Stutte Sonja, Gohlke Bettina, Peiler Annika, Schreiner Felix, Born Mark, Bartmann Peter, Woelfle Joachim
Paediatric Endocrinology Division, Children's Hospital, University of Bonn, 53113 Bonn, Germany.
Department for Orthopedic surgery, Franziskus Hospital, 53545 Linz, Germany.
Nutrients. 2017 Feb 10;9(2):124. doi: 10.3390/nu9020124.
To evaluate body composition, metabolism and growth as well as their interaction with early nutrition in former extremely low birth weight infants (ELBW), we assessed qualitative and quantitative nutritional intake during initial hospitalization and infantile growth parameters in 61 former ELBW infants with a birth weight <1000 g. In two follow-up exams, physical and biochemical development were measured at 5.7 and at 9.5 years. At the second follow-up, in addition to biochemical reassessment, body composition was analyzed by dual-energy x-ray absorptiometry (DEXA). Protein intake between birth and discharge was associated with weight gain in the first six months of life ( = 0.51; < 0.01). Weight catch-up preceded height catch-up. Protein intake in early infancy correlated highly significantly with abdominal fat mass ( = 0.49; < 0.05), but not with lean body mass at 9.5 years ( = 0.30; not significant (n.s.). In contrast to nutrient intake, birth weight was associated with lean body mass ( = 0.433; < 0.001). Early protein and carbohydrate intake were associated with high-density lipoprotein (HDL)-cholesterol, and early catch-up growth correlated with fasting insulin at follow-up. Stepwise linear regression demonstrated that protein intake predicted fat mass ( < 0.05), whereas only gender and birth weight standard deviation score (SDS) contributed significantly to lean body mass variation ( < 0.05). Our results suggest an important impact of early nutrient intake on body composition and metabolism in later childhood in ELBW children.
为了评估极早早产儿（ELBW）的身体成分、代谢和生长情况，以及它们与早期营养的相互作用，我们评估了61名出生体重<1000g的前ELBW婴儿在初次住院期间的定性和定量营养摄入以及婴儿生长参数。在两次随访检查中，分别在5.7岁和9.5岁时测量身体和生化发育情况。在第二次随访时，除了进行生化重新评估外，还通过双能X线吸收法（DEXA）分析身体成分。出生至出院期间的蛋白质摄入量与生命最初六个月的体重增加相关（r = 0.51；P < 0.01）。体重追赶先于身高追赶。婴儿早期的蛋白质摄入量与腹部脂肪量高度显著相关（r = 0.49；P < 0.05），但与9.5岁时的瘦体重无关（r = 0.30；无显著性差异（n.s.））。与营养摄入情况相反，出生体重与瘦体重相关（r = 0.433；P < 0.001）。早期蛋白质和碳水化合物摄入量与高密度脂蛋白（HDL）胆固醇相关，早期追赶生长与随访时的空腹胰岛素相关。逐步线性回归表明，蛋白质摄入量可预测脂肪量（P < 0.05），而只有性别和出生体重标准差评分（SDS）对瘦体重变化有显著贡献（P < 0.05）。我们的结果表明，早期营养摄入对ELBW儿童儿童期后期的身体成分和代谢有重要影响。
