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Lipoproteins in preterm and small-for-gestational-age infants during the first week of life
J M Morillas1, L Moltó, R Robles
1Department of Neonatology, Maternal-Infant Hospital of Granada, Spain.
Insights
Preterm and small-for-gestational-age infants have altered plasma lipoprotein profiles, including lower HDL and higher VLDL, suggesting impaired lipid metabolism. These findings highlight unique lipid challenges in vulnerable newborns.
Area of Science:
- Neonatal medicine
- Lipid metabolism
- Pediatric biochemistry
Background:
- Infant lipoprotein metabolism differs significantly from adults.
- Preterm and small-for-gestational-age (SGA) infants represent vulnerable populations with potentially altered physiological processes.
- Understanding lipoprotein profiles in early life is crucial for assessing metabolic health and long-term outcomes.
Purpose of the Study:
- To determine and compare plasma lipoprotein levels and composition in preterm, SGA, and full-term infants during the first week of life.
- To investigate potential differences in very-low-density lipoprotein (VLDL) metabolism and lecithin: cholesterol acyl transferase (LCAT) activity.
Main Methods:
- Analysis of plasma lipoprotein levels (HDL, VLDL) and composition.
- Comparison of lipid profiles between preterm, SGA, and full-term infant groups.
- Assessment of the cholesteryl ester to free cholesterol (CE/FC) ratio as an indicator of LCAT activity.
Main Results:
- Preterm and SGA infants exhibited significantly lower high-density lipoprotein (HDL) and higher VLDL levels compared to full-term infants.
- A low cholesteryl ester to free cholesterol (CE/FC) ratio was observed in both preterm and SGA infants, indicating reduced lecithin: cholesterol acyl transferase (LCAT) activity.
- SGA infants displayed higher lipoprotein lipid content than preterm infants, and their CE/FC ratio increased post-birth, unlike preterm infants.
Conclusions:
- Preterm and SGA infants demonstrate impaired VLDL metabolism and reduced LCAT activity shortly after birth.
- Lipoprotein profiles in SGA infants differ from preterm infants, with higher lipid content and a dynamic change in the CE/FC ratio.
- These findings underscore distinct lipid metabolic adaptations in vulnerable newborns, necessitating further investigation into clinical implications.
Abstract:
Plasma lipoprotein levels and composition have been determined in preterm and small-for-gestational-age (SGA) infants, and compared to full-term infants, during the first week of life. Significantly lower levels of HDL and higher levels of VLDL were found in both preterm and SGA infants in comparison to full-term healthy infants. These results suggest a low capacity to metabolize VLDL. Preterm infants showed a behaviour similar to full-term infants with regard to the changes in lipoprotein composition. Small-for-gestational-age infants showed a higher lipoprotein lipid content than preterm infants. A low ratio of cholesteryl ester to free cholesterol (CE/FC) was found in both preterm and SGA infants suggesting a reduced lecithin: cholesterol acyl transferase (LCAT) activity. In preterm infants we observed no changes in the CE/FC ratio during the first week of life, whereas in SGA infants this ratio increased after birth.