AUTHOR=Álvarez Patricia , Ramiro-Cortijo David , Montes María Teresa , Moreno Bárbara , Calvo María V. , Liu Ge , Esteban Romero Ana , Ybarra Marta , Cordeiro Malaika , Clambor Murube Marina , Valverde Eva , Sánchez-Pacheco Aurora , Fontecha Javier , Gibson Robert , Saenz de Pipaon Miguel 

TITLE=Randomized controlled trial of early arachidonic acid and docosahexaenoic acid enteral supplementation in very preterm infants

JOURNAL=Frontiers in Pediatrics

VOLUME=10

YEAR=2022

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.947221

DOI=10.3389/fped.2022.947221

ISSN=2296-2360

ABSTRACT=<sec><title>Objective</title><p>To evaluate changes in blood long-chain polyunsaturated fatty acid (LCPUFA) and oxylipin concentrations in very preterm infants from birth to 36 weeks’ postmenstrual age (WPA) after providing an emulsified arachidonic acid (ARA):docosahexaenoic acid (DHA) supplement at two different concentrations.</p></sec><sec><title>Study design</title><p>This prospective, randomized trial assigned infants to receive a supplement (1) 80:40 group (80 mg/kg/day ARA and 40 mg/kg/day DHA, <italic>n</italic> = 9) or (2) 120:60 group (120 mg/kg/day ARA and 60 mg/kg/day DHA, <italic>n</italic> = 9). Infants received supplement daily from birth until 36 WPA. At baseline, 21 days of life and 36 WPA, the LCPUFAs were measured in plasma by gas chromatography/mass spectrophotometry. Additionally, LCPUFAs and oxylipins were analyzed in whole blood by ultra-high-performance liquid chromatography-tandem mass spectrometry. Furthermore, a sample of oral mucosa was obtained to analyze single-nucleotide polymorphism located in the <italic>FADS1</italic> gene by PCR.</p></sec><sec><title>Results</title><p>Gestational age was similar between groups (80:40 = 28<sup>+6</sup> [27<sup>+3</sup>; 30<sup>+3</sup>] completed weeks<sup>+<italic>days</italic></sup>; 120:60 = 29<sup>+6</sup> [27<sup>+3</sup>; 30<sup>+5</sup>] completed weeks<sup>+<italic>days</italic></sup>, <italic>p</italic> = 0.83). At 36 WPA, the change in plasma ARA was significantly different between groups (80:40 group = 0.15 [−0.67; 0.69] %nmol, 120:60 = 1.68 [1.38; 3.16] %nmol, <italic>p</italic> = 0.031). In whole blood, the levels of ARA-derived oxylipins (5-, 8-, 9-, 11-, 15-HETE and 8,9-EET) and EPA-derived oxylipins (18-HEPE) significantly increase from baseline to 36 WPA in the 120:60 group than the 80:40 group.</p></sec><sec><title>Conclusion</title><p>Supplementation at high doses (120:60 mg/kg/day) increased levels of ARA, and EPA- and ARA-derived oxylipins compared to low doses (80:40 mg/kg/day). Differences were detected in EPA metabolites without a significant increase in plasma DHA.</p></sec>