Georgieff M K, Amarnath U M, Murphy E L, Ophoven J J
Department of Pediatrics, University of Minnesota Hospital, Minneapolis.
J Pediatr Gastroenterol Nutr. 1989 Feb;8(2):234-9. doi: 10.1097/00005176-198902000-00018.
We prospectively measured serum transferrin levels weekly from birth until discharge in 33 preterm newborn infants hospitalized on the newborn intensive care unit (n = 130 weeks) to study whether transferrin levels accurately reflect recent nutritional intakes and predict subsequent changes in anthropometric measurements and serum protein levels. Mean daily protein and caloric intakes were no greater during weeks when transferrin levels increased than when levels decreased. There were weak but statistically significant linear relationships between protein intake and transferrin levels (r = 0.24, p less than 0.01), caloric intake and transferrin levels (r = 0.27, p less than 0.01), and magnitudes of weekly changes in protein intake and transferrin levels (r = 0.31, p less than 0.001), and magnitudes of weekly changes in caloric intake and transferrin levels (r = 0.27, p less than 0.01). Transferrin levels did not reflect same-week weight or midarm circumference (MAC) gains, nor did they predict the following week's gains. Mean anthropometric measurement gains were similar following weeks when transferrin levels increased or decreased. There were no positive linear relationships between the magnitudes of changes in transferrin levels and same-week weight gain (r = -0.35), same-week MAC gain (r = -0.27), or following-week MAC gain (r = 0.01). Weak correlations were found with following-week albumin levels (r = 0.32, p less than 0.001) and with same-week transthyretin levels (r = 0.44, p less than 0.001). Weekly serum transferrin levels are not useful for longitudinal surveillance of protein-energy status in preterm infants.
我们前瞻性地测量了33名入住新生儿重症监护病房的早产新生儿从出生至出院期间每周的血清转铁蛋白水平（共130周），以研究转铁蛋白水平是否能准确反映近期营养摄入量，并预测随后人体测量指标和血清蛋白水平的变化。转铁蛋白水平升高的几周内，每日平均蛋白质和热量摄入量并不比水平降低时更高。蛋白质摄入量与转铁蛋白水平之间存在微弱但具有统计学意义的线性关系（r = 0.24，p < 0.01），热量摄入量与转铁蛋白水平之间存在线性关系（r = 0.27，p < 0.01），蛋白质摄入量每周变化幅度与转铁蛋白水平之间存在线性关系（r = 0.31，p < 0.001），热量摄入量每周变化幅度与转铁蛋白水平之间存在线性关系（r = 0.27，p < 0.01）。转铁蛋白水平并未反映当周体重或上臂围（MAC）的增加，也未预测下一周的增加情况。转铁蛋白水平升高或降低后的几周内，平均人体测量指标增加情况相似。转铁蛋白水平变化幅度与当周体重增加（r = -0.35）、当周MAC增加（r = -0.27）或下一周MAC增加（r = 0.01）之间不存在正线性关系。发现与下一周白蛋白水平存在弱相关性（r = 0.32，p < 0.001），与当周转甲状腺素蛋白水平存在弱相关性（r = 0.44，p < 0.001）。每周血清转铁蛋白水平对早产儿蛋白质-能量状态的纵向监测并无用处。
