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Differences in circulating carnitine status of preterm infants fed fortified human milk or preterm infant formula

Judit Bene1, Katalin Komlósi, Bela I Melegh

  • 1*Departments of Medical Genetics †Paediatrics, University of Pécs, Pécs, Hungary ‡Kinderklinik and Kinderpoliklinik, Dr von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany.

Journal of Pediatric Gastroenterology and Nutrition
|June 21, 2013
PubMed

Insights

Preterm infants fed formula showed altered plasma carnitine profiles, with increased free carnitine and short-chain esters, unlike those fed fortified human milk. This suggests formula alters carnitine metabolism in preterm infants.

Area of Science:

  • Biochemistry
  • Neonatal Nutrition
  • Metabolomics

Background:

  • Carnitine is essential for fatty acid metabolism.
  • Preterm infants have unique nutritional needs.
  • Human milk (HM) and infant formula composition differ significantly.

Purpose of the Study:

  • To compare plasma carnitine profiles in preterm infants fed fortified human milk (HM) versus preterm infants fed formula.
  • To investigate the impact of different feeding modalities on carnitine metabolism in preterm neonates.

Main Methods:

  • Plasma acylcarnitine concentrations were measured using isotope dilution ESI MS/MS.
  • The study included 20 formula-fed and 18 HM-fed preterm infants.
  • Measurements were taken on study days 0, 14, and 28.

Main Results:

  • Infants fed HM showed stable carnitine profiles over 4 weeks.
  • Formula-fed infants exhibited a significant increase in free carnitine (FC) and short-chain acylcarnitines (C2, C3).
  • Medium- and long-chain acylcarnitines decreased in formula-fed infants by day 14.

Conclusions:

  • Altered carnitine profiles in formula-fed preterm infants suggest a role in buffering and eliminating nonphysiological acyl moieties.
  • Carnitine metabolism is differentially affected by HM versus formula feeding in preterm neonates.
  • These findings highlight the importance of understanding carnitine dynamics in preterm infant nutrition.
Abstract

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