Original Article

European Journal of Clinical Nutrition (2006) 60, 756–762. doi:10.1038/sj.ejcn.1602379; published online 1 February 2006

Fat-soluble vitamins in breast-fed preterm and term infants

Guarantor: CA Drevon.

Contributors: CH had primary responsiblity for protocol development, patient enrollment, data analysis and writing the manuscript. AR and MG participated in the development of the protocol and analytical framework for the study and contributed to the writing of the manuscript. IBH contributed in the same ways as AR and MG and was responsible for patient enrollment of NBW infants. POI and CAD supervised the design and execution of the study, performed the final data analyses and contributed to the writing of the manuscript.

C Henriksen1, I B Helland2, A Rønnestad2, M Grønn2, P O Iversen1 and C A Drevon1

  1. 1Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
  2. 2Department of Pediatrics, Rikshospitalet University Hospital, Oslo, Norway

Correspondence: Professor CA Drevon, Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, POB 1046 Blindern, Oslo 0316, Norway. E-mail: c.a.drevon@medisin.uio.no

Received 14 June 2005; Revised 14 October 2005; Accepted 9 November 2005; Published online 1 February 2006.

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Abstract

Objective:

 

To examine the supply and status of fat-soluble vitamins in very low birth weight (VLBW) infants compared to a reference group of normal birth weight (NBW) infants.

Design:

 

A longitudinal study of VLBW infants in the early neonatal period. Blood samples were drawn at 1 week of age and at discharge from hospital. Plasma was analyzed for the fat-soluble vitamins: retinol, 25-OH-vitamin D, alpha-tocopherol and phylloquinone (vitamin K1) using high-performance liquid chromatography.

Subjects:

 

A total of 40 VLBW infants were included in the study. A reference group of 33 NBW infants was randomly selected from one of our previous studies.

Results:

 

The VLBW infants received fortified human milk, and daily oral vitamin supplement (Multibionta). In VLBW infants, plasma retinol concentrations decreased and plasma 25-OH-vitamin D increased during the study period. VLBW infants had significantly lower plasma retinol (0.3 vs 0.7 mu M) and higher plasma 25-OH-vitamin D (166 vs 25 nM) at discharge compared to NBW infants. Plasma phylloquinone concentration in VLBW infants was very high (53 ng/ml) at one week of age, especially in the youngest infants (192 ng/ml), but decreased rapidly during the study period resulting in low/normal plasma concentrations (0.9 ng/ml) at discharge.

Conclusions:

 

We observed alterations in plasma concentration of retinol and 25-OH-vitamin D in VLBW infants in the early neonatal period, resulting in marked differences between VLBW at discharge and NBW. Further trials are needed to evaluate whether changes in vitamin supplementation may improve clinical outcome in VLBW infants.

Sponsorship:

 

Norwegian Foundation for Health and Rehabilitation, the Johan Throne Holst Foundation for Nutrition Research and the Research Council of Norway.

Keywords:

very low birth weight (VLBW) infants, vitamin A, vitamin D, vitamin E, vitamin K

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