Fish oil may reverse neonatal nutritional cholestasis

Last Updated: 2015-01-15

By Reuters Staff

NEW YORK (Reuters Health) - Pooled data suggest that fish oil-containing lipid emulsion is effective for reversing parenteral nutrition-associated cholestasis (PNAC) in neonates, according to Korean researchers.

In a December 17 online paper in The Journal of Nutrition, Dr. Soo-Nyung Kim of Konkuk University School of Medicine, Seoul, and colleagues note that although such an approach is beneficial in adults there are limited data on neonates.

To investigate further, the researchers reviewed the literature and conducted a meta-analysis of three studies involving 93 participants in which reversal of PNAC was the aim and a further four studies with 1012 participants in which prevention was the intended outcome.

Compared with soybean-based or olive oil-based lipid emulsions, the fish-oil containing emulsion had no significant effect on the development of PNAC. Of the 471 neonates in the fish-oil group, 14 developed PNAC compared to 32 of the 541 patients in the control group (odds ratio 0.56).

However, the fish oil did appear more likely to reverse PNAC. Overall, 28 (59.6%) of the 47 neonates who received the fish oil-containing lipid emulsions recovered from PNAC, compared with 9 (19.6%) of the 46 neonates in the control group who showed signs of recovery (OR, 6.14).

The team observed a high incidence of PNAC in preterm and growth-restricted infants, who "may be a specific population to use to further evaluate the protective role of fish oil-containing lipid emulsions."

The researchers conclude, "Well-designed randomized controlled trials that use lipid emulsions that contain 100% fish oil . . . to evaluate the preventive effects of fish oil on PNAC are warranted."

Further studies, they add, are also needed to evaluate the effect of enteral fish oil-containing lipid emulsions.

Dr. Kim did not respond to requests for comments.

The authors reported no outside funding or disclosures.

SOURCE: http://bit.ly/1Cbcvdk

J Nutr 2014.