Adverse Metabolic Phenotypes in Parenterally Fed Neonatal Pigs Do Not Persist into Adolescence.

BACKGROUND: Nutrition during fetal and neonatal life is an important determinant for the risk of adult-onset diseases, especially Type 2 diabetes and obesity.

OBJECTIVE: Our aim was to determine whether total parenteral nutrition (TPN) vs. enteral formula feeding (EN) in term piglets during the first 2 weeks after birth would increase the long-term (5-month) development of metabolic syndrome phenotypes with adverse glucose homeostasis, fatty liver disease, and obesity.

METHODS: Neonatal female pigs were administered total parenteral nutrition (TPN, n=12) or fed enterally with a liquid enteral milk-replacer formula (EN, n=12) for 14 d. After transitioning TPN pigs to enteral feeding of liquid formula (d 15-26), both groups were adapted to a solid high-fat diet (HFD, 30% of the total diet) and sucrose (20% of the total diet) diet (d 27-33) which was fed until the end of the study (140 d). Body composition was measured by dual-energy X-ray absorptiometry (DXA) at 14, 45, and 140 d. Serum biochemistry and glucose-insulin values (after a fasting intravenous glucose tolerance test, IVGTT) were obtained at 140 d. Liver and muscle were analyzed for insulin receptor signaling and triglycerides.

RESULTS: Body weight was similar, but percent fat was higher while percent lean and bone mineral density were lower in TPN than in EN pigs (P < 0.01) at 45 d of age but not at 140 d. At 140 d, there were no differences in serum markers of liver injury or lipidemia. IVGTT test at 140 d showed a lower (P < 0.05) area-under-curve (AUC) for both glucose and insulin in TPN than in EN pigs, but the ratio of AUC insulin:glucose was not different between groups.

CONCLUSION: Administration of TPN during the neonatal period increased adipose deposition that transiently persisted in early adolescence when challenged with HFD but was not sustained or manifested as glucose intolerance.