Nutrient supplies for optimal health in preterm infants
Nutrient supplies for optimal health in preterm infants
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DOI：
10.1097/01.mpg.0000302965.93546.b8
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发表时间：
2007-12-01
影响因子：
2.9
通讯作者：
Hay, William W., Jr.
中科院分区：
文献类型：
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作者：
Hay, William W., Jr.
最常推荐的极早产儿产后营养标准是满足人类胎儿生长的独特营养需求并复制正常的子宫内胎儿生长（体重和身体成分）和发育的标准。因此，正常的胎儿营养可能是为需要在子宫外生长和发育的极早产儿设计产后营养策略的有用指南。这些信息表明，正常的胎儿营养需要最佳量的某些营养素和某些促生长激素，以响应营养供应，共同支持胎儿的最佳生长和发育；这些包括氧、葡萄糖、脂质、氨基酸和胰岛素。有趣的是，胎儿的营养限制和营养过剩虽然会导致不同的表型，但在以后的生活中会产生类似的表型，称为“代谢综合征”，包括肥胖、胰岛素抵抗、糖尿病和心血管疾病。出生后，早产儿（几乎普遍没有像正常生长的胎儿那样通过胎盘获得的营养供应）也会导致身材矮小的发生率更高，并且更容易患代谢综合征，而那些摄入过多能量以及在生命早期出现主要脂肪组织过度生长（体重与身长百分位的快速、正交叉）的早产儿也会出现更高的代谢综合征发生率。因此，很明显，需要适量的必需营养素才能产生最佳结果；对于早产儿和胎儿来说都是如此。
The most commonly recommended standard for postnatal nutrition of very preterm infants is one that meets the unique nutritional requirements of the growing human fetus and duplicates normal in utero human fetal growth (weight and body composition) and development. Normal fetal nutrition, therefore, may be a useful guide for designing postnatal nutritional strategies in very preterm infants who need to grow and develop outside the uterus. Such information indicates that normal fetal nutrition requires certain nutrients in optimal amounts and certain growth-promoting hormones in response to nutrient supply that together support optimal fetal growth and development; these include oxygen, glucose, lipids, amino acids, and insulin. Interestingly, nutrient restriction and nutrient excess in the fetus, while leading to different phenotypes, produce a similar phenotype in later life characterized as the "metabolic syndrome," consisting of obesity, insulin resistance, diabetes, and cardiovascular disease. After birth, preterm infants-who almost universally are not fed as much as normally growing fetuses receive in nutrient supply via the placenta-also end up with a higher incidence of short stature and a predisposition to the metabolic syndrome, whereas those fed excessive amounts of energy and who develop excessive growth primarily of adipose tissue in early life (rapid, positive crossing of weight-for-length centiles) also develop a higher incidence of the metabolic syndrome. It is clear, therefore, that just the right amount of the essential nutrients is required to produce optimal outcome; this is as true for the preterm infant as it is for the fetus.