Abstract
Very preterm infants (VPI, born at or before 32 weeks of gestation) are at risk of adverse health outcomes, from which they might be partially protected with appropriate postnatal nutrition and growth. Metabolic processes or biochemical markers associated to extrauterine growth restriction (EUGR) have not been identified. We applied untargeted metabolomics to plasma samples of VPI with adequate weight for gestational age at birth and with different growth trajectories (29 well-grown, 22 EUGR) at the time of hospital discharge. A multivariate analysis showed significantly higher levels of amino-acids in well-grown patients. Other metabolites were also identified as statistically significant in the comparison between groups. Relevant differences (with corrections for multiple comparison) were found in levels of glycerophospholipids, sphingolipids and other lipids. Levels of many of the biochemical species decreased progressively as the level of growth restriction increased in severity. In conclusion, an untargeted metabolomic approach uncovered previously unknown differences in the levels of a range of plasma metabolites between well grown and EUGR infants at the time of discharge. Our findings open speculation about pathways involved in growth failure in preterm infants and the long-term relevance of this metabolic differences, as well as helping in the definition of potential biomarkers.
Highlights
Prematurity is the leading cause of childhood morbidity and mortality
There was a trend for a higher postmenstrual age at discharge in the extrauterine growth restriction (EUGR)
Metabolism amino acids
Summary
Prematurity is the leading cause of childhood morbidity and mortality. In very preterm infants (VPI), born at or before 32 weeks of gestation, postnatal growth failure is a frequent complication [1]that can worsen short [2] and long [3,4,5] term outcomes. Metabolomic techniques aim to assess a whole array of small molecules present in a sample This can be performed by selecting a subset of metabolites under a specific hypothesis (targeted metabolomics) or with a discovery (untargeted) approach, trying to identify most of the present components [11]. In recent years, these strategies have been used to search for biomarkers or to uncover underlying pathways in some adult [11], childhood [12], and even perinatal [13,14] conditions, with a special interest in metabolic diseases [15] and altered body composition [16,17]
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