Enhanced nutrient supply to very low birth weight infants is associated with higher blood amino acid concentrations and improved growth
| Autor: | Marit B. Veierød, Britt Nakstad, Elin W. Blakstad, Per Ole Iversen, Astrid N. Almaas, Arild Rønnestad, Kristin Brække, Hannelore Daniel, Kenneth Strømmen, Christian A. Drevon, Sissel J. Moltu, Alexander Haag |
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| Rok vydání: | 2017 |
| Předmět: |
Male
0301 basic medicine Vitamin Pediatrics medicine.medical_specialty Endocrinology Diabetes and Metabolism Birth weight 03 medical and health sciences chemistry.chemical_compound Enteral Nutrition 0302 clinical medicine Animal science Intensive Care Units Neonatal 030225 pediatrics Intensive care medicine Humans Infant Very Low Birth Weight Amino Acids Infant Nutritional Physiological Phenomena Vitamin A chemistry.chemical_classification 030109 nutrition & dietetics Nutrition and Dietetics business.industry Infant Newborn Postmenstrual Age medicine.disease Low birth weight Treatment Outcome Bronchopulmonary dysplasia chemistry Dietary Supplements Fatty Acids Unsaturated Small for gestational age Female medicine.symptom business Infant Premature Polyunsaturated fatty acid |
| Zdroj: | Clinical Nutrition ESPEN. 18:16-22 |
| ISSN: | 2405-4577 |
| Popis: | Customized nutrient supply is vital to ensure optimal growth among very low birth weight infants (birth weight 1500 g). The supply of amino acids is especially important due to their impact on protein synthesis and growth. The objectives of this study were to evaluate the impact of enhanced nutrition on growth, blood concentrations of amino acids, and explore possible associations between amino acid concentrations and common neonatal morbidities. We hypothesized higher amino acids levels and growth velocity among infants on enhanced nutrient supply.This randomized controlled trial was performed in three university neonatal intensive care units in Oslo, Norway. Fifty very low birth weight infants were randomized to a control or intervention group. Within 24 h after birth, infants in the intervention group received enhanced supply of energy, amino acids, lipids, long-chain polyunsaturated fatty acids and vitamin A, whereas the control group received a standard nutrient supply. The intervention continued until 52 weeks postmenstrual age or until a body weight of 5.5 kg was reached. Amino acid analyses were performed at birth, day 3, 5 weeks of age and 5 months corrected age. Detailed information about nutrient intake, morbidities, blood amino acid concentrations and growth velocity were collected from 44 infants (6 infants excluded). High-performance liquid chromatography was used for amino acid analysis.The intervention group (n = 23) received higher supply of proteins, with higher blood concentrations of amino acids measured at 5 weeks of age, and improved growth velocity (mean 17.4 vs 14.3 g/kg/day, p 0.001) at 36 weeks postmenstrual age, compared to the control group (n = 21). The correlation between concentrations of branched chain amino acids (leucine, isoleucine and valine) and growth was stronger and more positive among infants: a) in the control group (correlation coefficient ≥ 0.68, p ≤ 0.004); b) born with birth weight appropriate for gestational age (correlation coefficient ≥ 0.53, p ≤ 0.009) and c) not diagnosed with septicemia (correlation coefficient ≥ 0.63, p ≤ 0.005).Enhanced nutrient supply to very low birth weight infants led to higher blood amino acid concentrations and improved growth. The correlations between amino acid concentrations and growth velocity were weaker in the intervention group as compared to the control group. This could reflect an upper threshold for protein synthesis and growth with our intervention, whereas a potential for further growth with increasing amino acid supply was possible for the control group.NCT01103219. |
| Databáze: | OpenAIRE |
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