Reduced serum amino acid concentrations in infants with necrotizing enterocolitis

Objective: To determine whether premature infants who have necrotizing ente rocolitis (NEC) have deficiencies in glutamine (GLN) and arginine (ARC), wh ich are essential to intestinal integrity. Study design: A 4-month prospective cohort study of serum amino acid and ur ea levels in premature infants was done. Serum amino acid and urea levels w ere measured by high-pressure liquid chromatography and enzymatic ic method s, respectively, on samples obtained on days of life 3, 7, 14, and 21. Results: Infants in the control (n = 32) and NEC groups (n = 13) were compa rable for birth weight, gestational age, and Apgar scores. NEC began on mea n day of life 14.5 (95% CI, day of life 11 to 18). Median values of GLN wer e 37% to 57% lower in the NEC group on days 7, 14, and 21 compared with tho se in the control group (P < .05). On days 7 and 14, median values of ARC, GLN, alanine, lysine, ornithine, and threonine were decreased 36% to 67% (P < .05) in the NEC group. Total nonessential amino and total essential amin o acids were 35% to 50% lower in the NEC group on days 7 and 14 (P < .05). Infants in the NEC group had significant reductions in GLN and ARG 7 days b efore the onset of NEC. Conclusions: infants who have NEC have selective amino acid deficiencies in cluding reduced levels of GLN and ARG that may predispose to the illness.