Choice of Lipid Emulsion Determines Inflammation of the Gut-Liver Axis, Incretin Profile, and Insulin Signaling in a Murine Model of Total Parenteral Nutrition

Scope The aim of this study is to test whether the choice of the lipid emulsion in total parenteral nutrition (TPN), that is, n‐3 fatty acid‐based Omegaven versus n‐6 fatty acid‐based Intralipid, determines inflammation in the liver, the incretin profile, and insulin resistance. Methods and results Jugular vein catheters (JVC) are placed in C57BL/6 mice and used for TPN for 7 days. Mice are randomized into a saline group (saline infusion with oral chow), an Intralipid group (IL‐TPN, no chow), an Omegaven group (OV‐TPN, no chow), or a chow only group (without JVC). Both TPN elicite higher abundance of lipopolysaccharide binding protein in the liver, but only IL‐TPN increases interleukin‐6 and interferon‐γ, while OV‐TPN reduces interleukin‐4, monocyte chemoattractant protein‐1, and interleukin‐1α. Insulin plasma concentrations are higher in both TPN, while glucagon and glucagon‐like peptide‐1 (GLP‐1) were higher in IL‐TPN. Gluconeogenesis is increased in IL‐TPN and the nuclear profile of key metabolic transcription factors shows a liver‐protective phenotype in OV‐TPN. OV‐TPN increases insulin sensitivity in the liver and skeletal muscle. Conclusion OV‐TPN as opposed to IL‐TPN mitigates inflammation in the liver and reduces the negative metabolic effects of hyperinsulinemia and hyperglucagonemia by “re‐sensitizing” the liver and skeletal muscle to insulin. © 2020 Wiley-VCH GmbH. ISSN:1613-4125 ISSN:1613-4133