Gastrin, motilin, insulin, and insulin-like growth factor-I concentrations in very-low-birth-weight infants receiving enteral or parenteral nutrition.

Blood concentrations of gastrin, motilin, insulin, and insulin-like growth factor-I were measured sequentially during the first 3 weeks of life in 22 very-low-birth-weight infants (birth weight 1.03 +/- 0.24 g; gestational age 28.3 +/- 1.9 weeks; mean +/- SD) who were in respiratory distress requiring mechanical ventilation and were receiving either total parenteral or enteral feedings. An increase in the blood concentration of motilin beyond the basal measurement was observed in enterally fed infants but not in infants receiving total parenteral nutrition. Motilin and gastrin concentrations were significantly increased in the enterally fed group compared with infants receiving total parenteral nutrition at 2 and 3 weeks and 1 and 3 weeks, respectively. There were no differences in serum insulin or plasma insulin-like growth factor-I concentrations between groups after the start of the study. The present data suggest that enteral nutrition in very-low-birth-weight infants is associated with a relative increase in peripheral motilin and gastrin concentrations compared with parenterally fed infants.