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Serial changes in selected serum constituents in low birth weight infants on peripheral parenteral nutrition with
Insights
High zinc supplementation is crucial for preterm infants receiving parenteral nutrition, helping maintain normal serum zinc levels. Other nutrient levels showed declines, indicating potential deficiencies despite supplementation.
Area of Science:
- Neonatal nutrition
- Trace element metabolism
- Parenteral nutrition
Background:
- Infants with very low birth weight (VLBW) often require parenteral nutrition (PN).
- Long-term PN can lead to deficiencies in essential trace elements like zinc and copper.
- Monitoring specific biomarkers is vital for assessing nutritional status in VLBW infants.
Purpose of the Study:
- To investigate the impact of varying zinc and copper supplementation doses on nutrient levels in VLBW infants receiving PN.
- To determine optimal zinc and copper supplementation strategies for preventing deficiencies.
Main Methods:
- Randomized controlled trial involving 105 VLBW infants (<2000 g) receiving PN for ≥3 weeks.
- Weekly monitoring of serum zinc, copper, retinol-binding protein, prealbumin, alkaline phosphatase, and aspartate transaminase.
- Comparison of nutrient and protein biomarker concentrations across different zinc and copper supplementation groups.
Main Results:
- Mean serum zinc, retinol-binding protein, and prealbumin levels significantly decreased over time.
- Alkaline phosphatase levels significantly increased over the study period.
- Only the highest zinc supplement group maintained serum zinc within the normal range at 7 weeks.
- No significant differences in protein or enzyme levels were observed between different zinc or copper dose groups.
Conclusions:
- Higher zinc supplementation is necessary to maintain adequate serum zinc concentrations in VLBW infants on PN.
- Current copper supplementation strategies may not significantly alter serum copper or ceruloplasmin levels.
- Further research is needed to optimize trace element and protein biomarker management in VLBW infants.
Abstract:
One hundred and five infants of birth weight 2000 g or less who received peripherally administered parenteral nutrition for periods of three or more weeks, were randomly assigned to groups receiving different amounts of zinc and copper supplement. The blood concentrations of zinc, copper, retinol-binding protein, prealbumin, alkaline phosphatase and aspartate transaminase were followed weekly. Mean serum zinc, retinol-binding protein and prealbumin declined significantly over time while alkaline phosphatase rose. Only the group receiving the highest zinc supplement maintained a mean serum zinc concentration within the normal range at seven weeks. No difference in the protein or enzyme concentrations was found between the different zinc supplement groups. No difference was seen in serum copper or ceruloplasmin between copper dose groups although one intravenous supplement was double that of the other.