Full
Outline
To systematically compare the effects of soybean oil-medium chain triglycerides-olive oil-fish oil (SMOF) and medium/long chain triglycerides (MCT/LCT) on parenteral nutrition-associated liver disease (PNALD) in neonates, thus to provide evidence-based guidance for clinical practice.
A comprehensive search was conducted in databases including CNKI, Wanfang, VIP, CBM, PubMed, Embase, Cochrane Library, and Web of Science, covering studies published from inception to December 30, 2024. Randomized controlled trials (RCTs) involving neonates receiving parenteral nutrition for ≥7 d were included. Eligible studies were assessed for quality, and data were extracted for analysis using R4.3.3 and Stata 14.
Seven RCTs involving 963 neonates were included. Compared to the MCT/LCT group, the SMOF group showed significantly lower levels of alanine aminotransferase (ALT) (SMD=-0.73, 95%CI: -1.34 to -0.12, P=0.018 7) and gamma-glutamyl transferase (GGT) (SMD=-0.89, 95%CI: -1.33 to -0.45, P<0.000 1), while aspartate aminotransferase and alkaline phosphatase levels were comparable between groups. In terms of bilirubin, the SMOF group had lower direct bilirubin levels (SMD=-0.61, 95%CI=-0.88 to -0.34, P<0.000 1), but no significant difference was observed in total bilirubin. Regarding lipid metabolism, triglyceride levels were lower in the SMOF group (SMD=-2.89, 95%CI: -3.80 to -1.97, P<0.000 1), whereas total bile acid levels were similar. The incidence of cholestasis was significantly reduced in the SMOF group (OR=0.54, 95%CI: 0.36 to 0.84, P=0.005 4). Additionally, SMOF did not increase the risk of sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia, or other severe adverse events compared to MCT/LCT, and there was no significant difference in mortality between the two groups.
Compared to MCT/LCT, SMOF improves PN-associated liver disease in neonates with a better safety profile.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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