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Bile acids in the serum and duodenal content of newborn infants of different classification
Insights
Formula feeding elevates total serum bile acids in mature infants by day 14. Infant nutrition and fetal development significantly impact bile acid metabolism, with formula feeding showing higher levels in mature infants.
Area of Science:
- Neonatal Physiology
- Biochemistry
- Pediatric Gastroenterology
Background:
- Bile acid metabolism is crucial for infant digestion and nutrient absorption.
- Factors like gestational age, birth weight, and feeding type can influence neonatal bile acid levels.
Purpose of the Study:
- To investigate the impact of feeding type and infant classification on total serum bile acids.
- To explore the relationship between fetal growth, distress, and bile acid concentrations.
- To examine the correlation between serum and duodenal bile acid levels.
Main Methods:
- Measurement of total serum bile acids in 83 infants.
- Comparison of bile acid levels in mature infants fed human milk versus formula.
- Analysis of bile acid concentrations in low-birth-weight infants (appropriate and small for gestational age) and those with fetal distress.
- Correlation analysis between serum and duodenal bile acid levels and fetal growth retardation.
Main Results:
- Formula feeding led to statistically significant elevations in total serum bile acids in mature infants by day 14.
- Low-birth-weight infants small for gestational age and those with fetal distress exhibited the highest, most variable serum bile acid levels.
- Serum bile acid concentrations in small for gestational age infants correlated with the degree of fetal growth retardation (r = -0.871).
- A direct hyperbolic relationship was observed between serum and duodenal bile acid content (r = +0.93).
Conclusions:
- Infant nutrition, particularly formula feeding, significantly influences total serum bile acid levels.
- Fetal growth retardation and fetal distress syndromes are associated with elevated serum bile acids.
- The interplay between fetal development, birth status, and postnatal nutrition critically affects neonatal bile acid metabolism.
Abstract:
Total serum bile acids were determined in 83 infants of different classification. In 33 mature infants total bile acids were measured after feeding human milk (n = 17) or formula (Milasan). Statistically significant elevations of total bile acids were found on the 14th day of life, if mature infants were formula fed. In low-birth-weight infants appropriate for gestational age total bile acids are not higher on the 8th day of life than in mature infants, but on the 14th day of life the elevations become significant. Low-birth-weight infants small for gestational age and infants suffering from fetal distress syndromes show the highest total bile acids with great variations. Low-birth-weight infants small for gestational age had serum total bile acid concentrations related to the degree of fetal growth retardation (r = -0.871). Some newborns suffering from late metabolic acidosis had lowest intraluminal total bile acids, especially dihydroxy bile acids. We found a direct hyperbolic dependence between total bile acids in the serum and the duodenal content (r = +0.93). In cases of serum total bile acids above 50 mumol/l, concentrations in duodenal content do not exceed 2 mmol/l. Therefore, the degree of fetal growth retardation, fetal distress syndromes, and the nutrition after birth have great influence on bile acid metabolism.