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Urinary metabolite profiles in premature infants show early postnatal metabolic adaptation and maturation.

Moltu SJ, Sachse D, Blakstad EW, Strømmen K, Nakstad B, Almaas AN, Westerberg AC, Rønnestad A, Brække K, Veierød MB, Iversen PO, Rise F, Berg JP, Drevon CA - Nutrients (2014)

Bottom Line: The intervention group received significantly higher amounts of energy, protein, lipids, vitamin A, arachidonic acid and docosahexaenoic acid as compared to the control group.This first nutri-metabolomics study in premature infants demonstrates that the physiological adaptation during the fetal-postnatal transition as well as maturation influences metabolism during the breastfeeding period.Elevated glycine and threonine levels were found in the first week urine samples of the SGA infants and emerged as potential biomarkers of an altered metabolic phenotype.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Oslo University Hospital, P.O. Box 4950 Nydalen, Oslo 0424, Norway. sissel.moltu@medisin.uio.no.

ABSTRACT

Objectives: Early nutrition influences metabolic programming and long-term health. We explored the urinary metabolite profiles of 48 premature infants (birth weight < 1500 g) randomized to an enhanced or a standard diet during neonatal hospitalization.

Methods: Metabolomics using nuclear magnetic resonance spectroscopy (NMR) was conducted on urine samples obtained during the first week of life and thereafter fortnightly.

Results: The intervention group received significantly higher amounts of energy, protein, lipids, vitamin A, arachidonic acid and docosahexaenoic acid as compared to the control group. Enhanced nutrition did not appear to affect the urine profiles to an extent exceeding individual variation. However, in all infants the glucogenic amino acids glycine, threonine, hydroxyproline and tyrosine increased substantially during the early postnatal period, along with metabolites of the tricarboxylic acid cycle (succinate, oxoglutarate, fumarate and citrate). The metabolite changes correlated with postmenstrual age. Moreover, we observed elevated threonine and glycine levels in first-week urine samples of the small for gestational age (SGA; birth weight < 10th percentile for gestational age) as compared to the appropriate for gestational age infants.

Conclusion: This first nutri-metabolomics study in premature infants demonstrates that the physiological adaptation during the fetal-postnatal transition as well as maturation influences metabolism during the breastfeeding period. Elevated glycine and threonine levels were found in the first week urine samples of the SGA infants and emerged as potential biomarkers of an altered metabolic phenotype.

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Related in: MedlinePlus

(a) Available urine samples by infants’ age in days, one infant per line, one sample per symbol. Grouped by intervention and control (red and gray lines, respectively), color-coded by week of life. Age in days was imputed for eight samples where only the week was recorded; (b) Available urine samples by infants’ week of life. Bars divided by nutritional intervention vs. control (left half of bar; red and gray, respectively) and further subdivided by small for gestational age (SGA) or appropriate for gestational age (AGA) infants (right half of bar; SGA white, AGA black).
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nutrients-06-01913-f001: (a) Available urine samples by infants’ age in days, one infant per line, one sample per symbol. Grouped by intervention and control (red and gray lines, respectively), color-coded by week of life. Age in days was imputed for eight samples where only the week was recorded; (b) Available urine samples by infants’ week of life. Bars divided by nutritional intervention vs. control (left half of bar; red and gray, respectively) and further subdivided by small for gestational age (SGA) or appropriate for gestational age (AGA) infants (right half of bar; SGA white, AGA black).

Mentions: Urine samples were obtained from the infants during the first week of life and thereafter approximately every other week until discharge (Figure 1). We collected 0.5–1.8 mL urine non-invasively by the use of cotton pads, transferred them to Nunc® CryoTubes® (Nalge Nunc International, Penfield, NY, USA) before they were stored at −80 °C. The urine samples had been thawed once prior to the metabolic NMR profiling when they were acidified for electrolyte analysis by mixing 400 μL of sample with 5 μL of 1 M HCl, resulting in a pH of approximately 3.


Urinary metabolite profiles in premature infants show early postnatal metabolic adaptation and maturation.

Moltu SJ, Sachse D, Blakstad EW, Strømmen K, Nakstad B, Almaas AN, Westerberg AC, Rønnestad A, Brække K, Veierød MB, Iversen PO, Rise F, Berg JP, Drevon CA - Nutrients (2014)

(a) Available urine samples by infants’ age in days, one infant per line, one sample per symbol. Grouped by intervention and control (red and gray lines, respectively), color-coded by week of life. Age in days was imputed for eight samples where only the week was recorded; (b) Available urine samples by infants’ week of life. Bars divided by nutritional intervention vs. control (left half of bar; red and gray, respectively) and further subdivided by small for gestational age (SGA) or appropriate for gestational age (AGA) infants (right half of bar; SGA white, AGA black).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4042575&req=5

nutrients-06-01913-f001: (a) Available urine samples by infants’ age in days, one infant per line, one sample per symbol. Grouped by intervention and control (red and gray lines, respectively), color-coded by week of life. Age in days was imputed for eight samples where only the week was recorded; (b) Available urine samples by infants’ week of life. Bars divided by nutritional intervention vs. control (left half of bar; red and gray, respectively) and further subdivided by small for gestational age (SGA) or appropriate for gestational age (AGA) infants (right half of bar; SGA white, AGA black).
Mentions: Urine samples were obtained from the infants during the first week of life and thereafter approximately every other week until discharge (Figure 1). We collected 0.5–1.8 mL urine non-invasively by the use of cotton pads, transferred them to Nunc® CryoTubes® (Nalge Nunc International, Penfield, NY, USA) before they were stored at −80 °C. The urine samples had been thawed once prior to the metabolic NMR profiling when they were acidified for electrolyte analysis by mixing 400 μL of sample with 5 μL of 1 M HCl, resulting in a pH of approximately 3.

Bottom Line: The intervention group received significantly higher amounts of energy, protein, lipids, vitamin A, arachidonic acid and docosahexaenoic acid as compared to the control group.This first nutri-metabolomics study in premature infants demonstrates that the physiological adaptation during the fetal-postnatal transition as well as maturation influences metabolism during the breastfeeding period.Elevated glycine and threonine levels were found in the first week urine samples of the SGA infants and emerged as potential biomarkers of an altered metabolic phenotype.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Oslo University Hospital, P.O. Box 4950 Nydalen, Oslo 0424, Norway. sissel.moltu@medisin.uio.no.

ABSTRACT

Objectives: Early nutrition influences metabolic programming and long-term health. We explored the urinary metabolite profiles of 48 premature infants (birth weight < 1500 g) randomized to an enhanced or a standard diet during neonatal hospitalization.

Methods: Metabolomics using nuclear magnetic resonance spectroscopy (NMR) was conducted on urine samples obtained during the first week of life and thereafter fortnightly.

Results: The intervention group received significantly higher amounts of energy, protein, lipids, vitamin A, arachidonic acid and docosahexaenoic acid as compared to the control group. Enhanced nutrition did not appear to affect the urine profiles to an extent exceeding individual variation. However, in all infants the glucogenic amino acids glycine, threonine, hydroxyproline and tyrosine increased substantially during the early postnatal period, along with metabolites of the tricarboxylic acid cycle (succinate, oxoglutarate, fumarate and citrate). The metabolite changes correlated with postmenstrual age. Moreover, we observed elevated threonine and glycine levels in first-week urine samples of the small for gestational age (SGA; birth weight < 10th percentile for gestational age) as compared to the appropriate for gestational age infants.

Conclusion: This first nutri-metabolomics study in premature infants demonstrates that the physiological adaptation during the fetal-postnatal transition as well as maturation influences metabolism during the breastfeeding period. Elevated glycine and threonine levels were found in the first week urine samples of the SGA infants and emerged as potential biomarkers of an altered metabolic phenotype.

Show MeSH
Related in: MedlinePlus