Yu Zhang-bin, Han Shu-ping, Zhu Chun, Sun Qing, Guo Xi-rong
Department of Pediatrics, Nanjing Maternal and Child Health Hospital Affiliated to Nanjing Medical University, Nanjing 210004, China.
Zhonghua Er Ke Za Zhi. 2009 Dec;47(12):904-10.
To evaluate the effects of infant formula containing palm oil on the nutrient absorption and defecation in infants.
A search in Cochrane Library, PubMed, OVID, Springer, China National Knowledge Infrastructure, Vip Chinese Periodical Database, Wanfang Chinese Periodical Database and Chinese Bio-medicine Database was performed to identify relevant English and Chinese language articles between January 1990 and March 2009. Two reviewers independently performed data extraction and appraised using Jadad instrument. Double data were input and analyzed by software of Review Manager 4.2 recommended by Cochrane Collaboration. Intestinal nutrient absorption, electrolyte content of fecal excretion, in vivo calcium deposition, and defecation were included as the target outcomes. These outcomes were evaluated as the combined standardized mean difference (SMD) and relative risk (RR) value and 95% CI of them.
Thirteen articles were included. Three articles meeting inclusion criteria were analyzed for the effects between infant formula containing palmitic acid at the Sn-2 positions and palmitic acid at the Sn-1, 3 positions; five articles were analyzed for the effects between infant formula containing palmitic acid at the Sn-1, 3 and without palmitic acid; another five articles were analyzed for the effects between infant formula containing palmitic acid at the Sn-2 positions and without palmitic acid. Absorption of fat and calcium was higher, the Ca(2+) of fecal excretion was lower when the infant formula provided palmitic acid at the Sn-2 positions or without palmitic acid than that determined when formula containing palmitic acid at the Sn-1 and Sn-3 positions was given (P < 0.01). The bone mineral content (BMC) and bone mineral density (BMD) increased at 3, 6 months when the infant formula without palmitic acid as compared with using the formula containing palmitic acid at the Sn-1 and Sn-3 positions (P < 0.01). The formation of calcium soaps in stool was reduced, the BMC increased when the infant formula provided palmitic acid at the Sn-2 positions as compared with using the infant formula without palmitic acid (P < 0.01). The incidence of soft stools was higher, and the incidence of hard stools was lower when the infant formula provided palmitic acid at the Sn-2 positions or without palmitic acid than that when formula containing palmitic acid at the Sn-1 and Sn-3 positions was used (P < 0.01).
Absorption of fat and calcium was lower, the Ca(2+) of fecal excretion was higher, the BMC was reduced, the incidence of hard stools increased when the infant formula provided the palmitic acid at the Sn-1 and Sn-3 positions as compared with using formula contained palmitic acid at the Sn-2 positions or without palmitic acid. However, this conclusion should be used cautiously because of the limited quality of studies included into the analysis.
评估含棕榈油的婴儿配方奶粉对婴儿营养吸收和排便的影响。
检索考克兰图书馆、PubMed、OVID、Springer、中国知网、维普中文期刊数据库、万方中文期刊数据库和中国生物医学数据库，以确定1990年1月至2009年3月期间相关的英文和中文文章。两名评价者独立进行数据提取，并使用Jadad工具进行评价。将数据双录入并采用考克兰协作网推荐的Review Manager 4.2软件进行分析。肠道营养吸收、粪便排泄物中的电解质含量、体内钙沉积和排便情况作为目标结局。这些结局以合并标准化均数差（SMD）和相对危险度（RR）值及其95%置信区间进行评估。
纳入13篇文章。分析了3篇符合纳入标准的文章，比较了含Sn-2位棕榈酸的婴儿配方奶粉与含Sn-1,3位棕榈酸的婴儿配方奶粉的效果；分析了5篇文章，比较了含Sn-1,3位棕榈酸的婴儿配方奶粉与不含棕榈酸的婴儿配方奶粉的效果；另外5篇文章分析了含Sn-2位棕榈酸的婴儿配方奶粉与不含棕榈酸的婴儿配方奶粉的效果。当婴儿配方奶粉提供Sn-2位棕榈酸或不含棕榈酸时，脂肪和钙的吸收较高，粪便排泄中的Ca(2+)较低，与给予含Sn-1和Sn-3位棕榈酸的配方奶粉时相比（P<0.01）。与使用含Sn-1和Sn-3位棕榈酸的配方奶粉相比，不含棕榈酸的婴儿配方奶粉在3、6个月时骨矿物质含量（BMC）和骨矿物质密度（BMD）增加（P<0.01）。与使用不含棕榈酸的婴儿配方奶粉相比，当婴儿配方奶粉提供Sn-2位棕榈酸时，粪便中钙皂的形成减少，BMC增加（P<0.01）。当婴儿配方奶粉提供Sn-2位棕榈酸或不含棕榈酸时，软便发生率较高，硬便发生率较低，与使用含Sn-1和Sn-3位棕榈酸的配方奶粉时相比（P<0.01）。
与使用含Sn-2位棕榈酸或不含棕榈酸的配方奶粉相比，当婴儿配方奶粉提供Sn-1和Sn-3位棕榈酸时，脂肪和钙的吸收较低，粪便排泄中的Ca(2+)较高，BMC降低，硬便发生率增加。然而，由于纳入分析的研究质量有限，该结论应谨慎使用。
