早期肠外脂质摄入可支持早产儿足月时小脑的神经代谢。
Early parenteral lipid intake supports cerebellar neurometabolism at term-age in preterm infants.
作者信息
Basu Sudeepta K, Ottolini Katherine M, Kapse Kushal J, Ngwa Julius, Hui Steve C N, Andescavage Nickie, Murnick Jonathan, du Plessis Adre J, Limperopoulos Catherine
机构信息
Neonatology, Children's National Hospital, Washington, DC, USA.
Developing Brain Institute, Children's National Hospital, Washington, DC, USA.
出版信息
J Perinatol. 2025 Jun 23. doi: 10.1038/s41372-025-02336-8.
OBJECTIVES
The impact of crucial early parenteral nutrition on neurometabolism of the preterm brain remains unclear. This study characterizes the relationship of parenteral lipid and caloric intake with cerebellar neurometabolites.
METHODS
Very premature infants [born ≤32-week gestational age (GA)] in a prospective observational cohort study underwent a proton magnetic resonance spectroscopy (H-MRS) acquisition from a cerebellar voxel at term-age. Parenteral lipid and caloric intake (g/kg/d or kcal/kg/d) in the first 4 weeks of life were calculated by chart review.
RESULTS
48 preterm infants born at 28.3 ± 2.4 weeks GA underwent H-MRS at 38.9 ± 1.9 weeks postmenstrual age. Cerebellar N-acetylaspartate [NAA] positively correlated with 4-week parenteral lipid (Rho = 0.4, p = 0.005) and caloric (Rho = 0.3, p = 0.047) intake. Glutamate [Glx] demonstrated a positive trend. Adjusted for covariates, 4-week parenteral lipid intake was associated with higher NAA (B coefficient = 0.89, p = 0.003) and Glx (B = 1.72, p = 0.045).
CONCLUSIONS
Parenteral lipid intake is associated with higher cerebellar NAA and Glx concentrations, supporting brain development in preterm infants.
目的
关键的早期肠外营养对早产儿大脑神经代谢的影响尚不清楚。本研究旨在描述肠外脂肪和热量摄入与小脑神经代谢物之间的关系。
方法
在一项前瞻性观察队列研究中，对极早产儿[出生时胎龄（GA）≤32周]在足月时从小脑体素进行质子磁共振波谱（H-MRS）采集。通过图表回顾计算出生后前4周的肠外脂肪和热量摄入量（g/kg/d或kcal/kg/d）。
结果
48例出生时GA为28.3±2.4周的早产儿在月经龄38.9±1.9周时接受了H-MRS检查。小脑N-乙酰天门冬氨酸[NAA]与4周肠外脂肪摄入量（Rho = 0.4，p = 0.005）和热量摄入量（Rho = 0.3，p = 0.047）呈正相关。谷氨酸[Glx]呈上升趋势。校正协变量后，4周肠外脂肪摄入量与较高的NAA（B系数 = 0.89，p = 0.003）和Glx（B = 1.72，p = 0.045）相关。
结论
肠外脂肪摄入与较高的小脑NAA和Glx浓度相关，支持早产儿的大脑发育。
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