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KMID : 0869620160330020141
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Journal of Korean Society of Hospital Pharmacists
2016 Volume.33 No. 2 p.141 ~ p.151
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Comparison of Changes in Liver Function of the Fish Oil and Non-fish Oil based Total Parenteral Nutrition in Cancer Patients
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Moon Seong-Eun
Kim So-Won
Son Jung-Hee
Chang Min-Jung
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Abstract
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Background : Malnutrition is common in cancer patients due to consequences of the disease progression and treatments. It is necessary to consider administration of TPN (Total Parenteral Nutrition) for cancer patients who cannot sustain adequate nourishment status through enteral nutrition or diet, in order to improve prognosis and prevent malnutrition. Cancer patients are susceptible to liver dysfunction, which is also a representative adverse reaction of TPN. Therefore, the aim of this study is to compare the changes in liver function of fish oil and non-fish oil based TPN in cancer patients, and to provide a clinical basis for administration of TPN.
Methods : The study aimed to collect data from cancer patients who received TNA (fish oil based TNA or non-fish oil based TNA, the latter consisting of either olive-soybean oil based TNA or soybean oil based TNA) for more than 5 consecutive days at National Health Insurance Service Ilsan Hospital between September 2014 and February 2015. The levels of liver enzymes AST (Aspartate Aminotransferase), ALT (Alanine Aminotransferase) and TB (Total Bilirubin) were analyzed retrospectively as primary endpoints.
Results : The study collected 162 subjects. 57 used fish oil based TPN, 36 used olive-soybean oil based TPN, and 69 used soybean oil based TPN. The changes of liver functions were statistically and clinically insignificant among the three groups. The AST level changes pre- and post-infusion for TPN were -15.63 IU/L in the fish oil group, -2.50 IU/L in the olive-soybean oil group, and -20.73 IU/L in the soybean oil group (p 0.05); the ALT level changes were -4.55 IU/L, +12.39 IU/L, and -5.59 IU/L, respectively (p 0.05). The changes in TB levels were -0.18 mg/dL in the fish oil group, -0.41 mg/dL in the olive-soybean oil group, and -0.79 mg/dL in the soybean oil group (p 0.05).
Conclusion : Types of lipid when TPN was administered did not influence liver function. It would be better to consider other nutrient contents rather than types of lipid in TPN in relation to cancer patients’liver function.
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KEYWORD
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TPN (Total Parenteral Nutrition), Fish oil, Liver function, Safety, Cancer Patients
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