Amylin peptide is increased in preterm neonates with feed intolerance.
BACKGROUND
Amylin, a 37-amino-acid peptide hormone, is a potent inhibitor of gastric emptying. It is co-secreted by the pancreatic beta cells in response to enteral nutrient intake. Feed intolerance is common in preterm neonates and often presents as increased gastric residual volume (GRV). It is therefore hypothesised that serum amylin concentrations are raised in preterm neonates with poor gastric emptying, which may contribute to this observed feed intolerance.


OBJECTIVE
To determine serum amylin concentrations in feed-intolerant preterm neonates.


METHODS
Feed-intolerant (nTOL) preterm neonates (GRV >50% of a previous 4 h feed volume on two consecutive occasions) were matched for gestation, birth weight and postnatal age with feed-tolerant (TOL) neonates. Blood samples were analysed for amylin concentration. Seventy neonates were studied with median (interquartile range) gestation of 29 weeks (28-33) and birth weight of 1.3 kg (1.0-1.8).


RESULTS
Serum amylin concentration and percentage GRV (median (interquartile range)) were significantly higher in the nTOL (47.9 pmol/l (21.4-79.8), 150% (100-350)) than the TOL (8.7 pmol/l (5.7-16), 5% (0-5)) group (p<0.001). In the nTOL group, a positive correlation was observed between serum amylin and GRV (r = 0.78, 95% CI 0.59 to 0.89, p<0.001), days to reach full enteral feeds (r = 0.40, 95% CI 0.08 to 0.68, p = 0.02), and days to discharge (r = 0.43, 95% CI 0.09 to 0.68, p = 0.01).


CONCLUSIONS
Amylin may be responsible for delaying establishment of enteral nutrition in preterm neonates by virtue of its inhibitory effect on gastric emptying. Serum amylin concentrations in these neonates correlate with GRVs and time to reach full enteral feeds.
Kairamkonda
V R
VR
Department of Neonatal Intensive Care, University Hospitals of Leicester NHS Trust, Leicester Royal Infirmary, Leicester LE1 5WW, UK. Venkatesh.Kairamkonda@uhl-tr.nhs.uk
Deorukhkar
A
A
Bruce
C
C
Coombs
R
R
Fraser
R
R
Mayer
A-P T
AP
D000682:Amyloid / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D016022:Case-Control Studies; D004750:Enteral Nutrition; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis*; D058228:Islet Amyloid Polypeptide; D008297:Male
D000682:Amyloid; D015415:Biomarkers; D001786:Blood Glucose; D058228:Islet Amyloid Polypeptide