Effect of Early Enteral Feeding on Apolipoprotein AI Levels and High-Density Lipoprotein Heterogeneity in Preterm Infants

Background/Aim: We have previously shown that infants receiving
total parenteral nutrition have low apolipoprotein Al levels which
are associated with high-density lipoprotein (HDL) class
distributions as in lecithin:cholesterol acyltransferase
deficiency. This study investigates the influence of early enteral
feedings on apolipoprotein Al and HDL subclasses. Methods:
Apolipoprotein Al and HDL distributions were determined in 15 total
parenterally fed preterm infants (TPN group) receiving early
feedings, in 28 enterally fed preterm infants (ENT group), and in
26 term infants at birth and on day 5. The HDL subclasses were
determined by gradient gel electrophoresis. Results: In the TPN
group, the apolipoprotein Al levels increased significantly
postnatally (from 73 +/- 16 to 104 +/- 23 mg/dl) to levels found in
the term and ENT groups on day 5 (88 +/- 16 and 96 +/- 19 mg/dl).
The HDL subclass distributions at birth and on day 5 were similar
in both TPN and ENT groups with more large HDL2b and less small
HDL3c than in term infants. Whereas the HDL subclass distribution
of term infants remained unchanged, in TPN and ENT infants, a shift
from HDL2b to HDL3c was observed, with no difference between term
and preterm infants on day 5. Conclusion: In contrast to
exclusively parenterally fed infants, infants receiving early
enteral feedings exhibited a significant rise of apolipoprotein Al
and HDL subclass distributions as fully enterally fed preterm
infants. Copyright (C) 2002 S. Karger AG, Basel.