O039 FATTY LIVER DISEASE MODEL CAUSED BY LONG-TERM FEEDING OF TRANS-FATTY ACIDS

18 O037 POSSIBLE INTERACTIONS BETWEEN DIETARY FIBRES AND 5-AMINOSALICYLIC ACID (5-ASA) C.D.B. Henriksen1 , S.H. Hansen2 , I. Nordgaard-Lassen3 , P. Madsen1 , J.R. Andersen4 . 1 Dept Human Nutrition, 2 Dept Pharmaceutics and Analytical Chemistry, University of Copenhagen, 3 Gastroenterology, Hvidovre Hospital, 4 Nutrition Unit 5711, Rigshospitalet, Copenhagen, Denmark Rationale: Hypothesis: If dietary fibres are able to bind 5-ASA they potentially could reduce systemic absorption and side effects. Aims: a. to investigate if selected dietary fibres bind 5-ASA in vitro, and b. a possible coherence between the consumption of dietary fibres and disease activity among patients with Ulcerative Colitis (UC) treated with 5-ASA. Methods: In vitro: 15 g of Ispaghula Husk, wheat bran, pectin (citrus), or wheat flour were incubated in a 37ºC buffered solutions of 5-ASA (1 g/l) in 3 hours at pH 6 and 7. The concentrations of 5-ASA were determined using HPLC before and after the incubation. In vivo: patients with UC were observed for 6 months and interviewed 2 3 times. The fibre consumption was estimated and correlated to disease activity (CAI (clinical activity index), plasma C-reactive protein (CRP)), Faecalcalprotectin and quality of life (IBDQ-questionnaire inflammatory bowel disease questionnaire). Results: In vitro: 5-ASA was bound to Ispaghula Husk (5.3 10.0 mg/g), wheat bran (4.6 5.5 mg/g), citrus pectin (1.7 4.8 mg/g), and wheat flour (1.1 1.7 mg/g). No differences were seen in relation to pH. In vivo: 34 patients participated of whom 29 completed the scheduled 3 interviews. No significant changes in fibre consumption were observed during the observation period, however a comparison between patients with high (>20 g/day) and low (<2 g/day) fibre consumptions showed significantly lower concentrations of CRP (p < 0.01) and faecal-calprotectin (p < 0.01) in patients with high consumption of fibre. Conclusion: Ispaghula Husk, wheat bran, pectin, and wheat flour bind to 5-ASA in vitro differently and are not affected by pH. In patients a high consumption of fibre correlated to a lower disease activity compared to a low fibre consumption. This indicates that consumption of Ispaghula Husk might be of beneficial clinical relevance for patients with UC in treatment with 5-ASA.

Oral presentations / Free scientific presentations O038 A 5 YEAR PROSPECTIVE FOLLOW UP OF PATIENTS ON HOME PARENTERAL NUTRITION (HPN) FOR CHRONIC INTESTINAL FAILURE (IF) L. Pironi1 , F. Joly1 , A. Forbes1 , V. Colomb1 , M. Lyszkowska1 , B. Janet1 , P. Thul1 , X. Hebuterne1 , M. Gambarara1 , F. Gottrand1 , C. Cuerda1 , O. Goulet1 , B. Messing1 , M. Staun1 , A. van Gossum1 . 1 Home Artificial Nutrition and Chronic Intestinal Failure Working Group, ESPEN, Bologna, Italy Rationale: to study the 5 year survival of patients on HPN for IF, grouped at baseline as non-candidates (NC) or candidates (C) for intestinal transplantation (ITx) Methods: 389 NC (no indication + no contraindication for ITx) and 156 C (indication + no contraindication) were enrolled. Indications for ITx: HPN-failure (liver failure; thrombosis 2 central veins; frequent catheter sepsis; severe dehydration), high risk primary disease (desmoids; congenital mucosal disorders; ultra short bowel), high morbidity IF. Statistics: Kaplan Meier method, chi-square test. Results: Intention to treat analysis demonstrated a 5 year probability of survival of 90% in NC and 79% in C (P < 0.001). During the follow up, 90 NC and 5 C were weaned-off HPN, 1 NC and 20 C underwent an ITx (without liver, 16; with liver, 5). In non-weaned and nontransplanted NC, survival was lower in those with the shortest duration of HPN at baseline (2 vs 2 5 vs >5 yrs; P = 0.014). In non-weaned and non-transplanted C, survival on HPN was 73% in HPN-failure, 86% in high risk disease and 100% in high morbidity IF (P = 0.032) (HPNfailure vs NC, P < 0.001). Among those with HPN-failure, survival was 65% in those with liver failure and 77% for those with a venous catheter-related thrombosis or sepsis (P < 0.001 and P = 0.078 vs NC, respectively). In ITx patients, survival was 51%. Death rate was 38% in those who were at home (18 pts) at time of calling for ITx and 100% in those who were hospitalized (P = 0.017). Conclusion: HPN is confirmed the primary therapeutic option for IF; only HPN-failure is associated with a significant increased risk of death; patient clinical status (at home or in hospital) is confirmed the main prognostic factor following ITx. Death rate on HPN appears higher in the short than in the long-term. Studies aimed to recognize patients at early risk of death on HPN are required to define the candidates for a timely referral for ITx Disclosure of Interest: None declared.

Disclosure of Interest: None declared.

O039 FATTY LIVER DISEASE MODEL CAUSED BY LONG-TERM FEEDING OF TRANS-FATTY ACIDS K. Fukushima1 , N. Obara2 , Y. Ueno1 , T. Asakura3 , T. Shimosegawa1 . 1 Department of Gastroenterology, Tohoku University Hospital, 2 Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, 3 Department of food and Nutrition, Miyagi Gakuin Women’s University, Sendai, Japan Rationale: The intake of trans-fatty acids (TFA) is one of the etiological factors for cardiovascular disease, a major

Liver and gastrointestinal tract cause of death of the steatohepatitis patients associated with metabolic syndrome. We aimed to clarify the effect of long-term feeding of TFA in terms of the causal role for fatty liver disease. Methods: Female C57/BL6 mice fed with normal (NC: fat 4%), TFA rich (NTFAC: TFA 28.5%/fat), high fat (HFC: fat 35%) or high fat & TFA rich (HFTFAC) chow for 24 weeks. We evaluated the liver/ body weight, histology, mRNAs of the whole liver for fibrosis, lipogenesis, lipid transport, cytokines by real-time polymerase chain reaction, the lipid peroxide and adipokines by enzymelinked immunosorbent assay. Kupffer cells (KC) isolated freshly from mice were tested for the phagocytosis, lipotoxicity by MTS and cytokine secretion induced by lipopolysaccharide (LPS: 6hr) after 24 hrs’ incubation in serum-free media with free FAs at the concentration of 200uM. Results: Body or relative liver weights increased in HFs or in HFTFA, respectively. Periportal macro/ microvesicular steatosis was prominent in HFTFA accompanied by ballooning of hepatocytes. Tumor necrosis factor (TNF) alfa and inducible nitric oxide synthetase were upregulated in HFs. Collagen 1a1 as a fibrotic marker increased 3.6 folds as the relative value to NC. In HFTFAC, there remarkably increased peroxisome proliferator-activated receptor gamma2 expression that reached 50 folds compared to NC in concordance with the upregulation of sterol regulatory element binding protein1. The hepatic lipid peroxide and serum leptin also increased. In vitro, LPS combined with TFA (C18:1 or 2) induced TNF alfa secretion without lipotoxicity, while the combination with saturated FAs (C18) reduced phagocytosis (5.8% of control) and attenuated cell viability (43% of control) of KCs. Conclusion: TFAs caused steatohepatitis with marked lipid depositions, degeneration of hepatocytes, cytokine secretion and modulation of redox of the liver especially to the mice fed together with fat rich chow. Disclosure of Interest: None declared.

O040 THE EFFECT OF BRANCHED-CHAIN AMINO ACID ON LIVER REGENERATION AFTER PARTIAL HEPATECTOMY IN RATS H. Lai1 , S. Wu1 , W. Chen1 . 1 Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan Rationale: Liver is the core organ for amino acid metabolism. Branched-chain amino acid (BCAA) is important for hepatic failure. This study evaluated the effect of BCAA on liver regeneration after partial hepatectomy (PH) in rats. Methods: Male Wistar rats weighted around 200g were used. A 67% PH was performed and followed with high amino acid solutions of high-BCAA (HB) or normal-BCAA (NB) intravenous infusion. The control rats were allowed to eat normally. They were sacrificed (8 in each) 6h, 24h, 48h and 72h after the operation. High energy phosphate (HEP) including creatine phosphate (CP) and adenosine triphosphate (ATP) in remnant liver were measured. Remnant liver weight/body weight (RLW/BW) ratio, DNA

19 synthetic rate, DNA content, and mitotic index were chosen as indicators of liver regeneration. Results: HEP (ATP and CP) in remnant liver decreased sharply after PH. The RLW/BW ratio were 4.31±0.32% before, and 1.52±0.13%, 2.20±0.18%, 2.77±0.22%, 3.73±0.25% respectively at 6h, 24h, 48h, and 72h after PH. HB group rats have a better RLW/BW ratio than NB and C group rats (4.13±0.23% vs 3.84±0.21% and 3.73±0.22%, p < 0.05) 72h after PH. DNA synthetic rate was significantly higher in HB than NB and C groups rats (78.8±10.1 vs 61.2±6.2, and 60.8±6.2 DMP/mg, p < 0.05) 24h after PH. DNA content was significantly higher in HB than NB and C group rats (13.2±1.2 vs 9.8±1.1 and 10.3±1.1 mg, p < 0.05) 72h after PH. Mitotic index is somewhat more in HB than in NB and C groups rats 48h after PH. Conclusion: HB rats have a better liver regeneration than NB rats and C rats in the indicators of RLW/BW ratio, DNA synthetic rate and DNA content. BCAA is important in the early stage for liver regeneration after PH. Disclosure of Interest: None declared.

O041 INVESTIGATING THE SAFETY AND METABOLIC EFFECTS OF A NEW ‘METABOLIC PREOPERATIVE PRECONDITIONING’ DRINK IN PATIENTS UNDERGOING GASTROINTESTINAL SURGERY: A RANDOMISED PLACEBO CONTROLLED DOUBLE-BLIND STUDY (NCT00662376) S. Awad1 , D. Constantin-Teodosiu2 , B.J. Rowlands1 , K.C.H. Fearon3 , I.A. Macdonald2 , D.N. Lobo1 . 1 Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre Biomedical Research Unit, 2 School of Biomedical Sciences, University of Nottingham, Nottingham; 3 Clinical and Surgical Sciences, University of Edinburgh, Edinburgh, United Kingdom Rationale: Preoperative carbohydrate loading attenuates the decline in postoperative insulin sensitivity and leads to clinical benefits. A new drink [Oral Nutritional Supplement (ONS), Fresenuis Kabi, Germany] has been developed which contains glutamine and antioxidants in addition to carbohydrate. We studied the safety profile and metabolic effects of preoperative ingestion of ONS. Methods: This was a double-blind study in 40 patients undergoing laparoscopic cholecystectomy. Patients were randomised to 2 groups, receiving either 500 ml of ONS or placebo the evening before surgery and 250 ml 3 4h before induction of anaesthesia. 250 ml of ONS contained 50g carbohydrate, 15 g glutamine, 1 g green tea extract, 750 mg vit C, 250 mg vit E, 5 mg bcarotene, 10 mg zinc and 150 mg selenium. Blood was sampled before ingestion of the evening drink, after induction of anaesthesia and on postoperative day 1. Rectus abdominis muscle and liver biopsies were performed intraoperatively for determination of glycogen content. Results: Patients [mean±SE age 50±2 years, BMI 29±0.9 kg/m2 , 32 female] ingested the second serving of the drinks a median (IQR) of 225 (213 255) min before induction of anaesthesia. There were no drinkrelated complications. Mean±SE liver glycogen was higher in the ONS-group [999±49 vs 694±48 mmol/kg dry