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This study analyzed urine samples from 314 extremely premature infants to identify metabolic differences between those who developed bronchopulmonary dysplasia (BPD) and those who did not. Researchers found that infants with BPD had significantly lower levels of vitamin-related metabolites (vitamins C, B1, and B6) and disruptions in lactoyl amino acid, xanthine, and fatty acid metabolism pathways during the first month of life. The metabolic deficiencies were particularly pronounced during the fourth week of life and occurred regardless of whether infants received parenteral or enteral nutrition.
Why it matters
These findings suggest that metabolic dysregulation and potential nutritional deficiencies may contribute to BPD development in extremely premature infants, opening possibilities for preventive interventions through targeted nutritional supplementation. Understanding these metabolic pathways could help identify at-risk infants earlier and guide more precise nutritional management strategies in neonatal intensive care.
⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
Rationale: Untargeted metabolomics may identify novel pathways involved in bronchopulmonary dysplasia (BPD), a poorly understood lung disease in extremely premature infants. Objective: To identify metabolites and pathways altered in infants who develop BPD through a metabolome-wide association study. Methods: We performed untargeted urinary metabolomics in 314 infants (<29 weeks gestational age) at two time points between postnatal days 5-15 and 23-32, with detailed time-series for 28 infants. We compared metabolite levels between infants with and without BPD at 36 weeks postmenstrual age using logistic regression and pathway enrichment analysis. A stratified analysis by nutrition type was performed at 23-32 days. Results: Among the 913 analyzed urinary metabolites, 23 and 68 were nominally associated with BPD between postnatal days 5-15 and 23-32, respectively (p<0.05). We found enrichment in the lactoyl amino acid sub-pathway (5-15 days; p=0.005, q=0.4) and xanthine metabolism and fatty acid metabolism (23-32 days; p[≤]0.002, q<0.1). Most BPD-differential metabolites were lower in infants with BPD at days 23-32 (OR=7.1, p=2×10-6), with similar patterns among infants receiving parenteral (OR=9.2, p=7×10-7) and full enteral nutrition (OR=6.1, p=0.003). Twenty-four metabolites, including vitamins C, B1, and B6, were lower in infants on parenteral nutrition with BPD at postnatal days 23-32. Discussion: BPD in extremely premature infants was associated with lower levels of vitamin-related metabolites and dysregulation of lactoyl amino acids, xanthine, and fatty acid metabolism. BPD-differential metabolites were lower in infants with BPD during the fourth week of life, potentially related to higher energy demand, metabolic dysregulation, insufficient nutrient availability, and/or impaired intestinal absorption.
Source: Metabolome-wide Association Study of Bronchopulmonary Dysplasia in Extremely Premature Infants