Effect of human milk or formula on gastric function and fat digestion in the premature infant
Effect of human milk or formula on gastric function and fat digestion in the premature infant
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DOI：
10.1203/00006450-199609000-00011
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发表时间：
1996-09-01
影响因子：
3.6
通讯作者：
Hamosh, P
中科院分区：
文献类型：
--
作者：
Armand, M;Hamosh, M;Hamosh, P
对28例符合胎龄的早产儿(胎龄：28.9±-1.4，29.1+/-0.9，29.5+/-0.6wk；出生体重：1.00±0.14~1.18+/-0.07 kg)的胃功能(脂肪酶活性、胃蛋白酶活性、pH和体积)和胃内脂肪消化的影响进行了研究。婴儿喂养母乳(n=11)、SMA Super Preemie配方奶粉(n=9)或Similac，特殊护理配方奶粉(n=8)。三组婴儿的空腹和餐后消化酶活性、pH和胃容(在灌胃喂养前或之后50分钟内测量)随饮食的变化没有差异。母乳、SMA SP或Similac SC喂养的婴儿的胃脂酶产量分别为23.1+/-5.1、28.3+/-6.6和22.5+/-6.4(U/kg体重)，与喂高脂饮食的健康成年人的胃脂酶产量(22.6+/-3.0)相当。然而，在母乳、SMA SP和Similac SC喂养的婴儿中，胃酶产量(597+/-77,743+/-97和639+/-142U/kg)显著低于健康成年人(3352+/-753U/kg)。母乳喂养的婴儿的膳食脂肪水解率是喂养两种配方奶粉的婴儿的1.7-2.5倍(p<；0.01)。我们得出的结论是，饲喂类型的不同，即不同的脂肪酸组成(长链或中链甘油三酯)、不同的乳剂(天然或人工)以及不同的脂肪颗粒大小不会影响胃酶的活性水平。然而，乳脂颗粒中的甘油三酯似乎比配方脂肪颗粒中的甘油三酯更容易被胃脂酶所接近。我们认为，胃脂酶在新生儿(胰腺功能不全时期)对总脂肪消化的贡献可能比成人更大。
The effect of diet, human milk or formula, on gastric function (lipase and pepsin activity, pH, and volume) and intragastric digestion of fat was assessed in 28 appropriate for gestational age preterm infants (gestational age, 28.9 +/- 1.4, 29.1 +/- 0.9, 29.5 +/- 0.6 wk; birth weight, 1.00 +/- 0.14 to 1.18 +/- 0.07 kg). The infants were fed either human milk (n = 11), SMA Super Preemie formula (n = 9), or Similac, Special Care formula (n = 8). Fasting and postprandial activity of digestive enzymes, pH, and gastric volume (measured before or during 50 min after gavage feeding) did not differ as a function of diet among the three groups of infants. Gastric lipase output, 23.1 +/- 5.1, 28.3 +/- 6.6, and 22.5 +/- 6.4 (U/kg of body weight) in human milk-, SMA SP-, or Similac SC-fed infants was comparable to the gastric lipase output of healthy adults fed a high fat diet (22.6 +/- 3.0). Pepsin output was, however, significantly lower (597 +/- 77, 743 +/- 97, and 639 +/- 142 U/kg of body weight) in human milk-, SMA SP-, and Similac SC-fed infants) than in healthy adults (3352 +/- 753 U/kg). The hydrolysis of dietary fat was 1.7-2.5-fold higher (p < 0.01) in human milk-fed infants than in infants fed either formula. We conclude that differences in type of feeding, i.e. different fatty acid profiles (long chain or medium chain triglycerides), different emulsions (natural or artificial), and different fat particle sizes do not affect the level of activity of gastric enzymes. However, the triglyceride within milk fat globules appears to be more accessible to gastric lipase than that within formula fat particles. We suggest that the contribution of gastric lipase to overall fat digestion might be greater in the newborn (a period of pancreatic insufficiency) than in the adult.