Differentical analysis of serum amino acid and acylcarnitine levels in late preterm infants

doi:10.3969/j.issn.1674-490X.2023.06.002

Abstract

Abstract: Objective To study the relationship between gestational age, birth mass and nutritional support modalities of late preterm infants and their blood amino acid and acylcarnitine levels and provide targeted guidance for the nutritional management of preterm infants at this stage of life. Methods 202 late preterm babies hospitalized from January 2017 to December 2021 were selected for the study. According to the relationship between gestational age and body mass at birth, they were divided into appropriate for gestational age(AGA), small for gestational age(SGA)and large for gestational age(LGA)groups. Nutritional support on the day of sampling was categorised as total parenteral nutrition(TPN), partial parenteral nutrition(PPN)and total enteral nutrition(TEN). Determination and comparison of amino acid and acylcarnitine levels in their peripheral blood were conducted by tandem mass spectrometry techniques Results There were statistically significant differences in the levels of valine, leucine, methionine, phenylalanine, tyrosine, citrulline, and proline between the AGA, SGA, and LGA groups, with the levels of these amino acids being generally higher in the LGA than in the AGA and SGA groups. The differences in acylcarnitine levels were not statistically significant among the three groups.The differences in the levels of glycine, ornithine, leucine, methionine, and citrulline between TPN, PPV, and TEN were all statistically significant, with ornithine, leucine, methionine, and citrulline being relatively low in the TPN approach and glycine being relatively high in the TEN approach.The levels of various short-chain, long-chain and some medium-chain acylcarnitines showed statistically significant differences among the different nutritional modalities, with the highest levels in TEN. Conclusion In late preterm infants, there were differences in the blood amino acid profiles of the AGA, SGA and LGA groups, and SGA could be supplemented with branched-chain amino acids, sulphur-containing amino acids and aromatic amino acids in moderation at an early stage. Blood amino acid and acylcarnitine levels are susceptible to nutritional support modalities. Nutrient ratios should be reasonably adjusted to appropriately increase glycine and carnitine levels in parenteral nutrition solutions, and leucine, methionine, ornithine and glutamine should be added as appropriate in enteral nutrition.

Key words: late preterm infants, amino acid, acylcarnitine, extraintestinal nutrition, enteral nutrition

CLC Number:

XIANG Jingjing, YANG Dongfei, ZHONG Xiaoyi, WANG Yu. Differentical analysis of serum amino acid and acylcarnitine levels in late preterm infants[J]. Journal of Hebei Medical College for Continuing Education, 2023, 40(6): 12-20.

References

[1] DELNORD M, ZEITLIN J. Epidemiology of late preterm and early term births:an international perspective[J]. Semin Fetal Neonatal Med, 2019, 24(1): 3-10. DOI: 10.1016/j.siny.2018.09.001.
[2] CHEN C, ZHANG J W, XIA H W, et al. Preterm birth in China between 2015 and 2016[J]. Am J Public Health, 2019, 109(11): 1597-1604. DOI: 10.2105/AJPH.2019.305287.
[3] MURRAY S R, SHENKIN S D, MCINTOSH K, et al. Long term cognitive outcomes of early term(37-38 weeks)and late preterm(34-36 weeks)births: a systematic review[J]. Wellcome Open Res, 2017, 2: 101. DOI: 10.12688/wellcomeopenres.12783.1.
[4] CHEONG J L, DOYLE L W, BURNETT A C, et al. Association between moderate and late preterm birth and neurodevelopment and social-emotional development at age 2 years[J]. JAMA Pediatr, 2017, 171(4): e164805. DOI: 10.1001/jamapediatrics.2016.4805.
[5] SRINIVAS JOIS R. Neurodevelopmental outcome of late-preterm infants: a pragmatic review[J]. Aust J Gen Pract, 2018, 47(11): 776-781. DOI: 10.31128/ajgp-03-18-4539.
[6] 孙中怡,李悦,李冰洁,等.早期充分氨基酸营养在低出生体质量早产儿中的应用[J].中华实用儿科临床杂志, 2018, 33(2): 124-129. DOI: 10.3760/cma.j.issn.2095-428X.2018.02.011.
[7] 朱丽,张蓉,张淑莲,等.中国不同胎龄新生儿出生体重曲线研制[J].中华儿科杂志, 2015, 53(2): 97-103. DOI: 10.3760/cma.j.issn.0578-1310.2015.02.007.
[8] LAPILLONNE A, BRONSKY J, CAMPOY C, et al. Feeding the late and moderately preterm infant: a position paper of the European society for paediatric gastroenterology, hepatology and nutrition committee on nutrition[J]. J Pediatr Gastroenterol Nutr, 2019, 69(2): 259-270. DOI: 10.1097/MPG.0000000000002397.
[9] 房巧燕.足月小于胎龄新生儿和足月适于胎龄新生儿血氨基酸和酰基肉碱的差异[J].中国儿童保健杂志, 2021, 29(11): 1242-1244. DOI: 10.11852/zgetbjzz2021-0294.
[10] NIE C X, HE T, ZHANG W J, et al. Branched chain amino acids: beyond nutrition metabolism[J]. Int J Mol Sci, 2018, 19(4): 954. DOI: 10.3390/ijms19040954.
[11] 全美盈, 孙秀静.探寻新生儿氨基酸的最佳营养组成[J].中国新生儿科杂志, 2013, 28(3): 213-215.
[12] MAHBUB M H, YAMAGUCHI N, HASE R, et al. Plasma branched-chain and aromatic amino acids in relation to hypertension[J]. Nutrients, 2020, 12(12): 3791. DOI: 10.3390/nu12123791.
[13] WANG F H, LIU J, DENG Q J, et al. The association between plasma levels of 20 amino acids and risk of diabetes[J]. Zhonghua Nei Ke Za Zhi, 2019, 58(4): 270-277. DOI: 10.3760/cma.j.issn.0578-1426.2019.04.007.
[14] 李翔文,李芳,刘敬,等.宫内生长受限新生儿代谢组学研究[J].中华实用儿科临床杂志, 2016, 31(14): 1066-1071. DOI: 10.3760/cma.j.issn.2095-428X.2016.14.007.
[15] LIU Q, WU J, SHEN W, et al. Analysis of amino acids and acyl carnitine profiles in low birth weight, preterm, and small for gestational age neonates[J]. J Matern Fetal Neonatal Med, 2017, 30(22): 2697-2704. DOI: 10.1080/14767058.2016.1261395.
[16] SCHUPPER A, ALMASHANU S, COSTER D, et al. Metabolic biomarkers of small and large for gestational age newborns[J]. Early Hum Dev, 2021, 160: 105422. DOI: 10.1016/j.earlhumdev.2021.105422.
[17] BERTRAND J, GOICHON A, DÉCHELOTTE P, et al. Regulation of intestinal protein metabolism by amino acids[J]. Amino Acids, 2013, 45(3): 443-450. DOI: 10.1007/s00726-012-1325-8.
[18] MORGAN C, BURGESS L. High protein intake does not prevent low plasma levels of conditionally essential amino acids in very preterm infants receiving parenteral nutrition[J]. J Parenter Enteral Nutr, 2017, 41(3): 455-462. DOI: 10.1177/0148607115594009.
[19] NEIS E P J G, SABRKHANY S, HUNDSCHEID I, et al. Erratum to: human splanchnic amino-acid metabolism[J]. Amino Acids, 2017, 49(6): 1145. DOI: 10.1007/s00726-017-2416-3.
[20] 杨庆.长链多不饱和脂肪酸对新生儿的影响研究进展[J].中国当代儿科杂志, 2021, 23(7): 755-760. DOI: 10.7499/j.issn.1008-8830.2104087.
[21] BAZINET R P, LAYÉ S. Polyunsaturated fatty acids and their metabolites in brain function and disease[J]. Nat Rev Neurosci, 2014, 15(12): 771-785. DOI: 10.1038/nrn3820.