University of Mississippi Medical Center, Jackson, MS, USA.
Connecticut Children's Medical Center, Hartford, CT, USA.
Biol Sex Differ. 2020 Apr 15;11(1):16. doi: 10.1186/s13293-020-00295-7.
We sought to determine whether there are sex-based differences in the requirements for calories or protein for optimal growth during the transition phase (TP) when an extremely low birth weight (ELBW) infant, defined as a preterm infant with a birth weight of < 1000 g, is progressing from parenteral to enteral feeds. A retrospective review of ELBW infants born from 2014 to 2016 was performed at a tertiary NICU. Infants with necrotizing enterocolitis, short bowel syndrome, or chromosomal anomalies were excluded. TP was defined as the period when the infant's enteral feeds were increased from 30 up to 120 ml/kg/day while weaning parenteral nutrition (PN). Effects of sex and protein-calorie intake on the change in growth parameters from the beginning to the end of TP were analyzed. Pre-TP growth percentiles and calorie and protein intake were similar in both sexes. There was a significant (r = 0.22, p = 0.026) correlation of total calorie intake with a change in weight percentiles (wt.pc) for the whole group, but on sex-specific analysis, this correlation was more robust and significant only in girls (r = 0.28, p = 0.015). Protein intake did not correlate with the changes in wt.pc in either sex. Despite a similar intake of calories and protein during the TP, we found a significant decrease in wt.pc only in girls. More extensive studies are needed to understand the sex-based differences in caloric needs and metabolic rate in ELBW infants.
我们旨在确定在极低出生体重（ELBW）婴儿从肠外喂养向肠内喂养过渡期间（TP），对于最佳生长所需的卡路里或蛋白质是否存在性别差异。TP 定义为婴儿的肠内喂养从 30ml/kg/天增加到 120ml/kg/天时，我们正在对 2014 年至 2016 年在一家三级新生儿重症监护病房出生的 ELBW 婴儿进行回顾性研究。排除患有坏死性小肠结肠炎、短肠综合征或染色体异常的婴儿。研究分析了性别和蛋白质-卡路里摄入量对 TP 期间生长参数从开始到结束的变化的影响。在 TP 之前，两性的生长百分位数和卡路里及蛋白质摄入量相似。总卡路里摄入量与整个组体重百分位数（wt.pc）的变化呈显著相关（r = 0.22，p = 0.026），但在性别特异性分析中，这种相关性在女孩中更显著（r = 0.28，p = 0.015）。蛋白质摄入量与两性 wt.pc 的变化均无相关性。尽管在 TP 期间摄入的卡路里和蛋白质相似，但我们仅在女孩中发现 wt.pc 显著下降。需要进行更多的研究来了解 ELBW 婴儿中热量需求和代谢率的性别差异。
