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Protracted Maturation of Pancreatic-Specific Elastase 1 Excretion in Preterm Infants of Extremely Low Gestational Age.
MedLine Citation:
PMID:  23201702     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES:: To better understand the exocrine pancreatic function of very preterm infants. METHODS:: Pancreas-specific elastase 1 (PSE1) activity was determined in spot stool samples of 69 preterm infants of gestational age <32 weeks and birth weight <1,250 g. Assays were conducted on samples collected at 2 (N = 56), 4 (N = 46), and 6 weeks of age (N = 23). RESULTS:: PSE1 activity increased from week 2 (median [interquartile range] 84 [48-187] μg/g) to week 4 (164 [87-251 μg/g, P < 0.001) but not thereafter (169 [82-298] μg/g at week 6). The maturational increase in PSE1 activity was observed only in infants of gestational age <28 weeks (P < 0.001). At 2 weeks after birth, PSE1 levels were lower in infants of gestational age <28 weeks than in infants of gestational age ≥28 weeks (77 [43-110] vs. 165 [56-300] μg/g, P = 0.019), but this difference was less pronounced at 4 weeks (153 [77-226] vs. 230 [108-503] μg/g, P = 0.070) and had disappeared by 6 weeks (163 [76-258] vs. 175 [85-418] μg/g, P = 0.576).In infants on full enteral feeding regimens 4 weeks after birth, PSE1 levels were associated with weight gain per unit of energy intake (Rs = 0.431, P = 0.005). This measure of weight gain was lower (P = 0.040) in infants with PSE1 levels <200 μg/g (0.110 [0.081-0.139] g/kcal, N = 25) than in those with PSE1 levels ≥200 μg/g (0.139 [0.117-0.157] g/kcal, N = 15). Administration of pancreatic enzymes to infants showing PSE1 excretion levels <200 μg/g did not enhance weight gain. CONCLUSIONS:: Extremely preterm infants have limited exocrine pancreatic function during the first weeks of life, which may contribute to growth failure.
Authors:
Annette Münch; Lars Garten; Christoph Bührer
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-29
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  -     ISSN:  1536-4801     ISO Abbreviation:  J. Pediatr. Gastroenterol. Nutr.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-12-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Neonatology, Charité University Medical Center, Berlin, Germany.
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