THE EFFECT OF BREAST-FEEDING OR FORMULA ON THE URINARY METHYL MALONIC ACID LEVELS

Yıl 2003, Cilt: 16 Sayı: 4, 266 - 269, 03.12.2016

Arif Bahar Ferhan Karademir Gökhan Aydemir İsmail Göçmen

Öz

Objective: This study was performed to determine the effect of feeding with breast milk or formula on the serum vitamin B12 and folic acid levels and the urinary methyl malonic acid (UMMA) levels as a marker of cobalamine catabolism
Materials and Methods: The study group consisted of 42 healthy newborn infants. Subjects were divided into two groups. Group 1 and 2 included 22 pre-term and 20 full-term neonates, respectively. The levels of B12, folic acid and UMMA were measured on 20th postnatal day in all cases. In Group 1, twelve infants were fed with breast milk, and the others with formula. Half of the infants in group 2 were fed with breast milk.
Results: There was no statistically significant difference for the levels of vitamin B12 and folic acid between two groups (p=0.771, p=0.371). In group 1, the levels of UMMA were found 30.5±9.2 mmol MMA/mol creatinine in the breast-fed neonates, and 47.0±9.7 mmol MMA/mol creatinine in the formula-fed infants. There was a statistically significant difference between groups (p<0.001). In group 2, the levels of UMMA were found 11,0±4.5 mmol MMA/mol creatinine in the breastfed neonates, and 19.0±9.5 mmol MMA/mol creatinine in the formula-fed neonates (p=0.001).
Conclusion: Our finding that the levels of UMMA in the formula-fed neonates were higher than the breast-fed infants suggested that breast-feeding has an effect of decreasing the UMMA levels.
Key Words: Breast-feeding, Pre-term, Full- term, Methyl malonic acid

Kaynakça

• Cooper BA, Rosenblatt DS, Whitehead VM. Megaloblastic anemia. In: Hathan DO, Oski FA, eds. Hematology of Infancy and Childhood Philadelphia: WB Saunders, 1998: 430-476.
• Dutra JC, Dutra-fUho CS, Cardozo SE, Wannmacher CM, Sarkis JJ, Wajner, M. Inhibition of succinate dehydrogenase and beta-hydroxbutyrate dehydrogenase activies by methymalonate in brain and liver of developing rats. J Inherit Metab Dis 1998; 16: 147-153.
• The e f fe c t o f b re a s t - fe e d in g o r fo rm u la on th e UMMA le ve ls
• Giorgio AJ, Piaut GW. A method for the colorimetric determination of urinary MMA in pernicious anemia. J Lab Clin Ned 1965; 66: 667-676.
• Lindenbaum J, Healton EB, Savage DG, et al. Neuropsychiatrie disorders caused by cobaiamin deficiency in absence of anemia or macrocytosis. Nutrition 1995; 11:180-182.
• Natchar DB, Feussner JR, Millington DS, Wilkinson Rfl, Warson DJ, Gale D. Isotope dillution assay for urinary methymalonic acid for the diagnosis of vitamin B12 deficiency. /I prospective clinical evaluation. Ann Intern Med 1987; 106: 707-710.
• McCormick MC. Longterm follow-up of infants discharged from neonatal intensive care unit. JAMA 1989; 261: 1773-1781.
• Narasimhan P, Sklar R, Murell M, Swanson RA, Sharp FR. Nethylmalonic-CoA mutase induction by cerebral ishemia and neurotoxicity of mitocondrial toxin methylmalonic acid. J Neurosci 1996; 16: 7336-7346.
• Norman EJ, Cronin C. Cobalamin deficiency, Neurology 1996; 47: 310-31 1.
• Norman EJ. Urinary methylmalonic acid creatinine ratio defines true tissue cobaiamin deficiency. Br J Haematol 1998; 100: 614- 615.
• Rezvani I, Rosenblatt DS. Metabolic Disorders. In: Behrman RE, Rliegman RM, Jenson MB, eds. Nelson Textbook of Pediatrics Philapdelphia: WB Saunders, 2000: 343-450.
• Toyoshima S, Watanabe F, Saido ft, Miyatake R, Nakano Y. Methymalonic acid inhibits respiration in rat liver mitocondria. J Nutr 1995; 125: 2846-2850.
• Tsang RC, Nichols BL. Nutrition During Infancy. Philadelphia: Hanley and Belfus,
• : 216-21 7.
• Walker M, Hull A. Preterm Labor and Birth. In: Taeusch HW, Ballard RA, eds. Avery's Diseases of the Newborn. Philadelphia: WB Saunders, 1998: ¡44-153.