Enhanced nutrition improves growth and increases blood adiponectin concentrations in very low birth weight infants

Background: Adequate nutrient supply is essential for optimal postnatal growth in very low birth weight (VLBW, birth weight < 1,500 g) infants. Early growth may influence the risk of metabolic syndrome later in life. Objective: To evaluate growth and blood metabolic markers (adiponectin, leptin, and insulin-like growth factor-1 (IGF-1)) in VLBW infants participating in a randomized nutritional intervention study. Design: Fifty VLBW infants were randomized to an enhanced nutrient supply or a standard nutrient supply. Thirty-seven infants were evaluated with growth measurements until 2 years corrected age (CA). Metabolic markers were measured at birth and 5 months CA. Results: Weight gain and head growth were different in the two groups from birth to 2 years CA (weight gain: p(interaction) = 0.006; head growth: p(interaction) = 0.002). The intervention group improved their growth z-scores after birth, whereas the control group had a pronounced decline, followed by an increase and caught up with the intervention group after discharge. At 5 months CA, adiponectin concentrations were higher in the intervention group and correlated with weight gain before term (r = 0.35) and nutrient supply (0.35 <= r <= 0.45). Leptin concentrations correlated with weight gain after term and IGF-1 concentrations with length growth before and after term and head growth after term (0.36 <= r <= 0.53). Conclusion: Enhanced nutrient supply improved early postnatal growth and may have prevented rapid catchup growth later in infancy. Adiponectin concentration at 5 months CA was higher in the intervention group and correlated positively with early weight gain and nutrient supply. Early nutrition and growth may affect metabolic markers in infancy.