Sampurna Mahendra, Angelika Dina, Utomo Martono Tri, Wijaya Nur Aisiyah, Budiono Budiono, Alkaff Firas Farisi, Irawan Roedi, Etika Risa
Department of Pediatrics, Airlangga University School of Medicine, Surabaya, Indonesia.
Department of Public Health, Airlangga University School of Medicine, Surabaya, Indonesia.
Turk Pediatri Ars. 2018 Dec 1;53(4):231-237. doi: 10.5152/TurkPediatriArs.2018.6834. eCollection 2018 Dec.
Glutamine is needed for optimal cell growth and for the immune system, especially in the enterocytes of gut mucosal immune responses. Low birth weight makes infants susceptible to glutamine depletion because nutrition is limited in the first week of life. To determine the effect of enteral glutamine supplementation on weight gain patterns and fecal secretory immunoglobulin A.
This study is a double-blind, randomized controlled trial. Infants were randomly assigned to the glutamine group and placebo group. The glutamine group was supplemented with glutamine 400 mg/kg/day for 14 days, and placebo group received glucose 400 mg/kg/day for 14 days. The infants were observed for 30 days. Return-to-birth-weight, weight gain velocity, and fecal secretory immunoglobulin A levels were monitored during the study.
Thirty-seven low-birth-weight infants were randomly assigned to the glutamine and placebo groups. The glutamine group had a shorter return-to-birth-weight time than the placebo group (8.1±0.9 vs. 11.0±1.6 days) and faster weight gain velocity (20.0±1.8 vs. 15.5±2.2 g/kg/day) (p<0.001). Secretory immunoglobulin A levels after glutamine supplementation were higher than in the placebo group (0.456±0.057 vs. 0.376±0.035 mg/g) (p<0.001). Levels of secretory immunoglobulin A after treatment in each group were increased. However, there was a significant difference before and after supplementation between the glutamine and placebo groups (0.247±0.024 vs. 0.140±0.016 mg/g) (p<0.001).
Enteral glutamine supplementation in low-birth-weight infants accelerates return to birth weight, increases the weight gain velocity, and the levels of fecal secretory immunoglobulin A.
谷氨酰胺是细胞最佳生长及免疫系统所必需的，尤其是在肠道黏膜免疫反应的肠上皮细胞中。低出生体重使婴儿易出现谷氨酰胺缺乏，因为在生命的第一周营养有限。本研究旨在确定肠内补充谷氨酰胺对体重增加模式及粪便分泌型免疫球蛋白A的影响。
本研究为双盲随机对照试验。将婴儿随机分为谷氨酰胺组和安慰剂组。谷氨酰胺组给予400mg/kg/天的谷氨酰胺，持续14天，安慰剂组给予400mg/kg/天的葡萄糖，持续14天。对婴儿进行30天的观察。在研究期间监测恢复出生体重的时间、体重增加速度及粪便分泌型免疫球蛋白A水平。
37名低出生体重婴儿被随机分为谷氨酰胺组和安慰剂组。谷氨酰胺组恢复出生体重的时间比安慰剂组短（8.1±0.9天对11.0±1.6天），体重增加速度更快（20.0±1.8对15.5±2.2g/kg/天）（p<0.001）。补充谷氨酰胺后的分泌型免疫球蛋白A水平高于安慰剂组（0.456±0.057对0.376±0.035mg/g）（p<0.001）。每组治疗后的分泌型免疫球蛋白A水平均升高。然而，谷氨酰胺组和安慰剂组补充前后存在显著差异（0.247±0.024对0.140±0.016mg/g）（p<0.001）。
低出生体重婴儿肠内补充谷氨酰胺可加速恢复出生体重，提高体重增加速度及粪便分泌型免疫球蛋白A水平。
