Abstract
Background
It is unknown how plasma amino acid (AA) concentrations vary with fortification type, growth and insulin-like growth factor 1 (IGF-1) concentrations in the first weeks of life in very preterm infants (VPIs).
Methods
Human milk for VPIs (n = 225) was fortified with bovine colostrum (BC, intact proteins, high bioactivity) or conventional fortifier (CF, hydrolysed bovine whey proteins). Plasma was sampled at fortification start (T0, ~1 week of age) and after one (T1) and two (T2) weeks. Changes in Z-scores for weight, length and head circumference (HC) were calculated from T0 to 35 weeks postmenstrual age.
Results
Compared with CF, BC fortification increased 12 AAs (~10–40%, p < 0.05) and reduced Lys concentrations (10–16%, p < 0.05). Analysed across groups, T0-T2 AA increments associated positively with HC growth (12 AAs) and IGF-1 concentrations (5 AAs), and inversely with gestational age (13 AAs) and weight (8 AAs) at birth. The plasma protein profile (proteome) was unaffected by fortification.
Conclusions
BC fortification increased the plasma concentrations of many AAs. Fortification-induced AA increments associated positively with HC growth and IGF-1 concentrations, and were affected by immaturity and birth weight. Still, plasma AA variability within physiological levels appears to have limited implications for clinical outcomes during the early life of VPIs.
It is unknown how plasma amino acid (AA) concentrations vary with fortification type, growth and insulin-like growth factor 1 (IGF-1) concentrations in the first weeks of life in very preterm infants (VPIs).
Methods
Human milk for VPIs (n = 225) was fortified with bovine colostrum (BC, intact proteins, high bioactivity) or conventional fortifier (CF, hydrolysed bovine whey proteins). Plasma was sampled at fortification start (T0, ~1 week of age) and after one (T1) and two (T2) weeks. Changes in Z-scores for weight, length and head circumference (HC) were calculated from T0 to 35 weeks postmenstrual age.
Results
Compared with CF, BC fortification increased 12 AAs (~10–40%, p < 0.05) and reduced Lys concentrations (10–16%, p < 0.05). Analysed across groups, T0-T2 AA increments associated positively with HC growth (12 AAs) and IGF-1 concentrations (5 AAs), and inversely with gestational age (13 AAs) and weight (8 AAs) at birth. The plasma protein profile (proteome) was unaffected by fortification.
Conclusions
BC fortification increased the plasma concentrations of many AAs. Fortification-induced AA increments associated positively with HC growth and IGF-1 concentrations, and were affected by immaturity and birth weight. Still, plasma AA variability within physiological levels appears to have limited implications for clinical outcomes during the early life of VPIs.
| Original language | English |
|---|---|
| Journal | Pediatric Research |
| Number of pages | 10 |
| ISSN | 0031-3998 |
| DOIs | |
| Publication status | E-pub ahead of print - 2025 |