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Early nutritional determinants of intrahepatocellular lipid deposition in preterm infants at term age
V Vasu1, E L Thomas, G Durighel
1Section of Neonatal Medicine, Department of Medicine, Imperial College London, Chelsea and Westminster Campus, London, UK. vimal.vasu@nhs.net
Insights
Preterm infants show higher intrahepatocellular lipid (IHCL) levels at term age. Early lipid intake in preterm infants may contribute to this increased IHCL, a risk factor for future cardiometabolic disease.
Area of Science:
- Neonatal nutrition
- Metabolic health
- Pediatric research
Background:
- Preterm infants exhibit elevated intrahepatocellular lipid (IHCL) content and altered adiposity by term age.
- These metabolic alterations in preterm infants are recognized risk factors for adult cardiometabolic diseases.
- Nutritional intake during the preterm period is a potential driver of these developmental trajectories.
Purpose of the Study:
- To investigate the association between macronutritional components of the preterm diet and intrahepatocellular lipid (IHCL) deposition.
- To quantify IHCL at term equivalent age using proton magnetic resonance spectroscopy ((1)H MRS).
Main Methods:
- A prospective observational case-control study was conducted in a UK neonatal unit.
- (1)H MR spectra were obtained from 18 preterm infants (<32 weeks gestational age) and 31 healthy term infants.
- Nutritional data were collected from birth to 34(+6) weeks postmenstrual age.
Main Results:
- Intrahepatocellular lipid (IHCL) levels were significantly higher in preterm infants compared to term-born controls (P=0.003).
- In preterm infants, IHCL was positively correlated with lipid intake during the first week of life (r=0.52, P=0.04).
Conclusions:
- This study confirms higher IHCL in preterm infants at term age.
- Early life lipid intake appears to be a significant determinant of IHCL deposition in preterm infants.
- Further research is needed to understand the clinical implications and the role of nutritional interventions.
Background:
We have previously shown that by term age, preterm infants have elevated intrahepatocellular lipid (IHCL) content and altered regional adiposity, both of which are risk factors for cardiometabolic illness in adult life. Preterm nutritional intake is a plausible determinant of these aberrant trajectories of development.
Objective:
We aimed to establish if macronutritional components of the preterm diet were determinants of IHCL deposition measured at term equivalent age, using (1)H Magnetic Resonance spectroscopy (MRS).
Methods:
Prospective observational case-control study in a single UK neonatal unit. (1)H MR spectra were acquired from 18 preterm infants (<32 weeks gestational age at birth) at term age and 31 healthy term infants, who acted as a control group. Neonatal nutritional information was collected from birth to 34(+6) weeks postmenstrual age.
Results:
IHCL (median, interquartile range) was significantly higher in preterm-at-term infants compared with term-born infants: 0.735, 0-1.46 versus 0.138, 0-0.58; P=0.003. In preterm infants, IHCL was positively correlated with lipid intake in the first week of life (r=0.52, P=0.04).
Conclusions:
This study confirms our previous observation of elevated IHCL in preterm infants at term and suggests that early lipid intake may be a determinant. Future work is warranted to establish the clinical relevance and the role of nutritional intervention in attenuating or exacerbating this effect in preterm infants.
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