Influence of Human Milk and Parenteral Lipid Emulsions on Serum Fatty Acid Profiles in Extremely Preterm Infants.
Arachidonic Acid
/ blood
Diet
Dietary Fats
/ administration & dosage
Docosahexaenoic Acids
/ blood
Enteral Nutrition
Fat Emulsions, Intravenous
/ chemistry
Fatty Acids
/ blood
Fatty Acids, Omega-3
/ blood
Female
Gestational Age
Humans
Infant
Infant, Extremely Premature
/ blood
Infant, Newborn
Male
Milk, Human
Parenteral Nutrition
Phospholipids
/ blood
Plant Oils
Soybean Oil
/ blood
arachidonic acid
docosahexaenoic acid (DHA)
extremely preterm
human milk
long-chain polyunsaturated fatty acids (LC-PUFA)
parenteral nutrition
Journal
JPEN. Journal of parenteral and enteral nutrition
ISSN: 1941-2444
Titre abrégé: JPEN J Parenter Enteral Nutr
Pays: United States
ID NLM: 7804134
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
12
01
2018
accepted:
19
03
2018
pubmed:
22
4
2018
medline:
18
8
2020
entrez:
22
4
2018
Statut:
ppublish
Résumé
Infants born prematurely are at risk of a deficiency in ω-6 and ω-3 long-chain polyunsaturated fatty acids (LC-PUFAs) arachidonic acid (AA) and docosahexaenoic acid (DHA). We investigated how fatty acids from breast milk and parenteral lipid emulsions shape serum LC-PUFA profiles in extremely preterm infants during early perinatal life. Ninety infants born < 28 weeks gestational age were randomized to receive parenteral lipids with or without the ω-3 LC-PUFAs eicosapentaenoic acid (EPA) and DHA (SMOFlipid: Fresenius Kabi, Uppsala, Sweden, or Clinoleic: Baxter Medical AB, Kista, Sweden, respectively). The fatty acid composition of infant serum phospholipids was determined from birth to postmenstrual age 40 weeks, and in mother's milk total lipids on postnatal day 7. Enteral and parenteral intake of LC-PUFAs was correlated with levels in infant serum. Infants administered parenteral ω-3 LC-PUFAs received 4.4 and 19.3 times more DHA and EPA, respectively, over the first 2 weeks of life. Parenteral EPA but not DHA correlated with levels in infant serum. We found linear relationships between dietary EPA and DHA and infant serum levels in the Clinoleic (Baxter Medical AB) group. The volume of administered SMOFlipid (Fresenius Kabi) was inversely correlated with serum AA, whereas Clinoleic (Baxter Medical AB) inversely correlated with serum EPA and DHA. There appears to be no or low correlation between the amount of DHA administered parenterally and levels measured in serum. Whether this observation reflects serum phospholipid fraction only or truly represents the amount of accreted DHA needs to be investigated. None of the parenteral lipid emulsions satisfactorily maintained high levels of both ω-6 and ω-3 LC-PUFAs in infant serum.
Sections du résumé
BACKGROUND
Infants born prematurely are at risk of a deficiency in ω-6 and ω-3 long-chain polyunsaturated fatty acids (LC-PUFAs) arachidonic acid (AA) and docosahexaenoic acid (DHA). We investigated how fatty acids from breast milk and parenteral lipid emulsions shape serum LC-PUFA profiles in extremely preterm infants during early perinatal life.
METHODS
Ninety infants born < 28 weeks gestational age were randomized to receive parenteral lipids with or without the ω-3 LC-PUFAs eicosapentaenoic acid (EPA) and DHA (SMOFlipid: Fresenius Kabi, Uppsala, Sweden, or Clinoleic: Baxter Medical AB, Kista, Sweden, respectively). The fatty acid composition of infant serum phospholipids was determined from birth to postmenstrual age 40 weeks, and in mother's milk total lipids on postnatal day 7. Enteral and parenteral intake of LC-PUFAs was correlated with levels in infant serum.
RESULTS
Infants administered parenteral ω-3 LC-PUFAs received 4.4 and 19.3 times more DHA and EPA, respectively, over the first 2 weeks of life. Parenteral EPA but not DHA correlated with levels in infant serum. We found linear relationships between dietary EPA and DHA and infant serum levels in the Clinoleic (Baxter Medical AB) group. The volume of administered SMOFlipid (Fresenius Kabi) was inversely correlated with serum AA, whereas Clinoleic (Baxter Medical AB) inversely correlated with serum EPA and DHA.
CONCLUSIONS
There appears to be no or low correlation between the amount of DHA administered parenterally and levels measured in serum. Whether this observation reflects serum phospholipid fraction only or truly represents the amount of accreted DHA needs to be investigated. None of the parenteral lipid emulsions satisfactorily maintained high levels of both ω-6 and ω-3 LC-PUFAs in infant serum.
Identifiants
pubmed: 29679529
doi: 10.1002/jpen.1172
pmc: PMC6437763
mid: NIHMS1006371
doi:
Substances chimiques
ClinOleic
0
Dietary Fats
0
Fat Emulsions, Intravenous
0
Fatty Acids
0
Fatty Acids, Omega-3
0
Phospholipids
0
Plant Oils
0
Docosahexaenoic Acids
25167-62-8
Arachidonic Acid
27YG812J1I
Soybean Oil
8001-22-7
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
152-161Subventions
Organisme : NEI NIH HHS
ID : R01 EY017017
Pays : United States
Organisme : NICHD NIH HHS
ID : U54 HD090255
Pays : United States
Organisme : NEI NIH HHS
ID : R24 EY024864
Pays : United States
Informations de copyright
© 2018 The Authors. Journal of Parenteral and Enteral Nutrition published by American Society for Parenteral and Enteral Nutrition.
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