Related Experiment Videos
Nutrition and exocrine pancreatic function in infancy: effects of total parenteral nutrition and first degree
Insights
Infants receiving long-term parenteral nutrition showed reduced pancreatic enzyme levels, specifically amylase and lipase, compared to controls. This suggests potential exocrine pancreatic dysfunction in infants on TPN.
Area of Science:
- Pediatric Gastroenterology
- Exocrine Pancreatic Function
- Nutritional Support
Background:
- Gastrointestinal diseases in infancy can impact exocrine pancreatic function.
- Long-term parenteral nutrition (TPN) is a critical intervention for infants with severe gastrointestinal issues.
- The effects of TPN on pancreatic enzyme secretion in infants are not fully understood.
Purpose of the Study:
- To evaluate exocrine pancreatic function in infants receiving long-term TPN.
- To compare pancreatic enzyme levels (amylase, lipase, trypsin) in TPN-fed infants versus those on oral diets with malnutrition or chronic diarrhea.
Main Methods:
- The pancreozymin-secretin test was administered intravenously to 36 infants.
- Duodenal fluid was analyzed for volume, protein, amylase, lipase, and trypsin.
- Infants were categorized into TPN, oral feeding with malnutrition, and control groups.
Main Results:
- No significant difference in duodenal fluid volume was observed between groups.
- Infants receiving TPN exhibited significantly lower amylase and lipase content and concentration (p < 0.05) after secretin administration.
- Trypsin levels and total protein content did not differ significantly across the groups.
Conclusions:
- Long-term TPN in infants may be associated with reduced secretion of pancreatic amylase and lipase.
- Exocrine pancreatic function, particularly lipase and amylase, should be monitored in infants on prolonged TPN.
- Further research is needed to elucidate the mechanisms and clinical implications of TPN-associated changes in pancreatic enzyme secretion.
Abstract:
Thirty-six infants suffering from gastrointestinal diseases during infancy were evaluated for exocrine pancreatic function by means of the pancreozymin-secretin test. Duodenal fluid volume, protein content, and content and peak-specific activity of amylase, lipase, and trypsin were determined following intravenous administration of either pancreozymin (CCK) or secretin. Seven infants receiving long-term parenteral nutrition and 17 infants receiving oral feedings and exhibiting first-degree malnutrition in association with chronic diarrhea underwent testing. Results were compared to those of a group of 12 age-matched infants with chronic diarrhea and weight loss. Four patients receiving total parenteral nutrition (TPN) suffered from severe short bowel syndrome and three had intractable diarrhea of infancy. The total duration of TPN ranged from 1.5-12 months, and the period of exclusive TPN in the absence of oral feedings ranged from 1-4 months. The heights, weights, and weight-for-height relationships were at or above the fifth percentile for all seven infants. The weight-for-height relationship of each patient in the control group was above the fifth percentile, while that of all malnourished infants was below the fifth percentile. No significant difference was found in the volume of fluid collected following either CCK or secretin administration. The content and concentration of amylase and lipase were lower in those patients receiving TPN. The levels were statistically significant (p less than 0.05) following secretin administration. In contrast, the peak-specific activity and total trypsin content, as well as protein content, was not significantly different in patients receiving TPN, controls, and malnourished patients.(ABSTRACT TRUNCATED AT 250 WORDS)