Effects of soybean oil-medium chain triglycerides-olive oil-fish oil vs medium/long chain triglycerides emulsions on parenteral nutrition-associated liver disease in neonates:a Meta-analysis
ZHAO Rong-da
GAN Wen-hui
ZHANG Ya-fei
YAN Mei-xing
MO Xiao-mei
Abstract：Objective: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.Methods: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.Results: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.Conclusion:Compared to MCT/LCT,SMOF improves PN-associated liver disease in neonates with a better safety profile.
Keywords：newbornsoybean oil-medium chain triglycerides-olive oil-fish oilmedium/long chain tri-glyceridesparenteral nutrition-associated liver diseasesafetyMeta-analysis
Publication Date：2026-05-30
Online Publishing Date：2026-08-14(First online date of this platform, not the publication date of the document)
Pages：9( 1099-1107 )