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Feeding preterm infants with L-carnitine supplemented formula
Insights
L-carnitine supplementation in preterm infants increased carnitine levels and excretion. Supplemented infants showed reduced ammonia and urea excretion, indicating improved nitrogen balance.
Area of Science:
- Neonatal nutrition
- Biochemistry
- Pediatric research
Background:
- Preterm infants often have altered carnitine metabolism.
- Enteral nutrition strategies require careful monitoring of metabolic status.
Purpose of the Study:
- To investigate the impact of L-carnitine supplementation on carnitine metabolism in preterm infants.
- To assess the effects of L-carnitine on nitrogen excretion and amino acid levels in this population.
Main Methods:
- A randomized controlled study involving 29 preterm infants on mixed enteral nutrition.
- L-carnitine supplementation (600 nmol/ml) for the first seven days in the intervention group.
- Monitoring of plasma and urinary carnitine levels, ammonia, urea, and amino acids.
Main Results:
- Supplemented infants showed increased plasma and urinary carnitines by day 7, with sustained high urinary excretion.
- Elevated urinary carnitine excretion correlated with increased clearance and decreased reabsorption in supplemented infants.
- Supplemented infants exhibited decreased daily excreted ammonia and urea, and lower plasma alanine and glutamine levels.
Conclusions:
- L-carnitine supplementation effectively increases carnitine levels and alters its excretion pattern in preterm infants.
- Supplementation appears to improve nitrogen balance by reducing ammonia and urea excretion.
Abstract:
A total of 29 preterm infants maintained on mixed enteral nutrition (50% pooled human milk, 50% formula daily) were studied over a 15 days period. 16 of them received L-carnitine supplemented formula during the first seven consecutive days (600 nmol/ml, as added supplement), 13 infants served as controls. In response to enhanced dietary intake, the plasma levels and urinary excretion rates of carnitines were increased by the 7th day of study. The plasma carnitines then returned to the initial values, whilst the urinary excretion remained elevated at the 14th day of study. The elevated daily urinary excretion of carnitines was accompanied by increased clearance and decreased relative reabsorption rates in the supplemented group. In the control group the plasma carnitine levels remained unchanged throughout the observations, while the daily excretion of free carnitine decreased by the end of the study. In the supplemented group statistically significant decrease was found in the daily excreted ammonia and urea with a decrease of plasma alanine and glutamine levels by the 7th day of study. The plasma levels of beta-hydroxybutyrate, glucose and creatinine remained unchanged in both groups.