitkanen et al., 2004 [63] | 28–33 week | OO (0.48 g/kg/day) MCT/LCT (0.48 g/kg/day) |
3 h § | TG increased significantly (p < 0.001) in both groups |
| Wang et al., 2016 [46] | <2000 g and <37 week |
OO (n = 50) (1.42 g/kg/day) MCT/LCT (n = 50) (1.30 g/kg/day) SO (n = 50) (1.39 g/kg/day) |
>14 day | No significant differences were observed in TC, TG, apolipoprotein A-I, apolipoprotein B, Lp(a), and apolipoprotein A-I/B among the groups. However, on Day 7, HDL level in the MCT/LCT group (0.89 ± 0.31 mmol/L) was significantly lower than in the OO (1.06 ± 0.40 mmol/L) or SO (1.05 ± 0.33 mmol/L) groups (p < 0.05). On Day 7, LDL levels were significantly higher in OO (1.77 ± 0.44 mmol/L) than in MCT/LCT (1.58 ± 0.44 mmol/L) or SO (1.54 ± 0.38 mmol/L) groups (p < 0.05). TC, TG, HDL, and LDL levels were within normal ranges * |
* Normal ranges based on ATPIII values: TG <150 mg/dL (1.69 mmol/L); TC 150–199 mg/dL (3.88–5.15 mmol/L); HDL ≥40 mg/dL (1.04 mmol/L); LDL ≤130 mg/dL (3.36 mmol/L) [68]. † Deterioration defined as a patient who moved to a more abnormal category after starting PN. Categories: within normal limits, elevation up to 2 × ULN, and elevation > 2 × ULN. ‡ Patients (n = 12) received a 24-h infusion of each lipid emulsion (in random order) on 2 consecutive days. § Patients (n = 13) received a 3-h infusion of each lipid emulsion (in random order) on 2 consecutive days. ATPIII—Adult Treatment Panel III; HDL—high-density lipoprotein; LDL—low-density lipoprotein; MCT/LCT—medium-chain triglycerides/long-chain triglycerides; NR—not reported; OO—olive oil; SMOF—soybean oil/MCT/olive oil/fish oil; SO—soybean oil; TC—total cholesterol; TG—triglycerides; ULN—upper limit of normal range; VLDL—very low-density lipoprotein.