Endocrine Abstracts

JOINT2760

Aim: Impaired postnatal growth is the most important issue in very low-birth-weight (VLBW) infants. Early nutrition is one of the modifiable factors and has the greatest influence on growth. Optimal nutrients intake in this population remain unknown. The aim of this study was to evaluate nutrients intake during the first 28 days of life and its impact on growth, metabolic and hormonal profile at this age.

Methods: 120 infants with birth weights below 1500 g and gestational ages below 35 weeks were included in the study. Nutrient intakes were assessed daily, and anthropometric measurements were checked weekly until 28th day postpartum. Glycaemia and hormonal levels were assessed on day 28th after birth before the meal.

Results: The mean birth weight SDS was -1.25±1.44 and length SDS was -1.69±1.62. The mean daily weight gain velocity in 28 days was 12.3±3.5 g/day. On 28th day after birth, mean weight SDS was -2.07±1.11; length SDS was -1.91±1.46; ponderal index was 22.5±2.3. Metabolic and hormonal parameters in 28th day were as follows (mean ± SD): fasting glycaemia - 4.72±1.51 mmol/l; fasting insulin - 17.6±18.0 mU/l; HOMA-IR – 4.46±6.39; IGF-1 – 1.83±1.19 nmol/l; IGF-BP-3 – 8.80±3.20 ng/ml; IGF-1/IGF-BP-3 ratio 1,55±0.82. Cumulative total energy and fat intake in 28 days (g/kg) correlated directly with IGF-BP-3 level (r=0.255, P = 0.01 and r=0.263, P = 0.008, respectively). Cumulative carbohydrate intake tend to be related to IGF-1 level (r=0.194, P = 0.054). Cumulative fat intake was inversely related to HOMA-IR and glucose level on 28th day after birth (r=0.210, P = 0.036 and r=-0.212, P = 0.033, respectively). Cumulative carbohydrates intake was inversely related to insulin level, HOMA-IR and glucose level (r=-0.230, P = 0.020; r=-0.275, P = 0.006 and r=-0.319, P = 0.001, respectively). Cumulative protein intake was also inversely related to glucose levels (r=-0.259, P = 0.009). However, protein to total energy ratio was inversely related to IGF-BP-3 and directly to insulin levels and HOMA-IR (r=-0.249, P = 0.013; r=0.216, P = 0.031 and r=0.251, P = 0.011, respectively). Length SDS at on 28th day after birth was not related to nutritional factors.

Conclusion: Total energy and higher carbohydrate intake lead to higher weight gain, but did not result in unfavorable carbohydrate metabolism. Protein-rich nutrition in VLBW infants was related to higher insulin resistance 4 weeks after birth. Ethics: Approval of the study was obtained at the Kaunas Regional Bioethics Committee (approval No. BE-2-12). The study was registered at ISRCTN Database (No. ISRCTN64647571). The written consent of both parents was obtained.