一项随机临床试验对早产儿长链多不饱和脂肪酸补充的 10 年随访：对生长和血压的影响。

The 10-year follow-up of a randomised trial of long-chain polyunsaturated fatty acid supplementation in preterm infants: effects on growth and blood pressure.

机构信息

MRC Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK.

出版信息

Arch Dis Child. 2010 Aug;95(8):588-95. doi: 10.1136/adc.2009.167270. Epub 2010 Jun 1.

DOI:10.1136/adc.2009.167270

PMID:20515959

Abstract

OBJECTIVE

To test the hypothesis that consumption of infant formulas containing long-chain polyunsaturated fatty acids (LCPUFAs) by preterm infants would favourably influence growth, body composition and blood pressure (BP) at age 10 years.

METHODS

This was a follow-up study of a preterm cohort (<35 weeks and birth weight <2000 g) randomly assigned to unsupplemented or LCPUFA-supplemented formulas to 9 months post term. The setting was a research clinic at Yorkhill Hospital for Sick Children, Glasgow, UK. A total of 107 children aged 9-11 years who participated in the original randomised controlled trial (45% follow-up) took part. Main outcome measures were: (1) anthropometry, (2) body composition and (3) BP.

RESULTS

There were no differences in growth or BP between randomised groups for the whole cohort. However, girls who had received LCPUFA-supplemented formula were heavier (42.20 (SD 9.61) vs 36.94 (9.46) kg, p=0.05), had greater skin fold thicknesses (biceps 10.7 (3.3) vs 8.5 (3.6) mm, p=0.03; suprailiac 16.7 (8.2) vs 12.0 (7.5) mm, p=0.03) and higher BP (mean 82.2 (8.4) vs 78.1 (6.2) mm Hg, p=0.04: systolic 111.4 (10.1) vs 105.9 (9.0) mm Hg, p=0.04: diastolic 64.8 (8.4) vs 61.1 (5.4) mm Hg, p=0.05). Differences in weight SD score (0.85 (95% CI 0.13 to 1.58), p=0.02), Ln sum of skin fold thicknesses (0.27 (0.02 to 0.52), p=0.04) and BP (mean 4.6 mm Hg (0.43 to 8.84), p=0.03; systolic 6.1 (0.45 to 11.7), p=0.04) remained after adjustment for prerandomisation confounders. Differences in BP were not significant following adjustment for current weight.

CONCLUSIONS

Girls born preterm and randomised to LCPUFA-supplemented formula showed increased weight, adiposity and BP at 9-11 years, which might have adverse consequences for later health. No effects were seen in boys. Long-term follow-up of other LCPUFA supplementation trials is required to further investigate this finding.

摘要

目的

检验以下假设，即早产儿摄入含有长链多不饱和脂肪酸（LCPUFA）的婴儿配方奶粉会对 10 岁时的生长、身体成分和血压（BP）产生有利影响。

方法

这是一项对早产儿队列（<35 周和出生体重<2000 克）的随访研究，这些早产儿在出生后 9 个月被随机分配到未补充或 LCPUFA 补充配方中。该研究在英国格拉斯哥约克希尔儿童医院的一个研究诊所进行。共有 107 名 9-11 岁的儿童参加了最初的随机对照试验（45%的随访率）。主要观察指标为：（1）人体测量学，（2）身体成分，（3）BP。

结果

整个队列中，随机分组之间的生长或 BP 无差异。然而，接受 LCPUFA 补充配方的女孩体重更重（42.20（SD 9.61）vs 36.94（9.46）kg，p=0.05），皮褶厚度更大（肱二头肌 10.7（3.3）vs 8.5（3.6）mm，p=0.03；骼前上棘 16.7（8.2）vs 12.0（7.5）mm，p=0.03），BP 更高（平均 82.2（8.4）vs 78.1（6.2）mmHg，p=0.04：收缩压 111.4（10.1）vs 105.9（9.0）mmHg，p=0.04：舒张压 64.8（8.4）vs 61.1（5.4）mmHg，p=0.05）。体重 SD 评分（0.85（95%CI 0.13 至 1.58），p=0.02）、皮褶厚度总和的 Ln 值（0.27（0.02 至 0.52），p=0.04）和 BP（平均 4.6mmHg（0.43 至 8.84），p=0.03；收缩压 6.1（0.45 至 11.7），p=0.04）在调整了预随机混杂因素后仍然存在差异。在调整了当前体重后，BP 的差异没有统计学意义。