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J Pediatr Gastroenterol Nutr. 2013 Nov;57(5):673-6. doi: 10.1097/MPG.0b013e31829fad06.

Differences in circulating carnitine status of preterm infants fed fortified human milk or preterm infant formula.

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*Departments of Medical Genetics †Paediatrics, University of Pécs, Pécs, Hungary ‡Kinderklinik and Kinderpoliklinik, Dr von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany.



The aim of the study was to compare plasma carnitine profiles in fortified human milk (HM)-fed preterm infants or formula-fed preterm infants.


Plasma acylcarnitine concentrations were determined in 20 formula-fed and 18 HM-fed preterm infants (birth weights between 1000 and 2200 g) by isotope dilution ESI MS/MS technique on study days 0, 14, and 28.


Concentrations of free carnitine (FC) and different acylcarnitines did not change during the 4 weeks of the study in infants fed HM. In contrast, in infants fed formula FC increased markedly (day 0: 29.989 [16.646] μmol/L, median [interquartile range], day 14: 43.972 [8.455], P < 0.05) along with increases of short-chain esters (C2 day 0: 5.300 [3.272], day 14: 6.773 [2.127], P < 0.05; C3 day 0: 0.070 [0.059], day 14: 0.110 [0.069], P < 0.05). In contrast, some medium-chain (C8:1, C12) and long-chain esters (C14, C16) decreased significantly in infant formula by day 14, whereas FC and C2 and C3 esters increased further by day 28 (FC: 47.672 [14.753], C2: 7.430 [4.688], C3: 0.107 [0.047]).


The altered carnitine ester profile likely reflects active involvement of the carnitine molecule in the buffering, metabolism, and elimination of nonphysiological acyl moieties.

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