Rosenfeld Eva, Beyerlein Andreas, Hadders-Algra Mijna, Kennedy Katherine, Singhal Atul, Fewtrell Mary, Lucas Alan, Koletzko Berthold, von Kries Rüdiger
Institute for Social Pediatrics and Adolescent Medicine, University of Munich, Heiglhofstrasse 63, Munich, Germany.
Acta Paediatr. 2009 Jan;98(1):91-7. doi: 10.1111/j.1651-2227.2008.00988.x. Epub 2008 Aug 8.
Clinical trials on the effects of long-chain polyunsaturated fatty acids (LC-PUFA) supplementation of formula milk on growth of term and preterm children have shown conflicting results. We examined the effects of LC-PUFAs-- especially docosahexaenoic acid (DHA) and arachidonic acid (AA)--on growth at 18 months.
We performed a meta-analysis based on individual patient data (IPD) of 901 children from four large, randomised clinical trials of formula milk with and without LC-PUFAs. Anthropometrics were assessed by z-scores based on weight for age, length for age, head circumference for age and body mass index (BMI) for age at 18 months. The studies differed in LC-PUFA composition and infant characteristics (two studies on preterm children, two on term children).
Multivariate regression analyses including the possible confounders, sex, gestational age, birth weight, smoking in the last trimester and maternal age, as well as interaction terms showed no significant effects of LC-PUFA supplementation on any z-score. Subgroup analyses on trials with high amounts of DHA and on studies with duration of supplementation of at least 6 months yielded the same result. These findings cannot be explained by the lack of power.
Our IPD meta-analysis shows no evidence that LC-PUFA supplementation affects children's growth at 18 months of age.
关于在配方奶中添加长链多不饱和脂肪酸(LC-PUFA)对足月儿和早产儿生长影响的临床试验结果相互矛盾。我们研究了LC-PUFA(尤其是二十二碳六烯酸(DHA)和花生四烯酸(AA))对18个月时生长情况的影响。
我们基于来自四项关于含或不含LC-PUFA配方奶的大型随机临床试验的901名儿童的个体患者数据(IPD)进行了一项荟萃分析。通过基于18个月时年龄别体重、年龄别身长、年龄别头围和年龄别体重指数(BMI)的z评分来评估人体测量学指标。这些研究在LC-PUFA组成和婴儿特征方面存在差异(两项针对早产儿的研究,两项针对足月儿的研究)。
多变量回归分析纳入了可能的混杂因素,即性别、胎龄、出生体重、孕晚期吸烟情况和母亲年龄,以及交互项,结果显示添加LC-PUFA对任何z评分均无显著影响。对高剂量DHA试验和补充时间至少6个月的研究进行亚组分析得出了相同结果。这些发现不能用检验效能不足来解释。
我们的IPD荟萃分析表明,没有证据支持添加LC-PUFA会影响18个月大儿童的生长。