USDA/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States.
School of Animal Sciences, Virginia Tech, Blacksburg, VA, United States.
J Nutr. 2024 Feb;154(2):638-647. doi: 10.1016/j.tjnut.2023.12.048. Epub 2024 Jan 3.
Nutrition during fetal and neonatal life is an important determinant for the risk of adult-onset diseases, especially type 2 diabetes and obesity.
We aimed to determine whether total parenteral nutrition (TPN) compared with enteral formula feeding [enteral nutrition (EN)] in term piglets during the first 2 wk after birth would increase the long-term (5-mo) development of metabolic syndrome phenotypes with adverse glucose homeostasis, fatty liver disease, and obesity.
Neonatal female pigs were administered TPN (n = 12) or fed enterally with a liquid enteral milk-replacer formula (EN, n = 12) for 14 d. After transitioning TPN pigs to enteral feeding of liquid formula (days 15-26), both groups were adapted to a solid high-fat diet (30% of the total diet) and sucrose (20% of the total diet) diet (days 27-33), which was fed until the end of the study (140 d). Body composition was measured by dual-energy X-ray absorptiometry at 14, 45, and 140 d. Serum biochemistry and glucose-insulin values (after a fasting intravenous glucose tolerance test) were obtained at 140 d. Liver and muscle were analyzed for insulin receptor signaling and triglycerides.
Body weight was similar, but percent fat was higher, whereas percent lean and bone mineral density were lower in TPN than in EN pigs (P < 0.01) at 45 d of age but not at 140 d. At 140 d, there were no differences in serum markers of liver injury or lipidemia. Intravenous glucose tolerance test at 140 d showed a lower (P < 0.05) AUC for both glucose and insulin in TPN than in EN pigs, but the ratio of AUCs of insulin and glucose was not different between groups.
Administration of TPN during the neonatal period increased adipose deposition that transiently persisted in early adolescence when challenged with a high-fat diet but was not sustained or manifested as glucose intolerance.
胎儿和新生儿期的营养是成年后发生疾病（尤其是 2 型糖尿病和肥胖）的重要决定因素。
我们旨在确定出生后 2 周内的足月仔猪通过全胃肠外营养（TPN）与肠内配方喂养（EN）相比，是否会增加代谢综合征表型的长期（5 个月）发展，其表现为葡萄糖稳态不良、脂肪肝和肥胖。
新生雌性小猪接受 TPN（n=12）或液体肠内牛奶替代配方喂养（EN，n=12）14 天。在将 TPN 小猪过渡到液体配方的肠内喂养（第 15-26 天）后，两组均适应固体高脂肪饮食（总饮食的 30%）和蔗糖（总饮食的 20%）饮食（第 27-33 天），直至研究结束（140 天）。在第 14、45 和 140 天，使用双能 X 射线吸收仪测量身体成分。在 140 天获得血清生化和葡萄糖-胰岛素值（在禁食静脉葡萄糖耐量试验后）。分析肝脏和肌肉中的胰岛素受体信号和甘油三酯。
体重相似，但 TPN 组的脂肪百分比更高，而 lean 百分比和骨矿物质密度更低，这在 45 天龄时比在 140 天龄时更明显（P <0.01）。在 140 天时，两组的血清肝损伤或血脂标志物均无差异。140 天时的静脉葡萄糖耐量试验显示，TPN 组的葡萄糖和胰岛素 AUC 均较低（P <0.05），但两组的胰岛素和葡萄糖 AUC 比值无差异。
新生儿期给予 TPN 会增加脂肪沉积，这种沉积在早期青春期受到高脂肪饮食的挑战时会暂时持续，但不会持续存在或表现为葡萄糖不耐受。
