Feeding-Induced Cortisol Response in Newborn Infants
Feeding-Induced Cortisol Response in Newborn Infants
复制标题
DOI：
10.1210/jc.2018-01052
复制
发表时间：
2018-12-01
影响因子：
5.8
通讯作者：
Iwata, Osuke
中科院分区：
文献类型：
--
作者：
Kinoshita, Masahiro;Iwata, Sachiko;Iwata, Osuke
背景：了解患病新生儿的生物节律和应激反应对于减少重症监护的负面影响很重要。唾液皮质醇已被用作肾上腺功能的非侵入性替代标记物;然而，对其控制变量的理解是不够的。目的：探讨新生儿喂养诱导的皮质醇反应及其控制变量的存在。设计，设置和患者：53名新生儿，校正年龄在30至40周之间，接受3小时定期口服/肠内喂养，主要观察指标：分别于进食前和进食后1 h采集唾液样本。皮质醇水平（调整出生后的年龄）和喂养相关的海拔对临床变量的依赖性进行了评估，通过使用广义估计equations.Results：较高的皮质醇水平与校正年龄>= 37周和喂养后收集的唾液样本（均P < 0.001）。与单纯肠道喂养相比，经口喂养与更大的喂养诱导的皮质醇反应相关（P = 0.034），而与短暂喂养相比，延长喂养时间（>= 30分钟）与降低的皮质醇反应相关（
Context: Understanding the biological rhythms and stress response in sick newborns is important to minimize the negative effects of intensive care. Salivary cortisol has been used as a noninvasive surrogate marker of adrenal function; however, understanding of its control variables is insufficient.Objective: To investigate the presence of feeding-induced cortisol response and its control variables in newborns.Design, Setting, and Patients: Fifty-three newborn infants, who were between 30 and 40 weeks' corrected age and were on 3-hourly regular oral/enteral feeding, were recruited between January 2013 and June 2014.Main Outcome Measure: Saliva samples were collected before and 1 hour after regular feeding. Dependence of cortisol levels (adjusted for postnatal age) and their feeding-related elevation on clinical variables was assessed by using generalized estimating equations.Results: Higher cortisol levels were associated with corrected age >= 37 weeks and saliva samples collected after feeding (both P < 0.001). Oral feeding was associated with a greater feeding-induced cortisol response compared with exclusive enteral feeding (P = 0.034), whereas a prolonged feeding duration (>= 30 minutes) was associated with a reduced cortisol response compared with brief feeding (