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Early Postnatal Changes of Bone Turnover Biomarkers in Very Low‐Birth‐Weight Neonates—The Effect of Two Parenteral Lipid Emulsions with Different Polyunsaturated Fatty Acid Content: A Randomized Double‐Blind Study
Author(s) -
Papandreou Panos,
Agakidis Charalampos,
Scouroliakou Maria,
KaragiozoglouLampoudi Thomai,
Kaliora Adriana,
Kalogeropoulos Nick,
Siahanidou Tania
Publication year - 2020
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1002/jpen.1533
Subject(s) - osteoprotegerin , osteocalcin , polyunsaturated fatty acid , bone remodeling , medicine , endocrinology , rankl , parenteral nutrition , fatty acid , chemistry , alkaline phosphatase , activator (genetics) , biochemistry , receptor , enzyme
Background ω‐3 polyunsaturated fatty acids (n‐3 PUFAs) are reported to have beneficial effect on bone mineral density. This study aimed to evaluate early changes of bone turnover biomarkers in very low‐birth‐weight (VLBW) neonates and the effect of 2 parenteral lipid emulsions (PLEs) with different PUFA composition. Methods This is a randomized double‐blind study with parallel design. VLBW neonates (n = 66) receiving parenteral nutrition (PN)>70% of daily energy requirements for >14 days were assigned into 2 groups that were prescribed soybean oil–based (n = 35) and n‐3–enriched PLE (n = 31), respectively. Osteoprotegerin (OPG), soluble receptor activator of nuclear factor‐kB ligand (sRANKL), osteocalcin (OC), interleukin‐6 (enzyme‐linked immunoblot assay kits), Ca, and P plasma levels were assessed before PLE implementation (T1) and on day 20 of life (T2). Results In the total population, sRANKL and OC significantly increased, whereas OPG and the OPG/sRANKL ratio decreased from T1 to T2. Within each group, T1‐to‐T2 changes of OC were significant in both groups, whereas those of OPG/sRANKL were significant only in the soybean‐based group. Multiple regressions showed an independent effect of group allocation on OPG change. Significant associations were observed between PN duration and sRANKL change (negatively), n‐6/n‐3 and OC changes (positively), and OPG and sRANKL changes (positively). Conclusions A high bone‐turnover rate in VLBW neonates with predominance of bone resorption is confirmed. The lower rate of OPG/sRANKL reduction in the n‐3–enriched PLE group indicates that n‐3 PUFA–enriched PLEs may help to attenuate early bone loss in VLBW neonates.