The Parenteral Feeding and Secretion of Regulatory Peptides in Infants
Przemysław J. Tomasik *
Department of Clinical Biochemistry, Collegium Medicum, Jagiellonian University, Wielicka St. 265,Krakow, Poland.
Andrzej Wędrychowicz
Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum, Jagiellonian University, Wielicka St 265, Krakow, Poland.
Andrzej ZajÄ…c
Department of Pediatric Surgery Collegium Medicum, Jagiellonian University, Wielicka St. 265, Krakow, Poland.
Miłosz Przybyszowski
Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum, Jagiellonian University, Wielicka St 265, Krakow, Poland.
Mikołaj Spodaryk
Andrzej Frycz Modrzewski KrakowUniversity, Herlinga-Grudzinskiego St.1, Krakow, Poland.
Krzysztof Fyderek
Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum, Jagiellonian University, Wielicka St 265, Krakow, Poland.
Krystyna Sztefko
Department of Clinical Biochemistry, Collegium Medicum, Jagiellonian University, Wielicka St. 265,Krakow, Poland.
*Author to whom correspondence should be addressed.
Abstract
Introduction: The direct effect of parenteral nutrition on secretion of regulatory peptides in infants has not been yet reported.
Aim: The aim of the study was the analysis of secretion of chosen regulatory peptides from the gut and adipose tissue in parenterally fed infants comparing to children fed orally as well as hydrated intravenously.
Materials and Methods: In this study, the response of glucose, ghrelin, leptin, PYY, GLP-1 and adiponectin to the enteral and parenteral feeding in babies has been investigated. We compared three groups of infants: formula-fed infants, infants on TPN and fasted, awaiting for general anaesthesia before CT examination, receiving an i.v. 5% glucose/saline mixture. The blood samples were taken in first group prior and 60 minutes after feeding, in the second in continuous course of TPN and third after 8 hours fasting.
Results: Oral feeding does not influence plasma concentrations of leptin and adiponectin in infants. The ghrelin plasma concentrations during the total parenteral nutrition mimics the postprandial levels observed in enterally fed children. A significant positive correlation was found between calorie intake and adiponectin concentration (r=0.76, p<0.001); and calorie intake and PYY concentration (r=0.76, p<0.001) as well CCK (r=0.50; p<0,005).
Conclusions: The lack of fasting/postprandial modulation of secretion of gut peptides might be responsible for disturbed development of parenterally fed children. Adiponectin and PYY are the putative marker of short-term energy balance.
Keywords: Ghrelin, leptin, GLP-1, CCK, adiponectin, PYY