极低出生体重儿队列中的能量消耗、蛋白质氧化和身体成分。

Energy Expenditure, Protein Oxidation and Body Composition in a Cohort of Very Low Birth Weight Infants.

机构信息

Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.

Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.

出版信息

Nutrients. 2021 Nov 6;13(11):3962. doi: 10.3390/nu13113962.

DOI:10.3390/nu13113962

PMID:34836218

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8620881/

Abstract

UNLABELLED

The nutritional management of preterm infants is a critical point of care, especially because of the increased risk of developing extrauterine growth restriction (EUGR), which is associated with worsened health outcomes. Energy requirements in preterm infants are simply estimated, so the measurement of resting energy expenditure (REE) should be a key point in the nutritional evaluation of preterm infants. Although predictive formulae are available, it is well known that they are imprecise. The aim of our study was the evaluation of REE and protein oxidation (Ox) in very low birth weight infants (VLBWI) and the association with the mode of feeding and with body composition at term corrected age.

METHODS

Indirect calorimetry and body composition were performed at term corrected age in stable very low birth weight infants. Urinary nitrogen was measured in spot urine samples to calculate Ox. Infants were categorized as prevalent human milk (HMF) or prevalent formula diet (PFF).

RESULTS

Fifty VLBWI (HMF: 23, PFF: 27) were evaluated at 36.48 ± 0.85 post-conceptional weeks. No significant differences were found in basic characteristics or nutritional intake in the groups at birth and at the assessment. No differences were found in the REE of HMF vs. PFF (59.69 ± 9.8 kcal/kg/day vs. 59.27 ± 13.15 kcal/kg/day, respectively). We found statistical differences in the protein-Ox of HMF vs. PFF (1.7 ± 0.92 g/kg/day vs. 2.8 ± 1.65 g/kg/day, respectively, < 0.01), and HMF infants had a higher fat-free mass (kg) than PFF infants (2.05 ± 0.26 kg vs. 1.82 ± 0.35 kg, respectively, < 0.01), measured with air displacement plethysmography.

CONCLUSION

REE is similar in infants with a prevalent human milk diet and in infants fed with formula. The HMF infants showed a lower oxidation rate of proteins for energy purposes and a better quality of growth. A greater amount of protein in HMF is probably used for anabolism and fat-free mass deposition. Further studies are needed to confirm our hypothesis.

摘要

目的

评估极低出生体重儿（VLBWI）的静息能量消耗（REE）和蛋白质氧化（Ox），并探讨其与喂养方式和校正胎龄时体成分的关系。

方法

稳定的极低出生体重儿在校正胎龄时进行间接测热法和体成分分析。使用随机尿样测量尿氮以计算 Ox。将婴儿分为人乳喂养（HMF）或配方奶喂养（PFF）。

结果

共评估了 50 名 VLBWI（HMF：23 名，PFF：27 名），其胎龄为 36.48±0.85 周。两组在出生时和评估时的基本特征和营养摄入无显著差异。HMF 与 PFF 的 REE 无差异（分别为 59.69±9.8 kcal/kg/d 和 59.27±13.15 kcal/kg/d）。HMF 与 PFF 的蛋白质 Ox 存在统计学差异（分别为 1.7±0.92 g/kg/d 和 2.8±1.65 g/kg/d，<0.01），空气置换体积描记法测量的 HMF 婴儿的去脂体重（kg）高于 PFF 婴儿（分别为 2.05±0.26 kg 和 1.82±0.35 kg，<0.01）。