Carnitine deficiency in premature infants receiving total parenteral nutrition: Effect of L-carnitine supplementation
1983
Schmidt-Sommerfeld, Eberhard | Penn, Duna | Wolf, Helmut
Extract: To investigate whether L-carnitine supplementation may correct nutritional carnitine deficiency and associated metabolic disturbances in premature infants receiving total parenteral nutrition, an intravenous fat tolerance test (1 gm/kg Intralipid over 4 hours) was performed on 29 premature infants, 6-10 days of age (15 receiving carnitine supplement 10 mg/kg/day L-carnitine IV; 14 receiving no supplement). Total carnitine plasma values were normal or slightly elevated in supplemented infants (but decreased in nonsupplemented). In both groups, fat infusion resulted in an increase in plasma concentrations of triglycerides, free fatty acids. D-beta-hydroxybutyrate, and short-chain and long-chain acylcarnitine, but total carnitine values did not change. After fat infusion, the free fatty acids/D-beta hydroxbutyrate ratios were lower and the increase of acylcarnitine greater, in supplemented infants of 29-33 weeks' gestation, than in nonsupplemented infants of the same gestational age. This study provides evidence that premature infants of less than 34 weeks' gestation requiring total parenteral nutrition, develop nutritional carnitine deficiency with impaired fatty acid oxidation and ketogenesis. Carnitine supplementation improves this metabolic disturbance. (author/wz)
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