二十二碳六烯酸和花生四烯酸补充对早产儿生长质量的影响：一项随机对照试验的二次分析。

Effect of arachidonic and docosahexaenoic acid supplementation on quality of growth in preterm infants: A secondary analysis of a randomized controlled trial.

机构信息

Department of Neonatal Intensive Care, Oslo University Hospital, Norway; Department of Pediatrics and Adolescence Medicine, Oslo University Hospital, Norway; Institute of Clinical Medicine, University of Oslo, Norway.

Department of Pediatrics and Adolescence Medicine, Oslo University Hospital, Norway.

出版信息

Clin Nutr. 2023 Dec;42(12):2311-2319. doi: 10.1016/j.clnu.2023.10.005. Epub 2023 Oct 17.

DOI:10.1016/j.clnu.2023.10.005

PMID:37856920

Abstract

BACKGROUND & AIMS: A balanced supply of arachidonic acid (ARA) and docosahexaenoic acid (DHA) may be crucial for quality of growth in preterm infants. This secondary analysis of a randomized controlled trial aimed to determine the effect of enhanced ARA and DHA supplementation on growth and body composition in infants born before 29 weeks of gestation. Furthermore, we aimed to study associations between human milk feeding, growth patterns and body composition.

METHODS

The ImNuT-trial randomized 121 infants to receive a daily supplement with medium chain triglycerides (control) or 100 mg/kg ARA and 50 mg/kg DHA (ARA:DHA group) from the second day of life until 36 weeks postmenstrual age. Growth and body composition were evaluated up to 3 months corrected age.

RESULTS

The ARA:DHA group showed better linear growth from birth to term equivalent age compared to the control group; mean difference in z score change from birth for length was 0.74 ([95% CI, 0.17-1.3]; p = 0.010). There were no differences in growth and body composition outcomes at 3 months corrected age between the groups. An increase in z score for weight after 36 weeks postmenstrual age and breastfeeding at 3 months corrected age were the strongest positive predictors of fat mass% at 3 months corrected age (both, p < 0.001).

CONCLUSION

Early enhanced supplementation of ARA and DHA may be beneficial with respect to somatic growth in very preterm infants.

CLINICAL TRIAL REGISTRATION

The trial has been registered on www.

CLINICALTRIALS

gov, ID: NCT03555019.

摘要

背景与目的

花生四烯酸（ARA）和二十二碳六烯酸（DHA）的均衡供应可能对早产儿的生长质量至关重要。本研究是一项随机对照试验的二次分析，旨在确定增强 ARA 和 DHA 补充对 29 周以下出生婴儿生长和身体成分的影响。此外，我们旨在研究人乳喂养、生长模式和身体成分之间的关联。

方法

ImNuT 试验将 121 名婴儿随机分为两组，从出生后的第二天开始，每天接受中链甘油三酯（对照组）或 100mg/kg ARA 和 50mg/kg DHA（ARA：DHA 组）补充，直至胎龄 36 周。生长和身体成分评估至校正 3 月龄。

结果

与对照组相比，ARA：DHA 组从出生到足月年龄的线性生长更好；出生时至足月年龄的 z 评分变化的平均差异为 0.74（[95%CI，0.17-1.3]；p=0.010）。两组在校正 3 月龄时的生长和身体成分结果无差异。校正 3 月龄时体重 z 评分增加和校正 3 月龄时母乳喂养是校正 3 月龄时脂肪量%的最强正预测因素（均，p<0.001）。