Division of Neonatology, Department of Paediatrics, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Br J Nutr. 2011 Jan;105(2):268-74. doi: 10.1017/S0007114510003405. Epub 2010 Sep 24.
Preterm infants have an impaired gut barrier function. We aimed to determine the effects of enteral supplementation of a prebiotic mixture consisting of neutral oligosaccharides (short-chain galacto-oligosaccharides (SCGOS)/long-chain fructo-oligosaccharides (LCFOS)) and acidic oligosaccharides (AOS) on intestinal permeability of preterm infants as measured by the sugar absorption test in the first week of life. Furthermore, we determined host- and treatment-related factors associated with intestinal permeability. In a randomised controlled trial, preterm infants with a gestational age < 32 weeks and/or birth weight (BW) < 1500 g received enteral supplementation of SCGOS/LCFOS/AOS or placebo (maltodextrin) between days 3 and 30 of life. Intestinal permeability, reflected by the urinary lactulose/mannitol (L/M) ratio after oral ingestion of lactulose and mannitol, was assessed at three time points: before the start of the study (t = 0), at day 4 (t = 1) and at day 7 (t = 2) of life. Data were analysed by generalised estimating equations. In total, 113 infants were included. Baseline patient and nutritional characteristics were not different between the SCGOS/LCFOS/AOS (n 55) and the placebo groups (n 58). SCGOS/LCFOS/AOS had no effect on the L/M ratio between t = 0 and t = 2. In both the groups, the L/M ratio decreased from t = 0 to t = 2 (P < 0·001). Low BW increased the L/M ratio (P = 0·002). Exclusive breast milk feeding and mixed breast milk/formula feeding during the first week of life decreased the L/M ratio (P < 0·001 and P < 0·05, respectively). In conclusion, enteral supplementation of a prebiotic mixture does not enhance the postnatal decrease in intestinal permeability in preterm infants in the first week of life.
早产儿的肠道屏障功能受损。我们旨在确定在生命的第一周通过糖吸收试验测量时，肠内补充由中性低聚糖（短链半乳糖寡糖（SCGOS）/长链果糖寡糖（LCFOS））和酸性低聚糖（AOS）组成的益生元混合物对早产儿肠道通透性的影响。此外，我们确定了与肠道通透性相关的宿主和治疗相关因素。在一项随机对照试验中，胎龄<32 周和/或出生体重（BW）<1500g 的早产儿在生命的第 3 天至第 30 天期间接受 SCGOS/LCFOS/AOS 或安慰剂（麦芽糊精）的肠内补充。通过口服乳果糖和甘露醇后评估肠道通透性，反映为尿中乳果糖/甘露醇（L/M）比值，在三个时间点进行评估：研究开始前（t=0）、第 4 天（t=1）和第 7 天（t=2）。通过广义估计方程分析数据。共纳入 113 名婴儿。SCGOS/LCFOS/AOS（n=55）和安慰剂组（n=58）之间的基线患者和营养特征无差异。SCGOS/LCFOS/AOS 对 t=0 至 t=2 之间的 L/M 比值没有影响。在两组中，L/M 比值从 t=0 到 t=2 均降低（P<0·001）。低 BW 增加了 L/M 比值（P=0·002）。生命第一周内纯母乳喂养和混合母乳喂养/配方奶喂养均降低了 L/M 比值（P<0·001 和 P<0·05）。总之，在生命的第一周内，肠内补充益生元混合物并不能增强早产儿肠道通透性的产后降低。
