The Transport of Long-Chain Polyunsaturated Fatty Acids in Preterm Infant Plasma

Plasma transport of long-chain polyunsaturated fatty acids in preterm infant plasma is dominated by phosphatidylcholine

Wolfgang Bernhard1, MD PhD, Christoph Maas1, MD, Anna Shunova1, Michaela Mathes1,

MD, Katrin Böckmann1, MD, Christine Bleeker, Julia Vek, Christian F. Poets1, MD, Erwin

Schleicher, PhD2, Axel R. Franz1,3, MD

Affiliations: Departments of 1Neonatology, 2Internal Medicine IV and 3Center for Pediatric

Clinical Studies, Faculty of Medicine, Eberhard-Karls-University, Tübingen, Germany.

Address of correspondence: Wolfgang Bernhard, MD, PhD, Department of Neonatology,

Faculty of Medicine, Eberhard-Karls-University, Calwer Straße 7, D-72076 Tuebingen,

Germany; [email protected]; Phone: #-49 7071 29 86377

Short title: LC-PUFA transport in preterm infant plasma

Names for PubMed indexing: Bernhard W, Maas C, Shunova A, Mathes M, Böckmann, K, Poets

CF, Schleicher E, Franz AR

Funding: This study was funded by an internal grant of the Eberhard-Karls-University, Tübingen

E03.27032.

Key words: Choline deficiency; neonate; neurological development; polyunsaturated fatty acids; preterm infants; LC-PUFA transport

Study registration: This study was registered at www.clinicaltrials.gov. Identifier: NCT01773902. 2

TABLE E1: Fatty acids of plasma neutral lipids in Preterm Infants compared to the Fetus

NICU patients Cord Plasma p

Lauric acid C12:0 1.31 (0.76-1.97) 0.59 (0.38-0.94) <0.0001 Myristic acid C14:0 3.58 (3.05-4.07) 2.55 (2.01-3.50) <0.0001 Palmitic acid C16:0 20.1 (18.9-21.5) 20.6 (18.6-21.5 0.5262 Palmitoleic acid C16:1-N7cis 3.83 (2.95-5.04) 4.65 (4.09-5.07 0.0115 Stearic acid C18:0 12.5 (10.5-15.4) 15.7 (13.7-18.7 0.001 Oleic acid C18:1-N9 31.1 (28.4-34.0) 26.8 (24.2-36.9 0.0246 Linoleic acid C18:2-N6 16.2 (13.9-18.5) 11.2 (9.3-12.8) <0.0001 gamma-Linolenic acid C18:3-N6 0.42 (0.31-0.53) 0.39 (0.17-0.52) 0.113 Arachidic acid C20:0 0.27 (0.22-0.35) 0.16 (0.09-0.30) <0.0001 alpha-Linolenic acid C18:3-N3 0.69 (0.59-0.90) 0.53 (0.41-0.61) <0.0001 cis-8,11,14-Eicosatrienoic acid C20:3-N6 3.69 (2.90-4.29) 5.13 (2.53-6.31) 0.0425 Behenic acid C22:0 0.09 (0.06-0.13) 0.10 (0.08-0.24) 0.0499 Arachidonic acid (ARA) C20:4-N6 2.67 (2.13-3.23) 5.74 (3.67-6.45) <0.0001 Eicosapentaenoic acid (EPA) C20:5-N3 0.31 (0.21-0.49) 0.46 (0.32-0.70) 0.0027 Adrenic acid (ADA) C22:4-N6 0.19 (0.12-0.25) 0.18 (0.11 0.27) 0.7526 Docosapentaenoic acid C22:5-N6 0.11 (0.08-0.17) 0.29 (0.16-0.33) <0.0001 Docosapentaenoic acid C22:5-N3 0.23 (0.10-0.35) 0.21 (0.08-0.36) 0.6874 Docosahexaenoic acid (DHA) C22:6-N3 0.48 (0.34-0.65) 0.88 (0.73-1.23) <0.0001 C20:4/ C22:6 5.23 (3.96-7.19) 5.81 (3.48-8.51) 0.6889 EDTA plasma from neonatal intensive care patients (NICU) (N=141) and from cord blood (N=35) was analyzed as described in Materials and Methods. Data are indicated as mol% of total fatty acids in neutral lipids, and are presented as median and (interquartile range). Non- parametric Dunn-test for group comparisons was used for statistical analysis. Abbreviations: p, significance level.