《一份关于乳母补充磷虾油对母乳中长链多不饱和脂肪酸(LCPUFAs)成分影响的可行性研究报告》Maternal Supplementation With Krill Oil During Breastfeeding and Long-Chain Polyunsaturated Fatty Acids (LCPUFAs) Composition of Human Milk: A Feasibility Study.|中冠生物科技(珲春)有限公司 

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《一份关于乳母补充磷虾油对母乳中长链多不饱和脂肪酸(LCPUFAs)成分影响的可行性研究报告》

Maternal Supplementation With Krill Oil During Breastfeeding and Long-Chain Polyunsaturated Fatty Acids (LCPUFAs) Composition of Human Milk: A Feasibility Study. Cimatti AG, Martini S et al.Front Pediatr. 2018 Dec 20;6:407. doi: 10.3389/fped.2018.00407. eCollection 2018.

背景:
二十二碳六烯酸(DHA)是神经元和视网膜的主要成分,在生命最初的几个月对大脑和视觉发育起着至关重要的作用。饮食摄入是保证新生儿充足DHA的基础;因此,母亲补充可能是提高母乳中DHA含量的有效策略,可能对新生儿神经发育有好处。南极磷虾是一种小型甲壳类动物,富含与磷脂相结合的DHA。本试验性研究的目的在于评估母乳喂养期间母亲补充磷虾油是否会增加母乳中长链多不饱和脂肪酸(LCPUFAs)的含量。
方法:
进入新生儿重症监护室的婴儿的母亲在分娩后4 - 6周被纳入这项开放式的随机对照研究,新生儿母亲被随机分为两组。第一组口服以磷虾油为基础的补充剂,每天提供250mgDHA和70mg二十碳五烯酸(EPA),持续30天;第二组作为对照组。在基线第0天(T0)和第30天(T1)采集两组的母乳样品,并通过气相色谱/质谱法对长链多不饱和脂肪酸成分进行定量分析。
结果:
在16名母乳喂养的母亲中,8例补充磷虾油,8例随机分为对照组。在第0天,两组之间母乳中的DHA(%DHA)、花生四烯酸(%AA)和EPA(%EPA)百分比没有显著性差异。在补充磷虾油组的第0天和第30天之间,DHA百分比(T 0:平均值0.23%[四分位差0.19;0.38]、T1:0.42%[0.32;0.49]、p 0.012)和EPA百分比(T 0:平均值0.10%[四分位差0.04;0.11]、T1:0.11%[0.04;0.15]、p 0.036)显著性增加,AA百分比(T 0:平均值0.48%[四分位差0.42;0.75]、T1:0.43%[0.38;0.61],p 0.017)显著性降低,而对照组中没有显著性差异。在第2组中。与上述结果相一致地,两组间第30天与第0天DHA含量(Δ%DHA,组1:平均值64.2%[四分位差27.5;134.6],组2:-7.8%[12.1;-3.13],p 0.025)和EPA含量(Δ%EPA,组1:平均值39%[四分位差15.7;73.4],组2:-25.62%[32.7;-3.4,p 0.035)变化的百分比存在显著性差异。
结论:口服磷虾油补充剂可有效增加母乳中的DHA和EPA含量。这一策略在母乳喂养对早产的新生儿大脑和视觉发育的潜在益处值得再有针对性的进一步评估。
临床注册号
www.ClinicalTrials.gov, identifier NCT03583502
文中提到,母乳喂养的新生儿,头4个月内补充了充足的DHA,在5岁、25岁时的持续注意力明显优于对照组。

Abstract:
Background: 
Docosahexaenoic acid (DHA) is a major constituent of neuronal and retinal membranes and plays a crucial role in brain and visual development within the first months of life. Dietary intakes are fundamental to provide neonates with adequate DHA supply; hence, maternal supplementation might represent a useful strategy to implement DHA contents in breast milk (BM), with possible benefits on neonatal neurodevelopment. Antarctic krill is a small crustacean rich in highly available phospholipid-bound DHA. This pilot study aimed to evaluate whether maternal supplementation with krill oil during breastfeeding increases long-chain polyunsaturated fatty acids (LCPUFAs) BM contents. 
Methods: 
Mothers of infants admitted to the Neonatal Intensive Care Unit were enrolled in this open, randomized-controlled study between 4 and 6 weeks after delivery and randomly allocated in 2 groups. Group 1 received an oral krill oil-based supplement providing 250 mg/day of DHA and 70 mg/day of eicosapentaenoic acid (EPA) for 30 days; group 2 served as control. BM samples from both groups were collected at baseline (T0) and day 30 (T1) and underwent a qualitative analysis of LCPUFAs composition by gas chromatography/mass spectrometry. 
Results: 
Sixteen breastfeeding women were included. Of these, 8 received krill-oil supplementation and 8 were randomized to the control group. Baseline percentage values of DHA (%DHA), arachidonic acid (%AA), and EPA (%EPA) did not differ between groups. A significant increase in %DHA (T0: median 0.23% [IQR 0.19;0.38], T1:0.42% [0.32;0.49], p 0.012) and %EPA (T0: median 0.10% [IQR 0.04;0.11], T1:0.11% [0.04;0.15], p 0.036) and a significant reduction in %AA (T0: median 0.48% [IQR 0.42;0.75], T1:0.43% [0.38;0.61], p 0.017) between T0 and T1 occurred in Group 1, whereas no difference was seen in Group 2. Consistently, a significant between-group difference was observed in percentage changes from baseline of DHA (Δ%DHA, group 1: median 64.2% [IQR 27.5;134.6], group 2: -7.8% [-12.1;-3.13], p 0.025) and EPA (Δ%EPA, group 1: median 39% [IQR 15.7;73.4]; group 2: -25.62% [-32.7;-3.4], p 0.035).
 Conclusions: 
Oral krill oil supplementation effectively increases DHA and EPA contents in BM. Potential benefits of this strategy on brain and visual development in breastfed preterm neonates deserve further evaluation in targeted studies. 
Clinical Trial Registration:
 www.ClinicalTrials.gov, identifier NCT03583502.