Romera Gerardo, Figueras Josep, Rodríguez-Miguélez José Manuel, Ortega Josep, Jiménez Rafael
Service of Neonatology, Integrated Unit of Pediatrics, Clínic and Sant Joan de Déu Hospitals, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
J Pediatr Gastroenterol Nutr. 2004 Apr;38(4):407-13. doi: 10.1097/00005176-200404000-00008.
To study metabolic and energy balances, growth and composition of increased body mass in healthy preterm infants fed control formula or control formula with three different nonprotein energy supplements.
Growing preterm infants (birth weight < 1,500 g and gestational age < 31 weeks) were fed standard preterm formula (control group) or the same formula enriched with three different nonprotein energy supplements. An energy supplement of 23 kcal/kg/day was achieved by adding medium-chain triglyceride and dextrinomaltose in three different caloric ratios: 33:66 in group A, 66:33 in group B, and 85:15 in group C. Energy balance was determined by open-circuit continuous (5-6 hours) measurements of energy expenditure, with simultaneous measurement of 24-hour urinary nitrogen excretion. Metabolic balance was determined by measurements of energy intake, energy oxidation, and energy output in urine and stool. The composition of body mass accretion was determined as the accretion of fat and protein in the total weight gain.
The fat accretion (4.9, 5.9, 6.2, and 3.8 g/kg/day in groups A, B, C and D, respectively) correlated directly with fat intake. Infants receiving standard energy intake had a fat percentage of weight gain significantly lower (28%) than that of the high-energy intake groups (31%, 40%, and 38% in groups A, B, and C, respectively). This difference corresponded to the results obtained from skinfold thickness measurements.
Excess nonprotein energy is stored as fat regardless of its source (fat or carbohydrate). High caloric and medium-chain triglyceride intake in otherwise healthy growing preterm infants does not promote nitrogen retention.
研究健康早产婴儿喂养对照配方奶粉或添加三种不同非蛋白能量补充剂的对照配方奶粉时的代谢及能量平衡、生长情况和体重增加的组成成分。
生长中的早产婴儿（出生体重<1500g且胎龄<31周）喂养标准早产配方奶粉（对照组）或添加三种不同非蛋白能量补充剂的相同配方奶粉。通过以三种不同热量比例添加中链甘油三酯和糊精麦芽糖来实现23kcal/kg/天的能量补充：A组为33:66，B组为66:33，C组为85:15。通过开路连续（5 - 6小时）测量能量消耗并同时测量24小时尿氮排泄来确定能量平衡。通过测量能量摄入、能量氧化以及尿液和粪便中的能量输出确定代谢平衡。体重增加的组成成分通过总体重增加中脂肪和蛋白质的增加来确定。
脂肪增加量（A组、B组、C组和D组分别为4.9、5.9、6.2和3.8g/kg/天）与脂肪摄入量直接相关。接受标准能量摄入的婴儿体重增加中的脂肪百分比（28%）显著低于高能量摄入组（A组、B组和C组分别为31%、40%和38%）。这种差异与皮褶厚度测量结果一致。
无论非蛋白能量来源是脂肪还是碳水化合物，过量的非蛋白能量都会以脂肪形式储存。在其他方面健康生长的早产婴儿中，高热量和中链甘油三酯摄入不会促进氮潴留。
