Metabolic products in urine of preterm infants characterized via gas chromatography-mass spectrometry.

Objective: To characterize the metabolic products of urine associated with preterm birth, thus providing clinical guidelines for intestinal and parenteral nutrition in preterm infants. Methods: Urine samples of 47 preterm infants and 45 full-term infants were collected and prepared for trimethylsilylation by treatment with urease. The levels of lysine, phenylalanine, histidine, ornithine, fumaric acid, malic acid, succinic acid, lactose, stearic acid, and 4-hydroxyphenylacetic acid were detected by gas chromatography-mass spectrometry (GC/MS), and statistically analyzed. Results: The normalized concentrations of the following metabolites in preterm infant urine samples were significantly lower than that of full-term infant urine samples: lysine (P = 0.003), phenylalanine (P = 0.001), histidine (P = 0.006), ornithine (P = 0.000), fumaric acid (P = 0.002), malic acid (P = 0.006), succinic acid (P = 0.000), lactose (P = 0.000), stearic acid (P = 0.000) and 4-hydroxyphenylacetic acid (P = 0.000). Conclusions: The results of the GC/MS analysis indicated that amino acid, carbohydrate, and fatty acid metabolism defects exist in preterm infants. The use of GC/MS to determine metabolic products in urine samples could be helpful for prospectively evaluating the nutritional status of preterm infants, and therefore providing clinical guidelines on reasonable nutritional support.