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Differentical analysis of serum amino acid and acylcarnitine levels in late preterm infants
- XIANG Jingjing, YANG Dongfei, ZHONG Xiaoyi, WANG Yu
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2023, 40(6):
12-20.
DOI: 10.3969/j.issn.1674-490X.2023.06.002
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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.
