title: Protracted maturation of pancreatic-specific elastase 1 excretion in preterm infants of extremely low gestational age.
abstract: OBJECTIVE
  The aim of the present study was to better understand the exocrine pancreatic function of extremely preterm infants.
  
  
  METHODS
  Pancreatic-specific elastase 1 (PSE1) activity was determined in spot stool samples of 69 preterm infants of gestational age <32 weeks and birth weight <1250 g. Assays were conducted on samples collected at 2 (N = 56), 4 (N = 46), and 6 weeks of age (N = 23).
  
  
  RESULTS
  PSE1 activity increased from week 2 (median [interquartile range] 84 [48-187] μg/g) to week 4 (164 [87-251 μg/g; P < 0.001) but not thereafter (169 [82-298] μg/g at week 6). The maturational increase in PSE1 activity was observed only in infants of gestational age <28 weeks (P < 0.001). At 2 weeks after birth, PSE1 levels were lower in infants of gestational age <28 weeks than in infants of gestational age ≥ 28 weeks (77 [43-110] vs 165 [56-300] μg/g; P = 0.019), but this difference was less pronounced at 4 weeks (153 [77-226] vs 230 [108-503] μg/g; P = 0.070) and had disappeared by 6 weeks (163 [76-258] vs 175 [85-418] μg/g; P = 0.576). In infants on full enteral feeding regimens 4 weeks after birth, PSE1 levels were associated with weight gain per unit of energy intake (Rs = 0.431; P = 0.005). This measure of weight gain was lower (P = 0.040) in infants with PSE1 levels <200 μg/g (0.110 [0.081-0.139] g/kcal, N = 25) than in those with PSE1 levels ≥ 200 μg/g (0.139 [0.117-0.157] g/kcal, N = 15). Administration of pancreatic enzymes to infants showing PSE1 excretion levels <200 μg/g did not enhance weight gain.
  
  
  CONCLUSIONS
  : Extremely preterm infants have limited exocrine pancreatic function during the first weeks of life, which may contribute to growth failure.
authors.affiliation: Department of Neonatology, Charité University Medical Center, Berlin, Germany. annette.muench@charite.de
authors.forename: Annette
authors.initials: A
authors.lastname: Münch
authors.forename: Lars
authors.initials: L
authors.lastname: Garten
authors.forename: Christoph
authors.initials: C
authors.lastname: Bührer
mesh_terms: D004750:Enteral Nutrition; D005243:Feces / Q000201:enzymology; D005865:Gestational Age; D006130:Growth Disorders / Q000209:etiology* / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development / Q000378:metabolism*; D007235:Infant, Premature, Diseases / Q000209:etiology / Q000378:metabolism; D019102:Infant, Very Low Birth Weight / Q000254:growth & development / Q000378:metabolism*; D010196:Pancreatic Elastase / Q000378:metabolism*; D015430:Weight Gain
chemical_list: D010196:Pancreatic Elastase