<p> 1 </p><p>Plasma transport of long-chain polyunsaturated fatty acids in preterm infant plasma is dominated by phosphatidylcholine </p><p>Wolfgang Bernhard1, MD PhD, Christoph Maas1, MD, Anna Shunova1, Michaela Mathes1,</p><p>MD, Katrin Böckmann1, MD, Christine Bleeker, Julia Vek, Christian F. Poets1, MD, Erwin</p><p>Schleicher, PhD2, Axel R. Franz1,3, MD</p><p>Affiliations: Departments of 1Neonatology, 2Internal Medicine IV and 3Center for Pediatric</p><p>Clinical Studies, Faculty of Medicine, Eberhard-Karls-University, Tübingen, Germany. </p><p>Address of correspondence: Wolfgang Bernhard, MD, PhD, Department of Neonatology,</p><p>Faculty of Medicine, Eberhard-Karls-University, Calwer Straße 7, D-72076 Tuebingen,</p><p>Germany; [email protected]; Phone: #-49 7071 29 86377</p><p>Short title: LC-PUFA transport in preterm infant plasma </p><p>Names for PubMed indexing: Bernhard W, Maas C, Shunova A, Mathes M, Böckmann, K, Poets</p><p>CF, Schleicher E, Franz AR</p><p>Funding: This study was funded by an internal grant of the Eberhard-Karls-University, Tübingen</p><p>E03.27032.</p><p>Key words: Choline deficiency; neonate; neurological development; polyunsaturated fatty acids; preterm infants; LC-PUFA transport</p><p>Study registration: This study was registered at www.clinicaltrials.gov. Identifier: NCT01773902. 2 </p><p>TABLE E1: Fatty acids of plasma neutral lipids in Preterm Infants compared to the Fetus</p><p>NICU patients Cord Plasma p</p><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.</p>