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早产儿早期能量摄入与氨基酸谱:一项准实验研究。

Early Energy Intake and Amino Acid Profile in Preterm Newborns: A Quasi-Experimental Study.

机构信息

Department of Maternal and Child Health, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy.

Department of Experimental Medicine, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy.

出版信息

Nutrients. 2023 Jun 27;15(13):2917. doi: 10.3390/nu15132917.

Abstract

(1) Background: An increased protein intake via parenteral nutrition (PN) in early life is associated with an improvement of the nitrogen balance in preterm newborns. However, the role of energy intake on amino acid (AA) utilization provided by PN remains to be defined. We investigated the effects of energy intake on blood AA levels and profiles. (2) Methods: Quasi-experimental study including preterm very low birth weight newborns who received an energy enhanced PN (Cohort A) or an energy standard PN (Cohort B), with a similar protein amount in the first week of life. Blood AA levels were measured between three and seven days of life (T0) and at fifteen days of life (T1) and compared between the two study cohorts. (3) Results: AA levels of 40 newborns from each group were analyzed. No difference was found for total essential and non-essential blood AA concentration at T0 between the two study cohorts. At T1, we found a significantly higher blood concentration of leucine, isoleucine and proline, and a significantly lower concentration of tyrosine in Cohort B. However, multivariate analysis did not confirm this result. (4) Conclusions: An enhanced PN protocol in terms of energy but not of protein did not influence AA levels and profiles. Considering the high risk of side effects, we suggest exercising caution when administering high energy intake via PN in the first week of life.

摘要

(1) 背景:通过肠外营养(PN)增加蛋白质摄入与改善早产儿的氮平衡有关。然而,PN 提供的能量摄入对氨基酸(AA)利用的作用仍有待确定。我们研究了能量摄入对血 AA 水平和谱的影响。

(2) 方法:包括接受能量增强 PN(队列 A)或能量标准 PN(队列 B)的极低出生体重早产儿的准实验研究,两组在生命的第一周接受相似数量的蛋白质。在生命的第 3 天至第 7 天(T0)和第 15 天(T1)测量血 AA 水平,并在两组研究队列之间进行比较。

(3) 结果:分析了来自每组 40 名新生儿的 AA 水平。两组在 T0 时总必需和非必需血 AA 浓度无差异。在 T1,我们发现队列 B 中亮氨酸、异亮氨酸和脯氨酸的血浓度显著升高,酪氨酸的血浓度显著降低。然而,多变量分析并未证实这一结果。

(4) 结论:在能量方面而不是蛋白质方面增强 PN 方案并没有影响 AA 水平和谱。考虑到副作用的高风险,我们建议在生命的第一周通过 PN 给予高能量摄入时要谨慎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71f6/10343583/3c6b9b3fd927/nutrients-15-02917-g001.jpg

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