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The Accumulation and Energy Load of Exogenous Lipids in Cirrhotic Rat Liver After Partial Hepatectomy

First Department of Surgery, Kansai Medical University, Osaka, Japan

Akihiko Nakagawa, MD

First Department of Surgery, Kansai Medical University, Osaka, Japan

Satoshi Kasamatsu, MD

First Department of Surgery, Kansai Medical University, Osaka, Japan

Manabu Nakagawa, MD

First Department of Surgery, Kansai Medical University, Osaka, Japan

Yoshifumi Hiramatsu, MD

First Department of Surgery, Kansai Medical University, Osaka, Japan

Yasuo Kamiyama, MD

First Department of Surgery, Kansai Medical University, Osaka, Japan

Background: The suitability of three energy substrates, glucose, medium-chain triglycerides (MCT) and long-chain triglycerides (LCT), was studied in cirrhotic rats after a partial hepatectomy. Methods: Rats with thioacetamide-induced cirrhosis underwent a 70% hepatectomy, and were divided into three groups. Each group was then injected with ¹⁴C-labeled glucose, ¹⁴C-labeled MCT or ¹⁴C-labeled LCT, respectively. The subsequent tissue distribution of ¹⁴C and the cumulative amount of expired ¹⁴CO₂ were determined. In a second experiment, the 70%-hepatectomized cirrhotic rats received total parenteral nutrition (TPN). The source of the nonprotein calories was 100% glucose (glucose group), 60% MCT + 40% glucose (MCT group), and 60% LCT + 40% glucose (LCT group). The adenylate energy charge and the glycogen content in the liver remnant were determined. Results: The tissue distribution of ¹⁴C revealed that the fat emulsions accumulated preferentially in the liver. One hour after the partial hepatectomy, the concentration of ¹⁴C-labeled MCT in the liver remnants was threefold higher than in sham-operated controls. Similarly, the concentration of ¹⁴C-labeled LCT was twofold higher. The adenylate energy charge in the glucose group with TPN recovered to preoperative levels within 1-hour after the partial hepatectomy, whereas the LCT group with TPN showed a 24-hour delay in their recovery. The MCT group with TPN exhibited an intermediate time course. Conclusions: It is suggested that the specific accumulation of MCT and especially LCT emulsions in the cirrhotic liver remnant acts as an energy load rather than an energy substrate. Uournal of Parenteral and Enteral Nutrition 19:313-318, 1995)

Journal of Parenteral and Enteral Nutrition, Vol. 19, No. 4, 313-318 (1995)
DOI: 10.1177/0148607195019004313


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