Threonine Requirement of the Enterally Fed Term Infant in the First Month of Life

Journal of Pediatric Gastroenterology and Nutrition - Tập 61 Số 3 - Trang 373-379 - 2015
Jacomine E. Hogewind‐Schoonenboom1, Lisha Huang2, Femke de Groof2, Li Zhu3, Gardi Voortman2, Henk Schierbeek1, András Vermes4, Chao Chen3, Ying Huang5, Johannes B. van Goudoever1
1Department of Pediatrics, Academic Medical Centre, Emma Children's Hospital, Amsterdam
2Department of Pediatrics, Division of Neonatology, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam
3Department of Pediatrics, Division of Neonatology, Children's Hospital of Fudan University, Shanghai, PR China
4Hospital Pharmacy Erasmus Medical Centre Rotterdam The Netherlands
5Department of Pediatrics, Division of Gastroenterology, Children's Hospital of Fudan University, Shanghai, PR China.

Tóm tắt

AbstractObjective:Threonine is one of the essential amino acids. Its major fate is incorporation into intestinal mucosal proteins and synthesis of secretory glycoproteins. Therefore, it has an important function in the neonatal gut barrier integrity. The objective was to quantify the threonine requirement in fully enterally fed term neonates by means of the indicator amino acid oxidation (IAAO) method, using L‐[1‐13C]phenylalanine as indicator.Methods:After a 24‐hour test diet adaptation, containing randomly assigned amounts of threonine (range 5–182 mg · kg−1 · day−1), the participating neonates received a primed continuous infusion of [13C]bicarbonate and L‐[1–13C]phenylalanine. At baseline and during the plateau phase of both infusions, breath samples were obtained for 13CO2. The fractional L‐[1‐13C]phenylalanine oxidation (F13CO2) was estimated and plotted against the threonine intakes. Biphasic linear regression crossover analysis was used to calculate the breakpoint of the F13CO2, representing the mean threonine requirement. Data are presented as mean ± SD.Results:Thirty‐two term neonates (gestational age 39 ± 1 weeks, birth weight 3.3 ± 0.3 kg, mean postnatal age 10 ± 4 days) were studied. The mean threonine requirement was estimated to be 68 mg · kg−1 · day−1 with an upper and lower 95% confidence interval of 104 and 32 mg · kg−1 · day−1, respectively (r2 = 0.37).Conclusions:The determined threonine requirement is extremely close to the existing requirement recommendations (~90% of the present World Health Organization requirement guidelines). Infant formula preparations presently on the market, however, contain up to twice as much threonine as recommended. The threonine intake in formula‐fed infants may therefore be reduced considerably.

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Thông tin xuất bản

Journal of Pediatric Gastroenterology and Nutrition

Tập 61 Số 3

373-379

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