Enteral Insulin‐like Growth Factor‐I Augments Intestinal Disaccharidase Activity in Piglets Receiving Total Parenteral Nutrition

Abstract

ABSTRACTBackground:Partial enteral nutrition is administered to infants on parenteral nutrition to stimulate intestinal function. Herein, the hypothesis that supplementation of partial enteral nutrition with insulin‐like growth factor‐I would augment intestinal development was investigated.Methods:One‐day‐old piglets (n = 29) were randomly assigned to five dietary treatment groups: 100% of energy as enteral formula, 100% of energy as total parenteral nutrition, or 80% parenteral nutrition/20% enteral formula supplemented with either 0, 0.2, or 1 mg/kg insulin‐like growth factor‐I for 7 days. Weight gain, intestinal weight, morphology, protein, and DNA content and disaccharidase activity and mRNA expression were assessed.Results:Parenterally fed piglets had similar whole body weight gain and serum hormone concentrations but reduced intestinal mucosal weight, villus height, and sucrase and lactase activity compared with 100% enterally fed pigs. Partial enteral nutrition alone increased mucosal weight and protein content, villus height, and disaccharidase activity compared with 100% parenterally fed piglets. No effect of the lower dose of insulin‐like growth factor‐I (0.2 mg/kg per day) was observed, but supplementing partial enteral nutrition with 1 mg insulin‐like growth factor‐I/kg further increased villus width and cross‐sectional area and disaccharidase activity compared with partial enteral nutrition alone. Lactase mRNA expression was not affected by insulin‐like growth factor‐I, suggesting that the primary site of regulation of lactase by insulin‐like growth factor‐I occurs after transcription.Conclusions:Enteral insulin‐like growth factor‐I augmented intestinal morphology and disaccharidase activity in parenterally fed piglets over that observed with partial enteral nutrition alone. Thus enteral insulin‐like growth factor‐I may represent an efficacious clinical adjunct to promote intestinal development of parenterally fed neonates.