Randomized controlled trial of early arachidonic acid and docosahexaenoic acid enteral supplementation in very preterm infants

• Main Authors: Patricia Álvarez (Author), David Ramiro-Cortijo (Author), María Teresa Montes (Author), Bárbara Moreno (Author), María V. Calvo (Author), Ge Liu (Author), Ana Esteban Romero (Author), Marta Ybarra (Author), Malaika Cordeiro (Author), Marina Clambor Murube (Author), Eva Valverde (Author), Aurora Sánchez-Pacheco (Author), Javier Fontecha (Author), Robert Gibson (Author), Miguel Saenz de Pipaon (Author)
• Format: Book
• Published: Frontiers Media S.A., 2022-08-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2296-2360; 10.3389/fped.2022.947221
• Keywords: long-chain polyunsaturated fatty acids; oxylipins; emulsion; supplementation; ARA; DHA; Pediatrics; RJ1-570
• Source: Frontiers in Pediatrics, Vol 10 (2022)

ObjectiveTo evaluate changes in blood long-chain polyunsaturated fatty acid (LCPUFA) and oxylipin concentrations in very preterm infants from birth to 36 weeks' postmenstrual age (WPA) after providing an emulsified arachidonic acid (ARA):docosahexaenoic acid (DHA) supplement at two different concentrations.Study designThis prospective, randomized trial assigned infants to receive a supplement (1) 80:40 group (80 mg/kg/day ARA and 40 mg/kg/day DHA, n = 9) or (2) 120:60 group (120 mg/kg/day ARA and 60 mg/kg/day DHA, n = 9). Infants received supplement daily from birth until 36 WPA. At baseline, 21 days of life and 36 WPA, the LCPUFAs were measured in plasma by gas chromatography/mass spectrophotometry. Additionally, LCPUFAs and oxylipins were analyzed in whole blood by ultra-high-performance liquid chromatography-tandem mass spectrometry. Furthermore, a sample of oral mucosa was obtained to analyze single-nucleotide polymorphism located in the FADS1 gene by PCR.ResultsGestational age was similar between groups (80:40 = 28+6 [27+3; 30+3] completed weeks+days; 120:60 = 29+6 [27+3; 30+5] completed weeks+days, p = 0.83). At 36 WPA, the change in plasma ARA was significantly different between groups (80:40 group = 0.15 [−0.67; 0.69] %nmol, 120:60 = 1.68 [1.38; 3.16] %nmol, p = 0.031). In whole blood, the levels of ARA-derived oxylipins (5-, 8-, 9-, 11-, 15-HETE and 8,9-EET) and EPA-derived oxylipins (18-HEPE) significantly increase from baseline to 36 WPA in the 120:60 group than the 80:40 group.ConclusionSupplementation at high doses (120:60 mg/kg/day) increased levels of ARA, and EPA- and ARA-derived oxylipins compared to low doses (80:40 mg/kg/day). Differences were detected in EPA metabolites without a significant increase in plasma DHA.