Modification of serum fatty acids in preterm infants by parenteral lipids and enteral docosahexaenoic acid/arachidonic acid: A secondary analysis of the Mega Donna Mega trial.
Arachidonic acid
Docosahexaenoic acid
Extremely preterm infants
Intravenous lipid emulsion
LCPUFA
Parenteral nutrition
Journal
Clinical nutrition (Edinburgh, Scotland)
ISSN: 1532-1983
Titre abrégé: Clin Nutr
Pays: England
ID NLM: 8309603
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
received:
24
01
2023
revised:
13
04
2023
accepted:
14
04
2023
medline:
16
6
2023
pubmed:
30
4
2023
entrez:
30
4
2023
Statut:
ppublish
Résumé
Preterm infants risk deficits of long-chain polyunsaturated fatty acids (LCPUFAs) that may contribute to morbidities and hamper neurodevelopment. We aimed to determine longitudinal serum fatty acid profiles in preterm infants and how the profiles are affected by enteral and parenteral lipid sources. Cohort study analyzing fatty acid data from the Mega Donna Mega study, a randomized control trial with infants born <28 weeks of gestation (n = 204) receiving standard nutrition or daily enteral lipid supplementation with arachidonic acid (AA):docosahexaenoic acid (DHA) (100:50 mg/kg/day). Infants received an intravenous lipid emulsion containing olive oil:soybean oil (4:1). Infants were followed from birth to postmenstrual age 40 weeks. Levels of 31 different fatty acids from serum phospholipids were determined by GC-MS and reported in relative (mol%) and absolute concentration (μmol l Higher parenteral lipid administration resulted in lower serum proportion of AA and DHA relative to other fatty acids during the first 13 weeks of life (p < 0.001 for the 25th vs the 75th percentile). The enteral AA:DHA supplement increased the target fatty acids with little impact on other fatty acids. The absolute concentration of total phospholipid fatty acids changed rapidly in the first weeks of life, peaking at day 3, median (Q1-Q3) 4452 (3645-5466) μmol l Our data show that parenteral lipids aggravate the postnatal loss of LCPUFAs seen in preterm infants and that serum AA available for accretion is below that in utero. Further research is needed to establish optimal postnatal fatty acid supplementation and profiles in extremely preterm infants to promote development and long-term health. ClinicalTrials.gov, identifier: NCT03201588.
Sections du résumé
BACKGROUND & AIM
Preterm infants risk deficits of long-chain polyunsaturated fatty acids (LCPUFAs) that may contribute to morbidities and hamper neurodevelopment. We aimed to determine longitudinal serum fatty acid profiles in preterm infants and how the profiles are affected by enteral and parenteral lipid sources.
METHODS
Cohort study analyzing fatty acid data from the Mega Donna Mega study, a randomized control trial with infants born <28 weeks of gestation (n = 204) receiving standard nutrition or daily enteral lipid supplementation with arachidonic acid (AA):docosahexaenoic acid (DHA) (100:50 mg/kg/day). Infants received an intravenous lipid emulsion containing olive oil:soybean oil (4:1). Infants were followed from birth to postmenstrual age 40 weeks. Levels of 31 different fatty acids from serum phospholipids were determined by GC-MS and reported in relative (mol%) and absolute concentration (μmol l
RESULTS
Higher parenteral lipid administration resulted in lower serum proportion of AA and DHA relative to other fatty acids during the first 13 weeks of life (p < 0.001 for the 25th vs the 75th percentile). The enteral AA:DHA supplement increased the target fatty acids with little impact on other fatty acids. The absolute concentration of total phospholipid fatty acids changed rapidly in the first weeks of life, peaking at day 3, median (Q1-Q3) 4452 (3645-5466) μmol l
CONCLUSIONS
Our data show that parenteral lipids aggravate the postnatal loss of LCPUFAs seen in preterm infants and that serum AA available for accretion is below that in utero. Further research is needed to establish optimal postnatal fatty acid supplementation and profiles in extremely preterm infants to promote development and long-term health.
CLINICAL TRIAL REGISTRY
ClinicalTrials.gov, identifier: NCT03201588.
Identifiants
pubmed: 37120902
pii: S0261-5614(23)00133-4
doi: 10.1016/j.clnu.2023.04.020
pmc: PMC10512593
mid: NIHMS1932044
pii:
doi:
Substances chimiques
Docosahexaenoic Acids
25167-62-8
Fatty Acids
0
Arachidonic Acid
27YG812J1I
Phospholipids
0
Banques de données
ClinicalTrials.gov
['NCT03201588']
Types de publication
Randomized Controlled Trial
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
962-971Subventions
Organisme : NEI NIH HHS
ID : R01 EY017017
Pays : United States
Organisme : NEI NIH HHS
ID : R01 EY030904
Pays : United States
Organisme : NICHD NIH HHS
ID : U54 HD090255
Pays : United States
Informations de copyright
Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Références
Clin Nutr ESPEN. 2017 Aug;20:17-23
pubmed: 29072164
Prostaglandins Leukot Essent Fatty Acids. 2008 Sep-Nov;79(3-5):141-6
pubmed: 18951004
J Biol Chem. 1957 May;226(1):497-509
pubmed: 13428781
Prostaglandins Leukot Essent Fatty Acids. 2009 Aug-Sep;81(2-3):143-50
pubmed: 19577914
Am J Clin Nutr. 2007 Nov;86(5):1323-30
pubmed: 17991642
J Pediatr. 2011 Nov;159(5):743-749.e1-2
pubmed: 21658712
Nutrients. 2021 Feb 17;13(2):
pubmed: 33671220
JPEN J Parenter Enteral Nutr. 2020 Jan;44(1):69-79
pubmed: 31441521
Pediatr Res. 1997 Feb;41(2):183-7
pubmed: 9029636
Biochim Biophys Acta Mol Cell Biol Lipids. 2021 Jul;1866(7):158939
pubmed: 33862236
J Pediatr. 2021 May;232:23-30.e1
pubmed: 33358843
Pediatr Res. 1996 Jul;40(1):169-74
pubmed: 8798265
Br J Nutr. 1996 Nov;76(5):649-67
pubmed: 8958000
Prostaglandins Leukot Essent Fatty Acids. 2015 Aug;99:1-6
pubmed: 25997653
Br J Nutr. 1995 Mar;73(3):405-22
pubmed: 7766564
Pediatr Res. 2021 Feb;89(3):604-612
pubmed: 32330929
Int J Pharm. 2009 Sep 8;379(1):125-30
pubmed: 19559776
BMC Pediatr. 2013 Apr 20;13:59
pubmed: 23601190
Pediatr Res. 2000 Jan;47(1):127-35
pubmed: 10625093
Invest Ophthalmol Vis Sci. 2022 Nov 1;63(12):23
pubmed: 36383353
J Pediatr Gastroenterol Nutr. 1992 Apr;14(3):300-8
pubmed: 1535657
J Pediatr. 2013 Jan;162(1):56-61
pubmed: 22878111
Clin Nutr. 2023 Jan;42(1):22-28
pubmed: 36473425
Eur J Nutr. 2018 Sep;57(6):2105-2112
pubmed: 28638995
Lipids. 2016 Apr;51(4):423-33
pubmed: 26846324
Acta Paediatr. 2018 Jun;107(6):1020-1027
pubmed: 29444356
Acta Paediatr. 2020 Jun;109(6):1138-1147
pubmed: 31747093
JAMA Pediatr. 2021 Apr 1;175(4):359-367
pubmed: 33523106
JAMA Ophthalmol. 2018 Mar 1;136(3):271-277
pubmed: 29423508
Arch Dis Child Fetal Neonatal Ed. 2021 Nov;106(6):676-681
pubmed: 33514630
Eur J Nutr. 2016 Oct;55(7):2265-74
pubmed: 26363610
N Engl J Med. 2017 Mar 30;376(13):1245-1255
pubmed: 28355511
Eur J Nutr. 2021 Mar;60(2):861-872
pubmed: 32476053
Pediatrics. 2008 Jun;121(6):1137-45
pubmed: 18519483
Clin Nutr. 2014 Dec;33(6):1002-9
pubmed: 24525115
JPEN J Parenter Enteral Nutr. 2019 Jan;43(1):152-161
pubmed: 29679529
JAMA Pediatr. 2018 Dec 1;172(12):1126-1134
pubmed: 30357263
J Pediatr. 1992 Apr;120(4 Pt 2):S129-38
pubmed: 1532827