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Optimal threonine intake for preterm infants fed on oral or parenteral nutrition
Insights
Premature infants show impaired threonine metabolism, leading to higher serum threonine levels. Recommended threonine intake for preterm infants should be limited to prevent potential harm.
Area of Science:
- Biochemistry
- Neonatal Nutrition
- Pediatric Metabolism
Background:
- Threonine is an essential amino acid crucial for infant development.
- Understanding threonine metabolism in low birthweight infants is vital for optimizing nutritional support.
- Premature infants may have unique metabolic requirements and challenges.
Purpose of the Study:
- To investigate the relationship between serum threonine concentration and threonine intake in low birthweight infants.
- To assess the impact of gestational age on threonine metabolism.
- To establish safe and effective threonine intake recommendations for preterm infants.
Main Methods:
- Serum threonine levels were measured in 163 low birthweight infants.
- Infants were fed human milk, adapted formulae, or received total parenteral nutrition.
- Data were analyzed to correlate serum threonine with dietary intake and gestational age.
Main Results:
- A significant positive correlation was observed between serum threonine concentration and threonine intake.
- Premature infants exhibited markedly higher serum threonine levels compared to term infants, especially with high threonine intake.
- Threonine metabolism appears to be impaired in preterm infants.
Conclusions:
- Threonine metabolism is impeded in preterm infants, leading to potential hyperthreoninemia.
- Recommended threonine intake for premature infants should not exceed 1200 microM (143 mg)/kg bodyweight/day.
- Dietary amino acid composition may require modification to meet protein needs in preterm infants.
Abstract:
Serum threonine concentration was determined during the first month of life in 163 low birthweight infants fed on either human milk, various adapted formulae, or total parenteral nutrition. On the pooled data, a significant positive relationship was found between the serum threonine concentration and threonine intake. However, the increase of the serum threonine level is more marked in the infants with the lowest actual gestational age; with a high threonine intake, the most premature infants have serum threonine levels twice as high (58.1 vs 31.7 microM/dl) as term infants. Therefore, threonine metabolism seems to be impeded in preterm infants. Considering the cord blood concentration of threonine (26.8 +/- 5.1 microM/dl) and the possible hazardous effect of hyperthreoninemia, it is suggested that threonine intake should not exceed 1200 microM (143 mg)/kg bodyweight/day in premature infants and that the amino acid composition of the diet should probably be modified in order to satisfy their protein requirement.