Department of Clinical Nutrition, Anhui Provincial Children's Hospital, Wangjiang East Road 39, Hefei, 23000, Anhui, China.
Beijing Paediatric Research Institute, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing Children's Hospital, Capital Medical University, National Centre for Children's Health, Beijing, 100045, China.
BMC Pediatr. 2022 Mar 2;22(1):113. doi: 10.1186/s12887-022-03174-9.
Retinopathy of prematurity (ROP) remains a leading cause of childhood blindness worldwide. This study aimed to investigate whether supplementation of n-3 polyunsaturated fatty acids (n-3 PUFAs) in parenteral nutrition may have beneficial effects on ROP in preterm infants.
A total of 89 preterm infants, admitted to Neonatal Intensive Care Unit (NICU) in Anhui Provincial Children's Hospital from September 2017 to August 2020, were recruited in the study. Based on the medical documents, the subjects were categorised into two groups: administration of the fish oil emulsion (n=43) containing soy oil, medium-chain-triglycerides (MCT), olive oil and fish oil (6g/dL, 6g/dL, 5g/dL and 3g/dL respectively), and the soy oil emulsion (n=46) containing 10g/dL of soy oil and MCT each. At 4 weeks of hospitalization, ROP was screened and diagnosed. Fatty acids in erythrocytes were determined using gas chromatography.
The averaged birth weight and gestational age were 1594±296 g and 31.9±2.3 wk, 1596±263 g and 31.6±2.3 wk respectively for preterm infants in the fish oil group and soy oil group. After 4 to 6 weeks of hospitalization, among all the preterm infants, 52 developed ROP (all stages) indicating an incidence of ROP at 58.43%. Although the incidence of ROP with any stages showed no differences between the two groups, the severe ROP incidence in the group with fish oil emulsions (2.33%) was significantly lower than that in the group with soy oil emulsions (23.91%) (P<0.05). After 14 days of nutrition support, the preterm infants administered fish oil emulsions had an increase in erythrocyte DHA content, with a reduction in ratio of arachidonic acid (AA) to DHA and an increase of n-3 index.
Supplementation of n-3 PUFAs through parenteral fish oil containing lipid emulsions resulted in an increase in erythrocyte DHA, and this might have beneficial effects on prevention of severe ROP in preterm infants.
早产儿视网膜病变（ROP）仍然是全球儿童失明的主要原因。本研究旨在探讨在早产儿的肠外营养中添加 n-3 多不饱和脂肪酸（n-3 PUFAs）是否对 ROP 有有益影响。
本研究共纳入 2017 年 9 月至 2020 年 8 月在安徽省立医院新生儿重症监护病房（NICU）住院的 89 例早产儿。根据病历资料，将受试者分为两组：一组给予含有大豆油、中链甘油三酯（MCT）、橄榄油和鱼油（6g/dL、6g/dL、5g/dL 和 3g/dL 分别）的鱼油乳剂（n=43），另一组给予含有 10g/dL 大豆油和 MCT 的大豆油乳剂（n=46）。住院 4 周时进行 ROP 筛查和诊断。采用气相色谱法测定红细胞中的脂肪酸。
鱼油组和大豆油组早产儿的平均出生体重和胎龄分别为 1594±296 g 和 31.9±2.3 周、1596±263 g 和 31.6±2.3 周。住院 4 至 6 周后，所有早产儿中有 52 例发生 ROP（所有分期），ROP 发生率为 58.43%。虽然两组间任何分期 ROP 的发生率均无差异，但鱼油乳剂组严重 ROP 发生率（2.33%）明显低于大豆油乳剂组（23.91%）（P<0.05）。营养支持 14 天后，给予鱼油乳剂的早产儿红细胞 DHA 含量增加，花生四烯酸（AA）与 DHA 的比值降低，n-3 指数增加。
通过含有脂质乳剂的肠外补充 n-3 PUFAs 可增加红细胞 DHA，这可能对预防早产儿严重 ROP 有益。
