Early Preterm Nutrition and the Urinary Metabolome in Young Adult Life: Follow-up of a Randomised Controlled Trial

Overview

Journal BMJ Paediatr Open

Publisher BMJ Publishing Group

Specialty Pediatrics

Date 2018 Apr 12

PMID 29637175

Citations 1

Authors

James R C Parkinson

Anisha D Wijeyesekera

Matthew J Hyde

Atul Singhal

Alan Lucas

Elaine Holmes

Neena Modi

Affiliations

Soon will be listed here.

Abstract

Objective: We aimed to test the hypothesis that early diet programmes the metabolic profile of young adults born preterm.

Design: We analysed banked urine samples obtained at a 20-year follow-up visit from adults that had participated as neonates in controlled trials involving randomisation within 48 hours of birth to feeds of preterm formula (PTF), banked breast milk (BBM) or term formula (TF) for 1 month postnatally.

Main Outcome Measures: We performed proton nuclear magnetic resonance spectroscopy, analysing spectra by dietary group and sex. Orthogonal projections to latent structure discriminant analyses was used to model class differences and identify metabolites contributing to the differences between groups. Additionally, spectra were correlated with birth weight, gestational age and weight z score at 2 weeks of age.

Results: Of the original number of 926 trial participants, urine samples were available from 197 (21%) healthy young adults (42% men) born preterm (mean 30.7±2.8 weeks) and randomised to BBM (n=55; 28 men), TF (n=48; 14 men) and PTF (n=93; 40 men). We found no significant differences in urinary spectra between dietary groups including when stratified by sex. Correlation analysis revealed a weak association between metabolic profile and gestational age that was lost on controlling for ethanol excretion.

Conclusions: We found no evidence that dietary exposures in the neonatal period influence the metabolic phenotype in young adult life.

Citing Articles

Metabolomic Profile of Young Adults Born Preterm.

Perrone S, Negro S, Laschi E, Calderisi M, Giordano M, De Bernardo G Metabolites. 2021; 11(10).

PMID: 34677412 PMC: 8538752. DOI: 10.3390/metabo11100697.

References

Lucas A, Morley R, Cole T, Gore S . A randomised multicentre study of human milk versus formula and later development in preterm infants. Arch Dis Child Fetal Neonatal Ed. 1994; 70(2):F141-6. PMC: 1061016. DOI: 10.1136/fn.70.2.f141. View

Esko T, Hirschhorn J, Feldman H, Hsu Y, Deik A, Clish C . Metabolomic profiles as reliable biomarkers of dietary composition. Am J Clin Nutr. 2017; 105(3):547-554. PMC: 5320413. DOI: 10.3945/ajcn.116.144428. View

Beckonert O, Keun H, Ebbels T, Bundy J, Holmes E, Lindon J . Metabolic profiling, metabolomic and metabonomic procedures for NMR spectroscopy of urine, plasma, serum and tissue extracts. Nat Protoc. 2007; 2(11):2692-703. DOI: 10.1038/nprot.2007.376. View

Singhal A, Cole T, Fewtrell M, Deanfield J, Lucas A . Is slower early growth beneficial for long-term cardiovascular health?. Circulation. 2004; 109(9):1108-13. DOI: 10.1161/01.CIR.0000118500.23649.DF. View

Dieterle F, Ross A, Schlotterbeck G, Senn H . Probabilistic quotient normalization as robust method to account for dilution of complex biological mixtures. Application in 1H NMR metabonomics. Anal Chem. 2006; 78(13):4281-90. DOI: 10.1021/ac051632c. View

Lucas A, Morley R, Cole T, Gore S, Davis J, Bamford M . Early diet in preterm babies and developmental status in infancy. Arch Dis Child. 1989; 64(11):1570-8. PMC: 1792630. DOI: 10.1136/adc.64.11.1570. View

Nicholson J, Lindon J, Holmes E . 'Metabonomics': understanding the metabolic responses of living systems to pathophysiological stimuli via multivariate statistical analysis of biological NMR spectroscopic data. Xenobiotica. 1999; 29(11):1181-9. DOI: 10.1080/004982599238047. View

Dessi A, Atzori L, Noto A, Visser G, Gazzolo D, Zanardo V . Metabolomics in newborns with intrauterine growth retardation (IUGR): urine reveals markers of metabolic syndrome. J Matern Fetal Neonatal Med. 2011; 24 Suppl 2:35-9. DOI: 10.3109/14767058.2011.605868. View

Singhal A, Farooqi I, ORahilly S, Cole T, Fewtrell M, Lucas A . Early nutrition and leptin concentrations in later life. Am J Clin Nutr. 2002; 75(6):993-9. DOI: 10.1093/ajcn/75.6.993. View

10.

Singhal A, Cole T, Lucas A . Early nutrition in preterm infants and later blood pressure: two cohorts after randomised trials. Lancet. 2001; 357(9254):413-9. DOI: 10.1016/S0140-6736(00)04004-6. View

11.

Dietz W . Critical periods in childhood for the development of obesity. Am J Clin Nutr. 1994; 59(5):955-9. DOI: 10.1093/ajcn/59.5.955. View

12.

Ibanez L, Lopez-Bermejo A, Suarez L, Marcos M, Diaz M, de Zegher F . Visceral adiposity without overweight in children born small for gestational age. J Clin Endocrinol Metab. 2008; 93(6):2079-83. DOI: 10.1210/jc.2007-2850. View

13.

Singhal A, Cole T, Fewtrell M, Kennedy K, Stephenson T, Elias-Jones A . Promotion of faster weight gain in infants born small for gestational age: is there an adverse effect on later blood pressure?. Circulation. 2006; 115(2):213-20. DOI: 10.1161/CIRCULATIONAHA.106.617811. View

14.

Bollard M, Stanley E, Lindon J, Nicholson J, Holmes E . NMR-based metabonomic approaches for evaluating physiological influences on biofluid composition. NMR Biomed. 2005; 18(3):143-62. DOI: 10.1002/nbm.935. View

15.

Lucas A, Morley R, Cole T . Randomised trial of early diet in preterm babies and later intelligence quotient. BMJ. 1998; 317(7171):1481-7. PMC: 28727. DOI: 10.1136/bmj.317.7171.1481. View

16.

Parkinson J, Hyde M, Gale C, Santhakumaran S, Modi N . Preterm birth and the metabolic syndrome in adult life: a systematic review and meta-analysis. Pediatrics. 2013; 131(4):e1240-63. DOI: 10.1542/peds.2012-2177. View

17.

Lucas A, Morley R, Cole T, Gore S, Lucas P, Crowle P . Early diet in preterm babies and developmental status at 18 months. Lancet. 1990; 335(8704):1477-81. DOI: 10.1016/0140-6736(90)93026-l. View

18.

Cloarec O, Dumas M, Trygg J, Craig A, Barton R, Lindon J . Evaluation of the orthogonal projection on latent structure model limitations caused by chemical shift variability and improved visualization of biomarker changes in 1H NMR spectroscopic metabonomic studies. Anal Chem. 2005; 77(2):517-26. DOI: 10.1021/ac048803i. View

19.

Lucas A, Gore S, Cole T, Bamford M, Dossetor J, Barr I . Multicentre trial on feeding low birthweight infants: effects of diet on early growth. Arch Dis Child. 1984; 59(8):722-30. PMC: 1628628. DOI: 10.1136/adc.59.8.722. View

20.

Thomas E, Parkinson J, Hyde M, Yap I, Holmes E, Dore C . Aberrant adiposity and ectopic lipid deposition characterize the adult phenotype of the preterm infant. Pediatr Res. 2011; 70(5):507-12. DOI: 10.1203/PDR.0b013e31822d7860. View