Early Enteral Administration of a Complex Lipid Emulsion Supplement Prevents Postnatal Deficits in Docosahexaenoic and Arachidonic Acids and Increases Tissue Accretion of Lipophilic Nutrients in Preterm Piglets
Early Enteral Administration of a Complex Lipid Emulsion Supplement Prevents Postnatal Deficits in Docosahexaenoic and Arachidonic Acids and Increases Tissue Accretion of Lipophilic Nutrients in Preterm Piglets
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DOI：
10.1002/jpen.1697
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发表时间：
2019-08-23
影响因子：
3.4
通讯作者：
Martin, Camilia R.
中科院分区：
文献类型：
--
作者：
Akinsulire, Olajumoke;Perides, George;Martin, Camilia R.
背景：早产和目前的营养策略导致关键的长链脂肪酸(FAs)和亲脂性营养物质的缺乏，增加了早产儿发病的风险。我们试图确定使用肠内浓缩脂肪补充剂预防早产仔猪出生后脂肪酸和脂类营养缺陷的有效性。方法用不含花生四烯酸(AA)和二十二碳六烯酸(DHA)的基础日粮喂养早产仔猪，随机分为3组：(1)Intralipid(IL)；(2)复合脂质补充剂1(CLS1)，AA：DHA为0.25；(3)CLS2，AA：DHA为1.2。第8天，测定血浆和组织中FAs和脂类营养素水平，并进行回肠组织学检查。结果IL组出生后第2天血浆DHA水平下降，而CLS1组和CLS2组出生后第2天DHA水平均高于出生时水平。IL组和CLS1组在8天方案中AA水平持续下降，而CLS2组第8天的AA水平与出生水平相当。CLS2组维持AA水平与较大回肠绒毛高度和肌层厚度相关。亲脂性营养物质在血浆和组织中被有效吸收。结论与出生水平相比，肠内注射CLS1和CLS2的DHA水平有相似的升高。只有CLS2维持AA出生水平。提供AA：DHA比例的浓缩复合脂肪乳剂在预防出生后AA缺乏症方面非常重要。
Background Preterm delivery and current nutrition strategies result in deficiencies of critical long-chain fatty acids (FAs) and lipophilic nutrients, increasing the risk of preterm morbidities. We sought to determine the efficacy of preventing postnatal deficits in FAs and lipophilic nutrients using an enteral concentrated lipid supplement in preterm piglets. Methods Preterm piglets were fed a baseline diet devoid of arachidonic acid (AA) and docosahexaenoic acid (DHA) and randomized to enteral supplementation as follows: (1) Intralipid (IL), (2) complex lipid supplement 1 (CLS1) with an AA:DHA ratio of 0.25, or (3) CLS2 with an AA:DHA ratio of 1.2. On day 8, plasma and tissue levels of FAs and lipophilic nutrients were measured and ileum histology performed. Results Plasma DHA levels decreased in the IL group by day 2. In contrast, DHA increased by day 2 compared with birth levels in both CLS1 and CLS2 groups. The IL and CLS1 groups demonstrated a continued decline in AA levels during the 8-day protocol, whereas AA levels in the CLS2 group on day 8 were comparable to birth levels. Preserving AA levels in the CLS2 group was associated with greater ileal villus height and muscular layer thickness. Lipophilic nutrients were effectively absorbed in plasma and tissues. Conclusions Enteral administration of CLS1 and CLS2 demonstrated similar increases in DHA levels compared with birth levels. Only CLS2 maintained AA birth levels. Providing a concentrated complex lipid emulsion with an AA:DHA ratio > 1 is important in preventing postnatal AA deficits.