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. 2022 Nov 9;14(22):4725.
doi: 10.3390/nu14224725.

Carnitine Intake and Serum Levels Associate Positively with Postnatal Growth and Brain Size at Term in Very Preterm Infants

Suvi Manninen  1 , Sanna Silvennoinen  2 , Paula Bendel  3 , Maria Lankinen  1 , Ursula S Schwab  1   4 , Ulla Sankilampi  2   5
Affiliations

Carnitine Intake and Serum Levels Associate Positively with Postnatal Growth and Brain Size at Term in Very Preterm Infants

Suvi Manninen et al. Nutrients. .

Abstract

Carnitine has an essential role in energy metabolism with possible neuroprotective effects. Very preterm (VPT, <32 gestation weeks) infants may be predisposed to carnitine deficiency during hospitalization. We studied the associations of carnitine intake and serum carnitine levels with growth and brain size at term equivalent age (TEA) in VPT infants. This prospective cohort study included 35 VTP infants admitted to Kuopio University Hospital, Finland. Daily nutrient intakes were registered at postnatal weeks (W) 1 and 5, and serum carnitine levels were determined at W1, W5, and TEA. The primary outcomes were weight, length, and head circumference Z-score change from birth to TEA, as well as brain size at TEA in magnetic resonance imaging. Carnitine intake at W1 and W5, obtained from enteral milk, correlated positively with serum carnitine levels. Both carnitine intake and serum levels at W1, W5, and TEA showed a positive correlation with weight, length, and head circumference Z-score change and with brain size at TEA. In linear models, independent positive associations of carnitine intake and serum carnitine levels with length and head circumference Z-score change and brain size at TEA were seen. In VPT infants, sufficient carnitine intake during hospitalization is necessary since it is associated with better postnatal growth and larger brain size at term age.

Keywords: acylcarnitine; brain size; carnitine; pediatric nutrition; postnatal growth; preterm.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Spearman rank correlation between the mean daily carnitine intake (mg/kg) and proportion of mean enteral energy of the total daily energy (%) at weeks 1 and 5.
Figure 2
Figure 2
Spearman rank correlations between mean daily carnitine intake (mg/kg) of weeks 1 and 5, and weight, length, and head circumference Z-score change from birth to TEA.
Figure 3
Figure 3
Pearson’s correlations between mean carnitine intake (mg/kg) of weeks 1 and 5 and the mean serum concentrations of free carnitine (C0) (A) and short-chain acylcarnitine C2 (B) and C3 (C) levels at week 1, week 5, and at term-equivalent age.
Figure 4
Figure 4
Spearman rank correlations between mean serum concentrations of free carnitine (C0) and short-chain acylcarnitines (C2 and C3) at week 1, week 5, and TEA, and weight (A–C), length (D–F), and head circumference (G–I) Z-score change from birth to TEA.
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