Term infant studies of DHA and ARA supplementation on neurodevelopment: results of randomized controlled trials.
Term infant studies of DHA and ARA supplementation on neurodevelopment: results of randomized controlled trials.
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DOI：
10.1067/s0022-3476(03)00398-6
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发表时间：
2003-10
期刊：
影响因子：
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通讯作者：
R. Uauy;D. Hoffman;P. Mena;A. Llanos;E. Birch
中科院分区：
文献类型：
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作者：
R. Uauy;D. Hoffman;P. Mena;A. Llanos;E. Birch
根据血浆和组织脂肪成分的变化，非母乳喂养的健康足月婴儿在喂养时可能需要长链多不饱和脂肪酸 (LCPUFA)。然而，过去二十年进行的不同研究中一致的功能效果更难以记录。随着 LCPUFA 补充配方的引入，对这些数据的解释具有科学性和公共利益。有 14 项针对足月婴儿的对照试验，其中包括含或不含 LCPUFA 的配方奶喂养以及视觉功能评估和其他神经发育指标；此外，7 人还评估了与认知发展相关的具体措施。我们选择检查每天提供的 DHA 剂量对视力发展的影响，以解释随机研究中视力反应的差异。使用 DHA 有效剂量作为自变量并使用 4 个月时的视力作为因变量进行“元回归”。由于 DHA 状态的两个主要饮食决定因素是提供的 LNA 和消耗的预先形成的 DHA，因此我们通过假设 LNA 转化为 DHA 的 1%、5% 和 10% 来定义跨研究的 DHA 等效剂量。结果表明，DHA 当量剂量对所有测试转换的视敏度反应幅度均产生强烈且显着的影响；当使用 10% 生物等效性时发现最大显着性（r(2)=0.68，P=.001）。我们得出的结论是，所提供的总 DHA 当量与 4 个月大时视力测量所定义的有效性之间存在显着关系。
Healthy term infants who are not breast-fed may need long-chain polyunsaturated fatty acids (LCPUFA) in their feeding, based on the changes in plasma and tissue fatty composition. However, consistent functional effects across different studies conducted over the past two decades has been more difficult to document. The interpretation of these data has scientific and public interest with the introduction of LCPUFA supplemented formula. There are 14 controlled trials in term infants that have included formula feeding with or without LCPUFA and functional assessment of visual and other measures of neural development; in addition, 7 have evaluated specific measures related to cognitive development. We chose to examine the effect of DHA dose provided daily on the development of visual acuity to explain the differences in visual acuity responses across randomized studies. A "meta-regression" was performed with the use of a DHA effective dose as the independent variable and visual acuity at 4 months as the dependent variable. Since the two main dietary determinants of DHA status are the LNA provided and the preformed DHA consumed, we defined DHA equivalent dose across studies by assuming a 1%, 5%, and 10% conversion of LNA to DHA. Results indicate a strong and significant effect of DHA equivalent dose on magnitude of the visual acuity response at all conversions tested; greatest significance was found when using a 10% bioequivalency (r(2)=0.68, and P=.001). We conclude that there is a significant relation between the total DHA equivalents provided and effectiveness as defined by visual acuity measurements at 4 months of age.