LIMITED FAT DIGESTION IN INFANTS WITH BRONCHOPULMONARY DYSPLASIA

In 10 hyaline membrane disease patients with development of bronchopul monary dysplasia, 16 hyaline membrane disease patients without develop ment of bronchopulmonary dysplasia, and 12 very-low-birthweight infant s without major medical problems, we measured the lipase and trypsin a ctivity as well as the bile acids concentrations in preprandially aspi rated duodenal juice. In addition, fat and nitrogen balances were perf ormed during the 5th and 6th weeks of postnatal life. The mean duodena l lipase activity in the patients with bronchopulmonary dysplasia was significantly lower than those of the patients without bronchopulmonar y dysplasia (4.41 +/- 3.0 versus 9.95 +/- 3.0 U/ml, p < 0.05) and of t he controls (19.94 +/- 6.8 U/ml). The mean total bile acid concentrati on was below the critical micellar concentration of 4 mmol/L only in t he patients with bronchopulmonary dysplasia. The fecal fat excretion r ate in the patients with bronchopulmonary dysplasia was significantly higher than in the patients without bronchopulmonary dysplasia (21.4 /- 4.6% versus 11.3 +/- 3.4% of intake, p < 0.01) as well as that of t he controls (7.9 +/- 2.8% of intake). The serum urea concentrations we re similar in the patients without bronchopulmonary dysplasia and in t he controls (1.97 +/- 0.6 and 1.89 +/- 0.4 mmol/L, respectively) but s ignificantly higher in the patients with bronchopulmonary dysplasia (2 .54 +/- 0.5 mmol/L). The lowest weight gain was found in the patients with bronchopulmonary dysplasia (8.2 +/- 4.7 g/kg/day). It was signifi cantly lower than one of the patients without bronchopulmonary dysplas ia or the controls (13.5 +/- 4.0 and 16.2 +/- 3.7 g/kg/day, respective ly). The data indicate that patients who develop bronchopulmonary dysp lasia have a limited fat absorption, which may help to explain the ina dequate weight gain.