Decrease in lipid metabolic indexes in infants with neonatal respiratory distress syndrome

Zheng,Guohong; Zheng,Jiansheng; Hu,Xiangrong; Zhu,Tang

doi:10.3892/etm.2023.12357

Decrease in lipid metabolic indexes in infants with neonatal respiratory distress syndrome

Authors:
- Guohong Zheng
- Jiansheng Zheng
- Xiangrong Hu
- Tang Zhu
View Affiliations

Affiliations: Department of Pediatrics, The First Hospital of Putian, Putian, Fujian 351199, P.R. China, Key Laboratory of Translational Tumor Medicine in Fujian Province, School of Basic Medical Science, Putian University, Putian, Fujian 351100, P.R. China
Published online on: December 19, 2023 https://doi.org/10.3892/etm.2023.12357
Article Number: 69
Copyright: © Zheng et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Incomplete pulmonary function and insufficient production of pulmonary surfactant in premature infants may affect alveolar relaxation, inducing neonatal respiratory distress syndrome (NRDS). The present study was a retrospective comparison of lipid metabolism indexes and clinic information between NRDS and non‑NRDS infants. Data on general information, pregnancy, clinical symptoms, family history as well as plasma biochemical and lipid metabolic indexes were retrospectively collected and statistically analyzed from 79 patients with NRDS and 44 non‑NRDS infants. Infants in the NRDS group showed lower body weight (2,055 vs. 3,225 g) and gestation age (33.39 vs. 38.53 weeks) than those in the non‑NRDS group (P<0.05). Baseline information was corrected by the inverse probability of treatment weighting (IPTW) analysis. The weighted adjusted median age was the same in both groups and there was no significant difference between two groups in birth weight. The IPTW analysis revealed that the levels of plasma triglyceride (TG), total cholesterol, low‑density lipoprotein, free triiodothyronine, free thyroxine, glucose, calcium (Ca²⁺) and phosphorus in the NRDS infants were significantly lower compared with those in the non‑NRDS infants. Additionally, NRDS infants had significantly higher incidence rates of pneumonia, sepsis, brain injury infection, preterm birth, patent foramen ovale, patent ductus arteriosus and premature rupture of membranes compared with the non‑NRDS infants (P<0.05). Multivariate logistic analysis showed that TG and Ca²⁺ were risk factors associated with NRDS (P<0.05). Infants with NRDS have significantly lower levels of plasma lipid indexes. The results of the present study provide data to guide the clinical management of NRDS.

View Figures

View References

1	Thompson BT, Chambers RC and Liu KD: Acute respiratory distress syndrome. N Engl J Med. 377:562–572. 2017.PubMed/NCBI View Article : Google Scholar
2	Khemani RG, Smith LS, Zimmerman JJ and Erickson S: Pediatric Acute Lung Injury Consensus Conference Group. Pediatric acute respiratory distress syndrome: Definition, incidence, and epidemiology: Proceedings from the pediatric acute lung injury consensus conference. Pediatr Crit Care Med. 16 (5 Suppl 1):S23–S40. 2015.PubMed/NCBI View Article : Google Scholar
3	Tochie JN, Choukem SP, Langmia RN, Barla E and Koki-Ndombo P: Neonatal respiratory distress in a reference neonatal unit in Cameroon: An analysis of prevalence, predictors, etiologies and outcomes. Pan Afr Med J. 24(152)2016.PubMed/NCBI View Article : Google Scholar
4	Schouten LR, Veltkamp F, Bos AP, van Woensel JB, Serpa Neto A, Schultz MJ and Wösten-van Asperen RM: Incidence and mortality of acute respiratory distress syndrome in children: A systematic review and meta-analysis. Crit Care Med. 44:819–829. 2016.PubMed/NCBI View Article : Google Scholar
5	Liu J, Cao HY, Wang HW and Kong XY: The role of lung ultrasound in diagnosis of respiratory distress syndrome in newborn infants. Iran J Pediatr. 24:147–154. 2014.PubMed/NCBI
6	Wang J, Liu X, Zhu T and Yan C: Analysis of neonatal respiratory distress syndrome among different gestational segments. Int J Clin Exp Med. 8:16273–16279. 2015.PubMed/NCBI
7	Wang T: Physiology, 9th edition. People's Medical Publishing House, 2018.
8	Lane DM, McConathy WJ, McCaffree MA and Hall M: Cord serum lipid and apolipoprotein levels in preterm infants with the neonatal respiratory distress syndrome. J Matern Fetal Neonatal Med. 11:118–125. 2002.PubMed/NCBI View Article : Google Scholar
9	Hassan HGEMA, Nagi MAMA, Salama AMM, Dawoud MOAEA, Elgendy GG and Abdelrahman AS: Sonographic prediction of fetal main pulmonary artery (MPA) Doppler indices of lung maturity and neonatal respiratory distress syndrome (RDS) development. J Ultrasound. 26:525–533. 2023.PubMed/NCBI View Article : Google Scholar
10	Whitsett JA and Weaver TE: Alveolar development and disease. Am J Respir Cell Mol Biol. 53:1–7. 2015.PubMed/NCBI View Article : Google Scholar
11	Hass MA and Longmore WJ: Surfactant cholesterol metabolism of the isolated perfused rat lung. Biochim Biophys Acta. 573:166–174. 1979.PubMed/NCBI View Article : Google Scholar
12	Voyno-Yasenetskaya TA, Dobbs LG, Erickson SK and Hamilton RL: Low density lipoprotein- and high density lipoprotein-mediated signal transduction and exocytosis in alveolar type II cells. Proc Natl Acad Sci USA. 90:4256–4260. 1993.PubMed/NCBI View Article : Google Scholar
13	Ryan AJ, Medh JD, McCoy DM, Salome RG and Mallampalli RK: Maternal loading with very low-density lipoproteins stimulates fetal surfactant synthesis. Am J Physiol Lung Cell Mol Physiol. 283:L310–L318. 2002.PubMed/NCBI View Article : Google Scholar
14	Shao XM: Practice of neonatology, 5th edition. People's Medical Publishing House, 2019.
15	Wang WP: Pediatrics, 9th edition. People's Medical Publishing House, 2018.
16	Kelishadi R, Barekatain B and Fatahi A: Comparison of serum triglyceride and cholesterol levels in premature neonates with or without respiratory distress syndrome (RDS). Int J Pediatr. 2021(8893754)2021.PubMed/NCBI View Article : Google Scholar
17	Kim JW, Kim YH, Moon JH, Jung HA and Noh EJ: The efficacy of third-generation cephalosporin plus metronidazole versus third-generation cephalosporin plus clarithromycin in neonatal outcomes and oxidative stress markers in women with preterm premature rupture of membranes. Clin Exp Obstet Gynecol. 47:194–198. 2020.
18	Moya F: Preterm nutrition and the lung. World Rev Nutr Diet. 110:239–252. 2014.PubMed/NCBI View Article : Google Scholar
19	Joss-Moore LA, Wang Y, Baack ML, Yao J, Norris AW, Yu X, Callaway CW, McKnight RA, Albertine KH and Lane RH: IUGR decreases PPARgamma and SETD8 expression in neonatal rat lung and these effects are ameliorated by maternal DHA supplementation. Early Hum Dev. 86:785–791. 2010.PubMed/NCBI View Article : Google Scholar
20	Blanco PG, Freedman SD, Lopez MC, Ollero M, Comen E, Laposata M and Alvarez JG: Oral docosahexaenoic acid given to pregnant mice increases the amount of surfactant in lung and amniotic fluid in preterm fetuses. Am J Obstet Gynecol. 190:1369–1374. 2004.PubMed/NCBI View Article : Google Scholar
21	Hopiavuori BR, Anderson RE and Agbaga MP: ELOVL4: Very long-chain fatty acids serve an eclectic role in mammalian health and function. Prog Retin Eye Res. 69:137–158. 2019.PubMed/NCBI View Article : Google Scholar
22	Jobe AH: Pulmonary surfactant therapy. N Engl J Med. 328:861–868. 1993.PubMed/NCBI View Article : Google Scholar
23	King RJ: The surfactant system of the lung. Fed Proc. 33:2238–2247. 1974.PubMed/NCBI
24	Wang H, Zhang W, Wang J, Li HL and Wen CL: Relationship between early serum lipid profiles and respiratory distress syndrome in preterm infants. Zhongguo Dang Dai Er Ke Za Zhi. 15:614–618. 2013.PubMed/NCBI(In Chinese).
25	Gunes T, Koklu E and Ozturk MA: Maternal and cord serum lipid profiles of preterm infants with respiratory distress syndrome. J Perinatol. 27:415–421. 2007.PubMed/NCBI View Article : Google Scholar
26	Dhanireddy R, Smith YF, Hamosh M, Mullon DK, Scanlon JW and Hamosh P: Respiratory distress syndrome in the newborn: Relationship to serum prolactin, thyroxine, and sex. Biol Neonate. 43:9–15. 1983.PubMed/NCBI View Article : Google Scholar
27	Hadeed AJ, Asay LD, Klein AH and Fisher DA: Significance of transient postnatal hypothyroxinemia in premature infants with and without respiratory distress syndrome. Pediatrics. 68:494–498. 1981.PubMed/NCBI
28	Keret R, Mathiash S, Brown M, Pertzelan A, Levy I and Laron Z: Correlation between plasma growth hormone and insulin and blood glucose concentrations in premature infants. Horm Res. 7:313–318. 1976.PubMed/NCBI View Article : Google Scholar
29	Nguyen P, Leray V, Diez M, Serisier S, Le Bloc'h J, Siliart B and Dumon H: Liver lipid metabolism. J Anim Physiol Anim Nutr (Berl). 92:272–283. 2008.PubMed/NCBI View Article : Google Scholar
30	Brem AS: Electrolyte disorders associated with respiratory distress syndrome and bronchopulmonary dysplasia. Clin Perinatol. 19:223–232. 1992.PubMed/NCBI
31	Kalok A, Aziz NHA, Malik DA, Shah SA, Nasuruddin DN, Omar MH, Ismail Nam and Shafiee MN: Maternal serum vitamin D and spontaneous preterm birth. Clin Exp Obstet Gynecol. 47:16–20. 2020.
32	Dautel SE, Kyle JE, Clair G, Sontag RL, Weitz KK, Shukla AK, Nguyen SN, Kim YM, Zink EM and Luders T: , et al: Lipidomics reveals dramatic lipid compositional changes in the maturing postnatal lung. Sci Rep. 7(40555)2017.PubMed/NCBI View Article : Google Scholar
33	Jamal M, Masood A, Belcastro R, Lopez L, Li J, Belik J, Jankov RP and Keith Tanswell A: Lipid hydroperoxide formation regulates postnatal rat lung cell apoptosis and alveologenesis. Free Radic Biol Med. 55:83–92. 2013.PubMed/NCBI View Article : Google Scholar
34	Viscardi RM: Role of fatty acids in lung development. J Nutr. 125 (6 Suppl):1645S–1651S. 1995.PubMed/NCBI View Article : Google Scholar
35	McGladdery SH and Frohlich JJ: Lipoprotein lipase and apoE polymorphisms: Relationship to hypertriglyceridemia during pregnancy. J Lipid Res. 42:1905–1912. 2001.PubMed/NCBI
36	Thadhani R, Stampfer MJ, Hunter DJ, Manson JE, Solomon CG and Curhan GC: High body mass index and hypercholesterolemia: Risk of hypertensive disorders of pregnancy. Obstet Gynecol. 94:543–550. 1999.PubMed/NCBI View Article : Google Scholar