Circulating Adiponectin in Preterm Infants Fed Long-Chain Polyunsaturated Fatty Acids (LCPUFA)-Supplemented Formula—A Randomized Controlled Study

Abstract

Adiponectin has potent insulin-sensitizing effects, improves lipid metabolism, and potentially protects against the development of metabolic syndrome. Thus, increasing adiponectin levels in preterm infants at risk for developing metabolic syndrome may be of special interest. The aim of this study was to examine the effects of dietary long-chain polyunsaturated fatty acids (LCPUFA) on serum adiponectin and lipid concentrations in preterm infants. Adiponectin and lipid levels of 60 healthy preterm infants [gestational age 32.7 (1.9) wk] randomly assigned to be fed either 1) a formula containing LCPUFA [arachidonic and docosahexanoic] (ϩLCPUFA group) or 2) the same formula without LCPUFA (ϪLCPUFA/control group), were determined at mean (SD) 33.8 (11.7) d. Adiponectin and HDL-C concentrations were significantly higher in the ϩLCPUFA group than in controls (p ϭ 0.002 and p ϭ 0.01, respectively); whereas, triglyceride levels were lower (p ϭ 0.06). Adiponectin correlated positively with HDL-C levels and negatively with triglyceride levels in the ϩLCPUFA group but not in the controls. In conclusion, circulating adiponectin concentrations were higher in preterm infants fed a formula containing LCPUFA than infants fed an LCPUFA-free formula and they correlated with lipidemic profile. L ow birth weight due to poor fetal growth has been identified as a factor contributing to the development of metabolic syndrome (insulin resistance, dislipidemia, hypertension) (1,2). Moreover, preterm infants are also at risk for insulin resistance, and possibly for other components of metabolic syndrome, irrespective of whether they were born appropriate or small for gestational age (3,4). Although the underlying mechanism(s) connecting preterm birth and the development of metabolic syndrome risk are not known, circulating concentrations of adiponectin have been shown to be lower in preterm than in full term infants (5). Adiponectin is an adipocyte-derived protein, which has potent insulinsensitizing effects, improves lipid metabolism, and potentially protects against the development of insulin resistance and metabolic syndrome (6). High plasma levels of adiponectin are associated with lower incidence of type-2 diabetes and coronary heart disease (7,8). Therefore, a means of increasing circulating concentrations of adiponectin in preterm infants may be of special interest.N-3 and n-6 long-chain polyunsaturated fatty acids (LCPUFA), mainly docosahexanoic (DHA) and arachidonic (AA) acid, have been added in some, but not all, commercially available infant formulas, in an attempt to mimic the composition of human milk. In animals and human adults, diets enriched with n-3 LCPUFA have been linked to beneficial effects against insulin resistance (9) and to a favorable impact on lipidemic profile (10,11). The influence of dietary n-3 LCPUFA on circulating concentrations of adiponectin has been studied in animals (12-15), in obese adults, and in patients, who have suffered a myocardial infarction (16 -18). Dietary n-3 LCPUFA appear to hav...

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