早产儿生后两周内营养供应对青春期身体组成及血压的影响

Influence of nutrition provision during the first two weeks of life in premature infants on adolescent body composition and blood pressure

摘要:

目的：充足的营养对早产儿至关重要。关于早期营养及其对后期生长影响的纵向信息十分有限。本研究的目的是确定早产儿的早期能量和蛋白质供应对青春期身体组成和血压的影响。方法：本研究于2007~2008年对36例男性青少年（12.3±1.7岁）和25例女性青少年（11.5±1.8岁）进行了调查，他们系出生于1989年10月1日至1995年12月31日之间胎龄23~34周、出生体重<1850 g的早产儿。根据其出生后两周内的营养模式（肠内与肠外）、能量供应（每日<70千卡/kg与每日 ≥70千卡/kg）及蛋白质供应情况（每日超过2.5 g/kg ≥5 d与每日超过2.5 g/kg <5 d），将调查对象分组，比较各组青春期身高、体重、血脂、血压等的差异。结果：在控制出生体重和生理成熟度的基础上，婴儿期能量摄入每天≥70千卡/kg的青少年身高（163±11 cm）和体重（58±16 kg）大于能量摄入每天<70千卡/kg的青少年（身高156±11 cm，体重49±16 kg），差异有统计学意义（P<0.05）；两组间血压与体脂百分含量未见明显差异。结论：婴儿期较高的能量摄入与青春期的体格大小相关，但并不会构成不利的风险因素，如血压升高或体脂增加。

Abstract:

OBJECTIVE: Adequate nutrition is paramount for premature infants. Longitudinal information is scant on the effects of early nutrition and later growth. The purpose of this study was to determine the influence of early energy and protein provision in premature infants on adolescent body composition and blood pressure. METHODS: In 2007-2008 we obtained data from 36 male (12.3±1.7 years) and 25 female (11.5±1.8 years) adolescents born preterm at <34 weeks gestation (range 23-34 weeks) between October 1st 1989 and December 31st 1995 (birth weight <1850 g). The adolescents were divided into groups depending on infant intake mode (enteral vs parenteral), energy provision (<70 kcal/kg/d and ≥70 kcal/kg/d) and protein provision (>2.5 g/kg/d for ≥5 days and>2.5 g/kg/d for <5 days) during the first 14 days of life. RESULTS: After controlling for birth weight and biological maturity, adolescents who received ≥70 kcal/kg/d during infancy were significantly taller (163±11 cm vs. 156±11 cm) and heavier (58±16 kg vs. 49±16 kg) than adolescents who received <70 kcal/kg/d. There were no significant differences in systolic and diastolic BP and total percent body fat between the two groups. CONCLUSIONS: Our data suggests that higher infant energy provision appears to be related to adolescent size, it does not appear to contribute to adverse risk factors such as higher systolic BP or increased body fat.