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Vitamin B-6 metabolism in premature infants
D J Raiten1, R D Reynolds, M B Andon
1Children's Hospital National Medical Center, Washington, DC.
Insights
Premature infants
Area of Science:
- Neonatal Medicine
- Nutritional Biochemistry
- Pediatric Research
Background:
- Vitamin B-6 is crucial for infant development.
- Assessing vitamin B-6 status in premature infants presents unique challenges.
- Pyridoxal 5'-phosphate (PLP) is the active form of vitamin B-6.
Purpose of the Study:
- To investigate the response of premature infants to intravenous pyridoxine and pyridoxal.
- To evaluate serum and erythrocyte pyridoxal 5'-phosphate (PLP) levels as indicators of vitamin B-6 status in preterm neonates.
Main Methods:
- Two studies were conducted involving premature infants.
- Serum and erythrocyte PLP levels were measured following supplementation with pyridoxine or pyridoxal.
- Infants were categorized by gestational age (GA).
Main Results:
- Infants <30 wk GA showed no serum PLP response to pyridoxine.
- Infants ≥30 wk GA demonstrated increased serum PLP by day 3.
- Erythrocyte PLP and whole-blood vitamin B-6 increased in all infants, irrespective of GA, suggesting vitamin presence in circulation.
Conclusions:
- Serum PLP may not accurately reflect vitamin B-6 status in premature infants.
- Erythrocyte PLP and total vitamin B-6 are potentially better indicators in this population.
- Further research is needed to determine the functional significance of these findings.
Abstract:
The response of premature infants to intravenous pyridoxine or pyridoxal was studied by measuring serum and erythrocyte pyridoxal 5'-phosphate (PLP). In the first study serum PLP was measured in 28 infants periodically through day 28. Infants less than 30 wk gestational age (GA) had no serum PLP response to the administration of pyridoxine. Infants greater than or equal to 30 wk GA had significantly greater concentrations of PLP by day 3. In the second study there was a negligible response of serum PLP in nine infants less than or equal to 28 wk GA to supplementation of pyridoxine or pyridoxal. However, erythrocyte PLP and whole-blood total vitamin B-6 concentrations increased in both groups, indicating the presence of a substantial amount of the vitamin in the circulation of the infants. Whereas the functional significance of these observations is not known, it appears that in premature infants, serum PLP may not be an appropriate indicator of vitamin B-6 status.