The effects of two different lipid preperations on antioxidant enzymes, lipid peroxidation and morbidity of premature newborns

The Effects of Two Different Lipid Preperations on Antıoxıdant Enzymes and Lipid Peroxidation and Morbidity of Premature Newborns Purpose: In this study; we aimed to investigate the effects of two different lipid preperations on antioxidant enzymes, lipid peroxidation and morbidity of preterm babies. Materials and Methods: We enrolled the preterm babies ≤32 gestastional weeks age and/or ≤1500 g who were applied lipid preperation for total parenteral nutrition in the first day of life and continued at least 7 days. The patients were enrolled to SMOFlipid or Clinoleic lipid groups randomly. Biochemical values, hematological values, oxidant and antioxidant levels in the first day of life, in the 7th day of lipid use and in the 28th day of life, retinopathy of prematurity (ROP), intraventricular hemorrhagia (IVH), broncopulmonary dysplasia (BPD), necrotising enterocolitis, cholestasis and infection rates were compared. Results: There were 27 patients in the SMOFlipid group and 23 patients in the Clinoleic groups. Frequency of eclampsia, preeclampsia, premature rupture of membranes, chorioamnionitis and urinary tract infection of mothers were similar between groups. Also there was no significant difference in terms of gestastional age, Apgar scores, duration of oxygen treatment and mechanical ventilation, day of full enteral feeding, durations of parenteral nutrition and lipid administration between groups. However prolonged premature rupture of membranes ratio was higher in the Clinoleic lipid group, (8/23, %34,8 versus 1/27, %3,7) (p= 0,007). Time of catch up birth weight was 10 days in SMOFlipid and 13 days in Clinoleic lipid groups (p= 0,013). Renal functions, hepatic enzymes, hematological and biochemical values were similar. In Clinoleic group; SOD levels were higher than SMOFlipid group at 7th day and also CAT levels were higher at days of 7 and 28. There was no difference in GPx levels between groups. TBARS, which are indicators of lipid peroxidation, were found to be higher in Clinoleic group at days of 1 and also 7 (p= 0,04, p= 0,05). There was no difference about TBARS levels at 28th day. While no difference was shown in TBARS and GPx levels within time in SMOFlipid group; TBARS decreased in Clinoleic group. CAT and SOD levels showed variability within time but this variability was not influced by the lipid preperation types. There was no difference in IVH, ROP, BPD, infection and cholestasis ratios. Conclusion: Both lipid preperations seem to be safe and well tolerated in preterm babies. There were no differences in terms of hematological and biochemical values. We also could not detect any difference in morbidities of the patients. However, further prospective randomised studies including more patients are needed for evaluating the effects of these lipid preperations on oxidant system and antioxidant enzymes. Key words: SMOFlipid, Clinoleic, preterm, morbidity, antioxidant enzymes, lipid peroxidation