Department of Life Sciences, University of Roehampton, Whitelands College, London, UK; Neonatal Unit, St George's University Hospital, London, UK.
Department of Life Sciences, University of Roehampton, Whitelands College, London, UK.
Clin Nutr. 2017 Dec;36(6):1593-1600. doi: 10.1016/j.clnu.2016.09.033. Epub 2016 Oct 8.
BACKGROUND & AIMS: Adequate supply of arachidonic (ARA) and docosahexaenoic (DHA) acids is essential for brain development, and extremely preterm infants may be at risk of deficiency. Current levels of ARA and DHA given to extremely preterm infants and the amounts available for accretion have not been established, although recent evidence suggests DHA intake is at a level likely to lead to severe deficits. This study quantified the omega-6 and omega-3 polyunsaturated fatty acid (PUFA) intakes from all sources in the first six weeks of life of preterm infants in standard care. In addition, the relationship between blood levels of circulating cytokines and PUFAs was explored.
Single centre longitudinal study with omega-6 and omega-3 PUFA intake data analysed from all sources for 17 infants born <28 weeks gestation. At six weeks of age the infants' whole-blood fatty acid levels were measured along with a range of cytokines and chemokines analysed by Luminex multiplex array.
ARA intake was significantly below international recommendations in weeks 1-5 (all p < 0.05), and DHA intake was significantly below recommendations in week 1 (p < 0.0001). The amounts of ARA and DHA available for accretion were significantly below estimated accretion rates in all weeks (all p < 0.001). Mean ARA and DHA intakes were correlated with their respective blood levels (r = 0.568, p = 0.017 and r = 0.704, p = 0.002). There were significant relationships between MIP-1β and blood DHA levels (rs = 0.559, p = 0.02) and between RANTES and omega-6:omega-3 PUFA ratio (rs = -0.498, p = 0.042).
This study establishes that extremely preterm infants receive insufficient intakes of ARA and DHA. Moreover, blood fatty acid levels may provide a useful measure of intake, where establishing sufficient consumption could have clinical importance. There may also be important interactions between long-chain PUFA status and markers of inflammation, which requires further study.
足够的花生四烯酸（ARA）和二十二碳六烯酸（DHA）供应对于大脑发育至关重要，而极早产儿可能存在缺乏的风险。目前给予极早产儿的 ARA 和 DHA 水平以及可用于积累的量尚未确定，尽管最近的证据表明 DHA 摄入量可能导致严重缺乏。本研究定量评估了标准护理下极早产儿生命最初 6 周内所有来源的ω-6 和 ω-3 多不饱和脂肪酸（PUFA）的摄入量。此外，还探讨了循环细胞因子和 PUFA 之间的关系。
对 17 名胎龄<28 周的婴儿进行了单中心纵向研究，分析了所有来源的 ω-6 和 ω-3 PUFA 摄入量数据。在 6 周龄时，测量了婴儿的全血脂肪酸水平，并通过 Luminex 多重分析检测了一系列细胞因子和趋化因子。
在第 1-5 周，ARA 的摄入量明显低于国际推荐量（均 p<0.05），在第 1 周 DHA 的摄入量明显低于推荐量（p<0.0001）。所有周数的 ARA 和 DHA 的可用积累量均明显低于估计的积累率（均 p<0.001）。平均 ARA 和 DHA 的摄入量与其相应的血液水平呈正相关（r=0.568，p=0.017 和 r=0.704，p=0.002）。MIP-1β 与血液 DHA 水平呈显著正相关（rs=0.559，p=0.02），RANTES 与 ω-6：ω-3 PUFA 比值呈显著负相关（rs=-0.498，p=0.042）。
本研究表明，极早产儿的 ARA 和 DHA 摄入量不足。此外，血液脂肪酸水平可能是一种有用的摄入量衡量指标，确定充足的摄入量可能具有临床意义。长链 PUFA 状态与炎症标志物之间可能存在重要的相互作用，这需要进一步研究。
