Parenteral fish oil in combination with ω-6/9 lipid emulsions was associated with improved outcome in premature neonates with SBS. When used instead of traditional soybean-based emulsions, this mixed lipid emulsion may facilitate intestinal adaptation by increasing the IFALD-free period.

Objective: To compare expression of messenger RNA (mRNA) coding for the cortisol regenerating enzyme 11b-hydroxysteroid dehydrogenase type 1 (11b-HSD1), and the adipocytokines leptin and resistin in paired biopsies of subcutaneous adipose tissue (SC) and omental adipose tissue (OM) from children. Design: Paired biopsies (SC and OM) were obtained from 54 children (age 0.17-16 years, body mass index (BMI) 12.5-28.3 kg/m 2 , BMI standard deviation score (SDS) À2.5-4.5) and 16 adults (age 27-79 years, BMI 19-46 kg/m 2 ) undergoing open abdominal surgery. mRNA levels of 11b-HSD1, leptin and resistin were measured using quantitative real-time polymerase chain reaction (PCR). Results: 11b-HSD1 mRNA level was higher in OM than in SC (Po0.05), whereas leptin mRNA was higher in SC than in OM (Po0.001). There was no difference in the resistin mRNA level between SC and OM. These results were consistent in children and adults. In children, 11b-HSD1 mRNA in SC was positively associated with BMI SDS (Po0.05), whereas in OM it was positively associated with age (Po0.05). The association between 11b-HSD1 expression and age remained significant after adjustment for BMI SDS and gender. Leptin mRNA was positively associated with BMI SDS (SC: Po0.001, OM: Po0.001) but not with age in children. In multiple regression analyses, including anthropometric variables and age, BMI SDS was independently associated with mRNA levels of 11b-HSD1 (Po0.05) and leptin (Po0.001) in SC. When normal weight and overweight children were analyzed separately, 11b-HSD1 mRNA levels were positively associated with leptin in OM in the overweight group (Po0.05). Conclusion: There are depot-specific differences in mRNA levels of 11b-HSD1 and leptin in children and adults. The positive association of 11b-HSD1 mRNA in OM with age may reflect a causal role in visceral fat accumulation during growth. Increasing 11b-HSD1 and leptin mRNA in SC with increasing BMI SDS could suggest that the risk of metabolic consequences of obesity may be established early in life.

The aim of the study was to explore if changes in muscle and plasma amino acid concentrations developed during growth and differed from levels seen in adults. The gradient and concentrations of free amino acids in muscle and plasma were investigated in relation to age in metabolic healthy children. Plasma and specimens from the abdominal muscle were obtained during elective surgery. The children were grouped into three groups (group 1: < 1 year, n = 8; group 2: 1-4 years, n = 13 and group 3: 5-15 years, n = 15). A reference group of healthy adults (21-38 years, n = 22) was included in their comparisons and reflected specific differences between children and adults. In muscle the concentrations of 8 out of 19 amino acids analysed increased with age, namely taurine, aspartate, threonine, alanine, valine, isoleucine, leucine, histidine, as well as the total sums of branched chain amino acids (BCAA), basic amino acids (BAA) and total sum of amino acids (P < 0.05). In plasma the concentrations of threonine, glutamine, valine, cysteine, methionine, leucine, lysine, tryptophane, arginine, BCAA, BAA and the essential amino acids correlated with age (P < 0.05). These results indicate that there is an age dependency of the amino acid pattern in skeletal muscle and plasma during growth.

These two feeding-access techniques are comparable regarding complications, operative times and postoperative length of stay. The choice of surgical method should be individualized based on the patient's characteristics and the experience of the surgeon. The favorable results with LAPG in adults are not necessarily transferable to children since there are physiological and anatomical differences.

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