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Open AccessArticle

Modifications of Own Mothers’ Milk Fortification Protocol Affect Early Plasma IGF-I and Ghrelin Levels in Preterm Infants. A Randomized Clinical Trial

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1st Department of Neonatology & NICU, Aristotle University of Thessaloniki, Ippokration General Hospital, Konstantinoupoleos 49, 54246 Thessaloniki, Greece
2
Department of Nutrition and Dietetics, Alexander Technological Educational Institute of Thessaloniki, 57400 Thessaloniki, Greece
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Laboratory of Milk Hygiene and Technology, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
4
1st Pediatric Department, Aristotle University of Thessaloniki, Ippokration General Hospital, Konstantinoupoleos 49, 54246 Thessaloniki, Greece
*
Author to whom correspondence should be addressed.
Nutrients 2019, 11(12), 3056; https://doi.org/10.3390/nu11123056
Received: 18 November 2019 / Revised: 3 December 2019 / Accepted: 11 December 2019 / Published: 14 December 2019
(This article belongs to the Section Clinical Nutrition)
The aim was to investigate the effect of two own mother’s milk (OMM) fortification protocols on (a) IGF-I and ghrelin plasma levels at 35 post-conceptional weeks (PCW, T2) and whether this effect is maintained after elimination of the differences in OMM fortification, and (b) growth until 12 months corrected age. Forty-eight OMM-fed preterm infants (GA 24–32 weeks) were randomly allocated to the fixed-fortification (FF) group (n = 23) and the protein-targeting fortification (PTF) group (n = 25) targeting the recommended daily protein intake (PI). Plasma IGF-I and ghrelin were assessed at 35 (T2) and 40 (T3) PCW while growth was longitudinally assessed until 12 months corrected age. PTF group had lower IGF-I and higher ghrelin than FF group at T2, while receiving lower daily protein and energy amounts. PI correlated positively to T2-IGF-I and inversely to T3-ghrelin while energy intake (EI) correlated inversely to T2- and T3-ghrelin. Group and PI were independent predictors of adjusted T2-IGF-I, while group and EI were predictors of adjusted and T2-ghrelin. Growth parameter z-scores were comparable between groups up to 12 months corrected age. Modifications of OMM fortification have a transient effect on early plasma IGF-I and ghrelin levels in preterm infants in a way consistent with the previously recognized protein-energy/endocrine balance, indicating a potential programming effect. View Full-Text
Keywords: BMI; ex-preterm children; feeding preterm infants; growth; human milk fortification; nutrition; programming; protein intake BMI; ex-preterm children; feeding preterm infants; growth; human milk fortification; nutrition; programming; protein intake
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Agakidou, E.; Karagiozoglou-Lampoudi, T.; Parlapani, E.; Fletouris, D.J.; Sarafidis, K.; Tzimouli, V.; Diamanti, E.; Agakidis, C. Modifications of Own Mothers’ Milk Fortification Protocol Affect Early Plasma IGF-I and Ghrelin Levels in Preterm Infants. A Randomized Clinical Trial. Nutrients 2019, 11, 3056.

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