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Mihatsch W, Dorronsoro Martín I, Barrios-Sabador V, Couce ML, Martos-Moreno GÁ, Argente J, Quero J, Saenz de Pipaon M. Bone Mineral Density, Body Composition, and Metabolic Health of Very Low Birth Weight Infants Fed in Hospital Following Current Macronutrient Recommendations during the First 3 Years of Life. Nutrients 2021; 13:nu13031005. [PMID: 33804764 PMCID: PMC8003951 DOI: 10.3390/nu13031005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/14/2021] [Accepted: 03/17/2021] [Indexed: 12/17/2022] Open
Abstract
The present study longitudinally evaluated growth, bone mineral density, body composition, and metabolic health outcome in very low birth weight (VLBW) infants whose in-hospital target nutrient intake was within recent recommendations. From six months to three years, bone mineral density (dual-energy X-ray absorptiometry, DXA), body composition, and metabolic health outcome were compared with a reference group of term infants. The aim was to test whether in-hospital achieved weight gain until 36 weeks of gestation (light or appropriate for term equivalent age; LTEA or ATEA) predicts later growth, bone mineral density (BMD), abdominal obesity, or metabolic health outcomes such as insulin resistance, relative to term infants, during the first three years of life. Target in-hospital energy and protein intake was not achieved. Growth in weight, length and head circumference, mid arm circumference, adiposity, fat free mass (FFM), and bone mineralization in VLBW infants was less than those in term infants and influenced by nutritional status at discharge. Preterm infants had poorer motor and cognitive outcomes. Post-discharge body composition patterns indicate FFM proportional to height but lower fat mass index in LTEA preterm infants than term infants, with no evidence of increased truncal fat in preterm infants. The hypothesis of early BMD catch-up in VLBW infants after discharge was not supported by the present data. The clinical significance of these findings is unclear. The data may suggest a reduced obesity risk but an increased osteoporosis risk. Since postnatal growth restriction may have permanent negative health effects, LTEA VLBW infants would especially appear to benefit from targeted preventive interventions. Further follow-up of the infants is required.
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Affiliation(s)
- Walter Mihatsch
- Department of Pediatrics, Ulm University and Neu-Ulm University of Applied Sciences, 89231 Neu-Ulm, Germany;
| | - Izaskun Dorronsoro Martín
- Department of Neonatology, Hospital Universitario La Paz, Department of Pediatrics, Universidad Autonoma de Madrid, 28046 Madrid, Spain; (I.D.M.); (J.Q.)
| | - Vicente Barrios-Sabador
- Department of Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Department of Pediatrics, Universidad Autónoma de Madrid, 28039 Madrid, Spain; (V.B.-S.); (G.Á.M.-M.); (J.A.)
- CIBER Fisiopatología de la obesidad y nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - María L. Couce
- Neonatology Department, University Clinical Hospital of Santiago de Compostela, IDIS-Health Research Institute of Santiago de Compostela, Universidad de Santiago de Compostela, 15704 Santiago de Compostela, Spain;
| | - Gabriel Á. Martos-Moreno
- Department of Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Department of Pediatrics, Universidad Autónoma de Madrid, 28039 Madrid, Spain; (V.B.-S.); (G.Á.M.-M.); (J.A.)
- CIBER Fisiopatología de la obesidad y nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Jesús Argente
- Department of Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Department of Pediatrics, Universidad Autónoma de Madrid, 28039 Madrid, Spain; (V.B.-S.); (G.Á.M.-M.); (J.A.)
- CIBER Fisiopatología de la obesidad y nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- IMDEA Institute, 28049 Madrid, Spain
| | - José Quero
- Department of Neonatology, Hospital Universitario La Paz, Department of Pediatrics, Universidad Autonoma de Madrid, 28046 Madrid, Spain; (I.D.M.); (J.Q.)
| | - Miguel Saenz de Pipaon
- Department of Neonatology, Hospital Universitario La Paz, Department of Pediatrics, Universidad Autonoma de Madrid, 28046 Madrid, Spain; (I.D.M.); (J.Q.)
- Correspondence:
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