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Fat emulsion given to very low-birthweight infants increases urinary L-FABP
Hiroki Suganuma1, Naho Ikeda, Natuki Ohkawa
1Neonatal Intensive Care Unit, Shizuoka Hospital, Juntendo University, Shizuoka, Japan.
Insights
Fat emulsion treatment significantly increased urinary L-type fatty acid-binding protein (L-FABP) levels in very low-birthweight infants (VLBWI). This suggests fat emulsions may impact the proximal tubules of premature infants.
Area of Science:
- Neonatal Medicine
- Pediatric Nephrology
- Biochemistry
Background:
- Premature infants face numerous renal tubule challenges, including asphyxia, respiratory issues, oxygen therapy, and hypotension.
- Renal microcirculatory pathology can lead to tubular ischemia and oxidative stress, marked by elevated urinary L-type fatty acid-binding protein (L-FABP).
Purpose of the Study:
- To investigate the effect of fat emulsion on urinary L-FABP levels in very low-birthweight infants (VLBWI).
- To assess potential impacts of fat emulsion on renal tubule function in premature neonates.
Main Methods:
- Urinary L-FABP levels were measured in 31 VLBWI over time.
- Infants were divided into a lipid group (n=20) receiving fat emulsion and a control group (n=11).
- Measurements were taken before, during, and after fat emulsion treatment.
Main Results:
- No significant difference in L-FABP levels was observed between groups before treatment.
- Urinary L-FABP levels were significantly higher in the lipid group during (7-14 days) and tended to be higher after (21-28 days) fat emulsion treatment.
- The lipid group showed elevated L-FABP levels compared to the control group at both post-treatment time points.
Conclusions:
- Fat emulsion administration led to a significant increase in urinary L-FABP levels in VLBWI.
- These findings suggest that fat emulsion treatment may affect the proximal tubules of very low-birthweight infants.
Background:
In premature infants, many factors influence the function of renal tubules, such as asphyxia, respiratory disorders, use of high-concentration oxygen, hypotension, and drug treatment. When tubular ischemia and oxidative stress develop due to renal microcirculatory pathology, urinary L-type fatty acid-binding protein (L-FABP) level increases.
Methods:
Urinary L-FABP level was measured over time in very low-birthweight infants (VLBWI), and the effect of fat emulsion on L-FABP level was investigated. Thirty-one VLBWI were divided into two groups with regard to treatment with fat emulsion: the lipid group (n = 20) and the control group (n = 11). Urinary L-FABP was measured before (0-3 days of age), during (7-14 days of age), and after fat emulsion treatment (21-28 days of age) in the two groups.
Results:
Median urinary L-FABP level before treatment was 459 ng/mgCr (range, 22.7-5100 ng/mgCr; mean, 1067 ± 1570 ng/mgCr) and 797 ng/mgCr (range, 69-3900 ng/mgCr; mean, 1066 ± 1188 ng/mgCr) in the lipid and control groups, respectively, showing no significant difference. Median urinary L-FABP level was 624 ng/mgCr (range, 50-2050 ng/mgCr; mean ± SD, 799 ± 655 ng/mgCr) and 273 ng/mgCr (range, 31-987 ng/mgCr; mean ± SD, 359 ± 323 ng/mgCr) at 7-14 days of age, respectively, showing that the level was significantly higher in the lipid group. At 21-28 days of age, the median level was 462 ng/mgCr (range, 49-1867 ng/mgCr; mean ± SD, 557 ± 534 ng/mgCr) and 130 ng/mgCr (range, 20-993 ng/mgCr; mean ± SD, 290 ± 329 ng/mgCr), respectively, showing that L-FABP level tended to be higher in the lipid group.
Conclusions:
Fat emulsion treatment induced a significant increase in urinary L-FABP level, suggesting that fat emulsion affected the proximal tubule in VLBWI.
