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 AI 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 AI and HDL subclasses. METHODS Apolipoprotein AI 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 AI 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 HDL(2b) and less small HDL(3c )than in term infants. Whereas the HDL subclass distribution of term infants remained unchanged, in TPN and ENT infants, a shift from HDL(2b) to HDL(3c) 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 AI and HDL subclass distributions as fully enterally fed preterm infants.