Plasma phospholipids indicate impaired fatty acid homeostasis in preterm infants
Plasma phospholipids indicate impaired fatty acid homeostasis in preterm infants
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DOI：
10.1007/s00394-014-0658-3
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发表时间：
2014-10-01
影响因子：
5
通讯作者：
Franz, Axel R.
中科院分区：
文献类型：
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作者：
Bernhard, Wolfgang;Raith, Marco;Franz, Axel R.
在胎儿发育过程中，二十二碳六烯酸（DHA）和花生四烯酸（ARA）在脑磷脂中含量特别丰富。早产之后，通过胎盘转运实现的胎儿体内DHA和ARA的富集被肠内和肠外营养所取代，而这些营养富含的是亚油酸（LA）。脂蛋白中特定的DHA和ARA富集情况可由血浆磷脂酰胆碱（PC）种类反映出来，而血浆磷脂酰乙醇胺（PE）的组成则反映肝脏储备情况。我们对早产儿血浆中的PC和PE种类进行了分析，并与脐带血和母体血液进行比较，以评估当前的喂养方式是否符合这些患儿的胎儿期状况。
收集了早产儿血浆（N = 171，月经后年龄（PMA）为23 - 35周，出生后第1 - 103天）、脐带血浆（N = 194）和母体血清（N = 121）（PMA均为24 - 41周）。经过脂质提取后，使用串联质谱法分析PC和PE的分子种类。
在校正PMA后，早产儿血浆中的磷脂浓度高于脐带血浆。这主要是由于出生后含LA的PC和PE增加，导致含DHA和ARA的相应成分所占比例下降。早产儿血浆磷脂的这些变化发生在向完全肠内喂养过渡期间（分娩后第0 - 10天）。此后，含ARA的磷脂所占比例进一步下降，而含DHA的磷脂所占比例缓慢回升，但仍保持在与PMA匹配的脐带血水平的50%。
早产儿血浆中LA - PC在出生后的增加导致DHA - PC和ARA - PC所占比例下降。这些变化也反映在PE分子组成上，可作为肝脏脂肪酸内稳态改变的一个指标。它们可能是由于在ARA - PC和DHA - PC本应较高的发育阶段，LA含量过高，而ARA和DHA供应不足所致，这可能会降低发育中的大脑可获得的DHA和ARA，进而导致早产儿神经发育受损。
During fetal development, docosahexaenoic (DHA) and arachidonic acid (ARA) are particularly enriched in brain phospholipids. After preterm delivery, fetal enrichment of DHA and ARA via placental transfer is replaced by enteral and parenteral nutrition, which is rich in linoleic acid (LA) instead. Specific DHA and ARA enrichment of lipoproteins is reflected by plasma phosphatidylcholine (PC) species, whereas plasma phosphatidylethanolamine (PE) composition reflects hepatic stores.We profiled PC and PE species in preterm infant plasma, compared with cord and maternal blood, to assess whether current feeding practice meets fetal conditions in these patients.Preterm infant plasma (N = 171, 23-35 w postmenstrual age (PMA), postnatal day 1-103), cord plasma (N = 194) and maternal serum (N = 121) (both 24-41 w PMA) were collected. After lipid extraction, PC and PE molecular species were analyzed using tandem mass spectrometry.Phospholipid concentrations were higher in preterm infant than in cord plasma after correction for PMA. This was mainly due to postnatal increases in LA-containing PC and PE, resulting in decreased fractions of their DHA- and ARA-containing counterparts. These changes in preterm infant plasma phospholipids occurred during the time of transition to full enteral feeds (day 0-10 after delivery). Thereafter, the fraction of ARA-containing phospholipids further decreased, whereas that of DHA slowly reincreased but remained at a level 50 % of that of PMA-matched cord blood.The postnatal increase in LA-PC in preterm infant plasma results in decreased fractions of DHA-PC and ARA-PC. These changes are also reflected by PE molecular composition as an indicator of altered hepatic fatty acid homeostasis. They are presumably caused by inadequately high LA, and low ARA and DHA supply, at a stage of development when ARA-PC and DHA-PC should be high, probably reducing the availability of DHA and ARA to the developing brain and contributing to impaired neurodevelopment of preterm infants.