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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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Temporal development of glycine and threonine log-pseudo-concentrations (means and 95% CIs) related to nutritional intervention, SGA status and age. (a) Glycine levels by nutritional intervention (intervention red, control gray); (c) Glycine levels by SGA status (SGA orange, AGA green) for samples from weeks 1, 3, 5 and 7; (e) As above, but samples selected by PMA instead of weeks of life; (b, d, f) Corresponding figures for threonine.
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nutrients-06-01913-f004: Temporal development of glycine and threonine log-pseudo-concentrations (means and 95% CIs) related to nutritional intervention, SGA status and age. (a) Glycine levels by nutritional intervention (intervention red, control gray); (c) Glycine levels by SGA status (SGA orange, AGA green) for samples from weeks 1, 3, 5 and 7; (e) As above, but samples selected by PMA instead of weeks of life; (b, d, f) Corresponding figures for threonine.

Mentions: The previous considerations are summarized for the urinary metabolites glycine and threonine in Figure 4. There were similar levels of glycine and threonine in the intervention and control group (Figure 4a,b). Glycine and threonine levels appeared to differ between SGA and AGA children in the first week of life, but not at later time points (Figure 4c,d). The same applied when the infants’ age was defined as PMA instead of chronological age (Figure 4e,f).


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)

Temporal development of glycine and threonine log-pseudo-concentrations (means and 95% CIs) related to nutritional intervention, SGA status and age. (a) Glycine levels by nutritional intervention (intervention red, control gray); (c) Glycine levels by SGA status (SGA orange, AGA green) for samples from weeks 1, 3, 5 and 7; (e) As above, but samples selected by PMA instead of weeks of life; (b, d, f) Corresponding figures for threonine.
© Copyright Policy
Related In: Results  -  Collection

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

nutrients-06-01913-f004: Temporal development of glycine and threonine log-pseudo-concentrations (means and 95% CIs) related to nutritional intervention, SGA status and age. (a) Glycine levels by nutritional intervention (intervention red, control gray); (c) Glycine levels by SGA status (SGA orange, AGA green) for samples from weeks 1, 3, 5 and 7; (e) As above, but samples selected by PMA instead of weeks of life; (b, d, f) Corresponding figures for threonine.
Mentions: The previous considerations are summarized for the urinary metabolites glycine and threonine in Figure 4. There were similar levels of glycine and threonine in the intervention and control group (Figure 4a,b). Glycine and threonine levels appeared to differ between SGA and AGA children in the first week of life, but not at later time points (Figure 4c,d). The same applied when the infants’ age was defined as PMA instead of chronological age (Figure 4e,f).

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