Enhanced nutrition improves growth and increases blood adiponectin concentrations in very low birth weight infants

Elin W. Blakstad; Sissel J. Moltu; Britt Nakstad; Marit B. Veierød; Kenneth Strømmen; Pétur B. Júlíusson; Astrid N. Almaas; Arild E. Rønnestad; Kristin Brække; Christian A. Drevon; Per O. Iversen

doi:10.3402/fnr.v60.33171

Elin W. Blakstad Department of Pediatric and Adolescent Medicine, Akershus University Hospital and Institute for Clinical Medicine, Campus Ahus, University of Oslo, Nordbyhagen, Norway Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
Sissel J. Moltu Department of Neonatal Intensive Care, Women and Children’s Division, Ullevål, Oslo University Hospital, Norway Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
Britt Nakstad Department of Pediatric and Adolescent Medicine, Akershus University Hospital and Institute for Clinical Medicine, Campus Ahus, University of Oslo, Nordbyhagen, Norway
Marit B. Veierød Oslo Centre of Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
Kenneth Strømmen Department of Neonatal Intensive Care, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Rikshospitalet Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
Pétur B. Júlíusson Department of Clinical Science, University of Bergen, Norway
Astrid N. Almaas Department of Pediatric and Adolescent Medicine, Akershus University Hospital and Institute for Clinical Medicine, Campus Ahus, University of Oslo, Nordbyhagen, Norway Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
Arild E. Rønnestad Department of Neonatal Intensive Care, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Rikshospitalet
Kristin Brække Department of Neonatal Intensive Care, Women and Children’s Division, Ullevål, Oslo University Hospital, Norway
Christian A. Drevon Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
Per O. Iversen Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway

DOI: https://doi.org/10.3402/fnr.v60.33171

Keywords: Premature, metabolic syndrome, leptin, adiponectin, IGF-1

Abstract

Background: Adequate nutrient supply is essential for optimal postnatal growth in very low birth weight (VLBW, birth weight<1,500 g) infants. Early growth may influence the risk of metabolic syndrome later in life.

Objective: To evaluate growth and blood metabolic markers (adiponectin, leptin, and insulin-like growth factor-1 (IGF-1)) in VLBW infants participating in a randomized nutritional intervention study.

Design: Fifty VLBW infants were randomized to an enhanced nutrient supply or a standard nutrient supply. Thirty-seven infants were evaluated with growth measurements until 2 years corrected age (CA). Metabolic markers were measured at birth and 5 months CA.

Results: Weight gain and head growth were different in the two groups from birth to 2 years CA (weight gain: p_interaction=0.006; head growth: p_interaction=0.002). The intervention group improved their growth z-scores after birth, whereas the control group had a pronounced decline, followed by an increase and caught up with the intervention group after discharge. At 5 months CA, adiponectin concentrations were higher in the intervention group and correlated with weight gain before term (r=0.35) and nutrient supply (0.35≤r≤0.45). Leptin concentrations correlated with weight gain after term and IGF-1 concentrations with length growth before and after term and head growth after term (0.36≤r≤0.53).

Conclusion: Enhanced nutrient supply improved early postnatal growth and may have prevented rapid catch-up growth later in infancy. Adiponectin concentration at 5 months CA was higher in the intervention group and correlated positively with early weight gain and nutrient supply. Early nutrition and growth may affect metabolic markers in infancy.

Clinical Trial Registration (ClinicalTrials.gov) no.: NCT01103219

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