Plasma and Urine Riboflavin During Riboflavin‐Free Nutrition in Very‐Low‐Birth‐Weight Infants

• Published in: Journal of pediatric gastroenterology and nutrition Vol. 31; no. 2; pp. 142 - 148
• Main Authors: Porcelli, Peter J., Rosser, Mary L., DelPaggio, Dia, Adcock, Eugene W., Swift, Larry, Greene, Harry
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-08-2000; Lippincott
• Subjects: Aging; Biological and medical sciences; Female; General and cellular metabolism. Vitamins; Humans; Infant Food; Infant Nutritional Physiological Phenomena; Infant, Newborn; Infant, Very Low Birth Weight; Kinetics; Male; Medical sciences; Neonatal; Nutrition; Parenteral Nutrition; Pharmacology. Drug treatments; Preterm infant formula; Riboflavin - administration & dosage; Riboflavin - blood; Riboflavin - urine; Human; Premature; Pregnancy disorders; Nutrition; Pathogenesis; Nutrition disorder; Infant; Supplemented diet; Kidney; Very low birthweight; Hypervitaminosis; Multivitamin; Urinary system; Complication; Immaturity; Nutritional status
• ISSN: 0277-2116; 1536-4801
• DOI: 10.1002/j.1536-4801.2000.tb07079.x

ABSTRACT
Background
Very‐low‐birth‐weight (VLBW; birth weight <1500 g) infants receive enteral and parenteral nutriture that provides greater daily riboflavin (vitamin B2) than does term infant nutriture, and elevated plasma riboflavin develops in these infants after birth. The purpose of this study was to measure plasma and urine riboflavin concentrations in VLBW infants during riboflavin‐free nutrition. Our hypothesis was that elevated plasma riboflavin develops in VLBW infants because of high daily intake and immature renal riboflavin elimination.
Methods
Eighteen clinically healthy VLBW infants received parenteral nutrition and preterm infant formula during the first postnatal month. On postnatal days 10 and 28, the infants received specially prepared riboflavin‐free enteral and parenteral nutrition for the 24‐hour study period. Serial collections of plasma were made at time 0 and at 12 and 24 hours. Urine was collected continuously for the 24‐hour period in 4‐hour aliquots. Samples were analyzed for riboflavin concentration.
Results
During the 24‐hour riboflavin‐free study period on postnatal day 10, plasma riboflavin decreased 56% from 185 ± 37 ng/mL (mean ± SEM), and urine riboflavin decreased 75% from 3112 ± 960 mg/mL. Similarly, on postnatal day 28, plasma riboflavin decreased 79% from 184 ± 32 ng/mL, and urine riboflavin concentration decreased 91% from 5092 ± 743 ng/mL during the 24‐hour riboflavin‐free study period. Riboflavin half‐life (t½) was 18.5 hours on postnatal day 10 and decreased 48% by postnatal day 28. Riboflavin elimination was 145.1 ± 20.6 mg/kg per day on postnatal day 10 and increased 40% by postnatal day 28.
Conclusion
The VLBW infants who received parenteral nutrition and preterm infant formula had elevated plasma riboflavin on postnatal days 10 and 28. Plasma riboflavin t½ was shorter and renal riboflavin elimination was greater on postnatal day 28 than on postnatal day 10. Plasma riboflavin was normal after 24 hours of riboflavin‐free nutrition. The pattern of plasma and urine riboflavin in VLBW infants suggests a lower daily intake would maintain plasma riboflavin close to normal.