[Changes in plasma lipids, lipoproteins and utilization of energy substrates during continuous enteral nutrition with 50% medium chain triacylglycerols (Preciten MCT 50)].

Enteral nutrition (EN) containing part of the energy substrates in the form of triacylglycerols with medium chain fatty acids (MCT) has a number of advantages in particular in patients with an impaired utilization of energy and impaired nutrient absorption from the small intestine. The increased MCT supply reduces the risk of the development of shock lung, consumption coagulopathy and has a very favourable effect in patients with severe catabolism associated with Crohn's disease. On the other hand EN containing MCT may produce also some undesirable effects such as deterioration of glucose utilization in the liver, changes, on the composition of plasma lipids and lipoproteins and an undesirable thermogenic effect. Investigations of the effect of EN containing 50% of fat in the form of MCT (Preciten MCT 50R, Sandoz Nutrition-Wander) indicate that even an energy supply corresponding to 1.7 X REE in the form of EN with 50% MCT does not lead to a statistically significant rise of REE, does not produce a marked thermogenic effect and the value of the respiratory quotient (RQ) does not increase significantly. Already after 8 days of EN significant changes occur in the spectrum of lipids and lipoproteins characterized by a decline of high density lipoproteins HDL3 (p less than 0.05). The parallel decline of low density lipoproteins LDL and VLDL, however, is the reason why adverse changes of the atherogenic index do not occur.