一项针对极早产儿的横断面研究中出生一周内的ω-3和ω-6脂肪酸状况
ω-3 and ω-6 fatty acid status within a week of birth in a cross-sectional study of very preterm infants.
作者信息
Gibson Robert A, Bednarz Jana M, Sullivan Thomas R, Makrides Maria, McPhee Andrew J, Davis Peter G, Doyle Lex W, Cheong Jeanie Ly, Travadi Javeed, Tan Kenneth, Morris Scott, Lui Kei, Bolisetty Srinivas, Stark Michael John, Thio Marta, Harris Deborah L, Stack Jacqueline, Berry Max, Rajadurai Victor, Chua Mei-Chien, Jayagobi Pooja A, Sharp Mary, Opie Gillian, Liley Helen, Gould Jacqueline F
机构信息
SAHMRI Women and Kids, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia; School of Agriculture, Food and Wine, The University of Adelaide, Glen Osmond, South Australia, Australia.
SAHMRI Women and Kids, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia; School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
出版信息
Am J Clin Nutr. 2025 Aug;122(2):593-600. doi: 10.1016/j.ajcnut.2025.05.014. Epub 2025 Jul 4.
BACKGROUND
Concentrations of the long-chain polyunsaturated fatty acids, in particular, the ω-3 (n-3) fatty acid DHA and the ω-6 fatty acid arachidonic acid (AA), decrease in infant blood during the first days after very preterm birth.
OBJECTIVES
This study aimed to explore factors associated with blood DHA and AA concentrations of very preterm infants receiving standard care, in the days following birth.
METHODS
We examined the fatty acid composition of whole blood samples collected on cards at 0-6 d after birth, from a cross-sectional study of 1174 infants born <29 weeks of gestation in Australia, New Zealand, and Singapore.
RESULTS
Considerable variation was observed in the proportions of blood AA (1.4%-18.0%) and DHA (0.4%-5.7%) concentrations. Infant blood DHA status was not associated with gestational age at birth, but AA was lower by 0.11% for each week of gestation (95% CI: -0.07%, 0.15%). There was an inverse relationship between age of sampling after birth and DHA (0.07% lower per day; 95% CI: 0.04%, 0.09%) and AA (0.09% lower; 95% CI: 0.04%, 0.14%). A concomitant positive relationship was observed between days after birth and the fatty acids present in the intravenous lipid emulsion administered: ω-6 linoleic acid (range: 2.1%-35.1%) and ω-9 oleic acid (range: 12.2%-52.9%).
CONCLUSIONS
Preterm infants whose blood was sampled later after birth have lower DHA and AA status relative to those sampled earlier after birth; samples taken at later timepoints are concurrently higher in the fatty acids of linoleic acid and oleic acid, which are the major compositional components of intravenous lipid emulsions routinely administered to preterm infants. The results support calls to develop intravenous feeds closely matching the fatty acid composition of infant blood at birth. The N3RO Trial is registered at the Australian New Zealand Clinical Trial Registry as ACTRN12612000503820 (https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12612000503820).
背景
极早产儿出生后的头几天内，其血液中的长链多不饱和脂肪酸，尤其是ω-3（n-3）脂肪酸二十二碳六烯酸（DHA）和ω-6脂肪酸花生四烯酸（AA）的浓度会降低。
目的
本研究旨在探讨出生后几天内接受标准护理的极早产儿血液中DHA和AA浓度的相关因素。
方法
我们对澳大利亚、新西兰和新加坡1174例孕周小于29周出生的婴儿进行了横断面研究，检测了出生后0至6天采集在卡片上的全血样本的脂肪酸组成。
结果
血液中AA（1.4%-18.0%）和DHA（0.4%-5.7%）浓度比例存在显著差异。婴儿血液中的DHA状态与出生时的孕周无关，但AA每增加一周会降低0.11%（95%可信区间：-0.07%，0.15%）。出生后采样时间与DHA（每天降低0.07%；95%可信区间：0.04%，0.09%）和AA（降低0.09%；95%可信区间：0.04%，0.14%）呈负相关。出生天数与静脉注射脂质乳剂中的脂肪酸之间存在正相关：ω-6亚油酸（范围：2.1%-35.1%）和ω-9油酸（范围：12.2%-52.9%）。
结论
相对于出生后较早采样的早产儿，出生后较晚采样的早产儿血液中的DHA和AA水平较低；在较晚时间点采集的样本中，亚油酸和油酸的脂肪酸含量同时较高，这两种酸是常规用于早产儿的静脉注射脂质乳剂的主要成分。研究结果支持开发与婴儿出生时血液脂肪酸组成紧密匹配的静脉营养制剂的呼吁。N3RO试验已在澳大利亚新西兰临床试验注册中心注册，注册号为ACTRN12612000503820（https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12612000503820）。
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