Chao Chen

Fudan University, Shanghai, Shanghai Shi, China

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Publications (72)137.53 Total impact

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    ABSTRACT: Phenylalanine, which is an essential aromatic amino acid, is either used for protein synthesis or irreversibly hydroxylated to tyrosine. The provision of optimal amounts of dietary phenylalanine is not only important for growth and development but might also influence catecholamine synthesis and release rates. The current recommended aromatic amino acid requirement for infants aged 0-6 mo is based on the amino acid content of human milk. We quantified the requirements for phenylalanine in the presence of excess tyrosine (166 or 177 mg/kg per day for term and preterm infants, respectively) for term and preterm neonates by using the indicator amino acid oxidation method with l-[1-(13)C]lysine 2HCl as an indicator. Hence, we determined the minimum obligatory phenylalanine requirement. Fully enterally fed term and preterm infants received randomly graded amounts of phenylalanine (5-177 mg/kg per day) as part of an elemental formula. Data are expressed as means ± SDs. Twenty term (birth weight: 3.19 ± 0.34 kg; gestational age: 38.9 ± 1 wk) and 16 preterm (birth weight: 1.75 ± 0.17 kg; gestational age: 32.5 ± 0.6 wk) Asian infants participated at a postnatal age of 17 ± 8 d. In total, 44 studies were performed. The minimum obligatory phenylalanine requirement was 58 mg/kg per day (95% CI: 38-78 mg/kg per day) and 80 mg/kg per day (95% CI: 40-119 mg/kg per day) for term and preterm infants, respectively. The determined mean phenylalanine-requirement estimates are lower than the contents of term and preterm formulas currently on the market. This trial was registered at www.trialregister.nl as NTR1610. © 2015 American Society for Nutrition.
    American Journal of Clinical Nutrition 04/2015; DOI:10.3945/ajcn.114.089664 · 6.92 Impact Factor
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    ABSTRACT: Hypomyelination is the major cause of neurodevelopmental deficits that are associated with perinatal white matter injury. Chondroitin sulfate proteoglycans (CSPGs) are known to exert inhibitory effects on the migration and differentiation of oligodendrocytes (OLs). However, few studies describe the roles of CSPGs in myelination by OLs and the cognitive dysfunction (CD) that follows perinatal white matter injury. Here, we examined the alterations in the expression of CSPGs and their functional impact on the maturation of OLs and myelination in a neonatal rat model of hypoxic-ischemic (HI) brain injury. Three-day-old Sprague-Dawley (SD) rats underwent a right common carotid artery ligation and were exposed to hypoxia (6% oxygen for 2.5h). Rats were given cABC via an intracerebroventricular injection to digest CSPGs. Animals were sacrificed at 7, 14, 28 and 56days after HI injury and the accompanying surgical procedure. We found that the expression of CSPGs was significantly up-regulated in the cortical regions surrounding the white matter after HI injury. cABC successfully degraded CSPGs in the rats that received cABC. Immunostaining showed decreased expression of the pre-oligodendrocyte marker O4 in the cingulum, external capsule (EC) and corpus callosum (CC) in HI+cABC rats compared to HI rats. However HI+cABC rats exhibited greater maturation of OLs than did HI rats, with increased expression of O1 and myelin basic protein (MBP) in the white matter. Furthermore, using electron microscopy, we demonstrated that myelin formation was enhanced in HI+cABC rats, which had an increased number of myelinated axons and decreased G-ratios of myelin compared to HI rats. Finally, HI+cABC rats performed better in the Morris water maze task than HI rats, which indicates an improvement in cognitive ability. Our results suggest that CSPGs inhibit both the maturation of OLs and the process of myelination after neonatal HI brain injury. The data also raise the possibility that modifying CSPGs may repair this type of lesion associated with demyelination. Copyright © 2015. Published by Elsevier Inc.
    Experimental Neurology 04/2015; 269. DOI:10.1016/j.expneurol.2015.03.026 · 4.62 Impact Factor
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    ABSTRACT: Few data are available on central-line associated bloodstream infections (CLABSIs) in Chinese neonatal intensive care units (NICUs). The aims of this study were to characterize CLABSIs among neonates in a Chinese NICU and evaluate the impact of a multifaceted evidence-based practice for improving quality program to decrease CLABSI. We conducted a prospective before-after intervention study with a 1-year follow-up among patients with central lines at the NICU of the Children's Hospital of Fudan University between January 2008 and December 2010. The study was conducted in 3 phases: before, during, and after the intervention. A multifaceted infection control program was introduced in phase 2 with successive surveillance. CLABSIs were prospectively monitored and compared. A total of 171 patients with central lines (CLs) were observed; 29 of them developed CLABSI corresponding to 7.35 per 1,000 catheter days, with a CL utilization ratio of 37.9%. Overall CLABSI rate decreased gradually from 16.7 per 1,000 CL days in phase 1 to 7.6 per 1,000 CL days in phase 2 (P = .08) to 5.2 per 1,000 CL days in phase 3 (P < .01). Gram-negative bacterium (54.5%) was the predominant pathogen in CLABSIs. A multifaceted infection control program is effective in reducing the CLABSI rate among neonates. Such interventions could be extended to other resource-limited countries. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
    American Journal of Infection Control 03/2015; 43(3):275-9. DOI:10.1016/j.ajic.2014.12.001 · 2.33 Impact Factor
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    ABSTRACT: Since 1986, the reference of birth weight for gestational age has not been updated. The aim of this study was to set up Chinese neonatal network to investigate the current situation of birth weight in China, especially preterm birth weight, to develop the new reference for birth weight for gestational age and birth weight curve. A nationwide neonatology network was established in China. This survey was carried out in 63 hospitals of 23 provinces, municipalities and autonomous regions. We continuously collected the information of live births in participating hospitals during the study period of 2011-2014. Data describing birth weight and gestational age were collected prospectively. Newborn's birth weight was measured by electronic scale within 2 hours after birth when baby was undressed. The evaluation of gestational age was based on the combination of mother's last menstrual period, ultrasound in first trimester and gestational age estimation by gestational age scoring system. the growth curve was drawn by using LMSP method, which was conducted in GAMLSS 1.9-4 software package in R software 2.11.1. A total of 159 334 newborn infants were enrolled in this study. There were 84 447 male and 74 907 female. The mean birth weight was (3 232 ± 555) g, the mean birth weight of male newborn was (3 271 ± 576) g, the mean weight of female newborn was (3 188 ± 528) g. The test of the variables' distribution suggested that the distribution of gestational age and birth weight did not fit the normal distribution, the optimal distribution for them was BCT distribution. The Q-Q plot test and worm plot test suggested that this curve fitted the distribution optimally. The male and female neonatal birth weight curve was developed using the same method. Using GAMLSS method to establish nationwide neonatal birth weight curve, and the first time to update the birth weight reference in recent 28 years.
    Zhonghua er ke za zhi. Chinese journal of pediatrics 02/2015; 53(2):97-103.
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    ABSTRACT: Abstract Background: Low birth weight is associated with an increased risk of adverse outcomes in many diseases in adult life. We investigated the expression of IGF-II and the status of differentially methylated regions (DMR) in small for gestational age (SGA) infants after birth. Methods: Plasma IGF-II, IGF-II receptor (IGF2R), IGF-I, and IGF-binding protein 3 (IGFBP3) levels were measured after birth in 150 newborn infants. These included 30 term appropriate for gestational age (AGA), 30 term SGA, 30 term large for gestational age (LGA), 30 preterm AGA, and 30 preterm SGA infants. H19 and IGF2 mRNA levels were quantified by fluorescence quantitative polymerase chain reaction (PCR). The methylation status of H19 DMR and IGF2 DMR2 was assessed by methylation-specific PCR (MSP). Plasma IGF-II, IGF2R, IGF-I, and IGFBP3 levels were measured by enzyme-linked immunosorbent assay in AGA infants of different gestational ages and term AGA infants on different days. Result: Plasma IGF-II levels after birth were lower in both term SGA (435.1±33.82 vs. 620.4±44.79, p=0.002) and LGA infants (483.7±33.8 vs. 620.42±44.79, p=0.018) than in term AGA infants. The expression of IGF2 mRNA was higher in the term SGA group than in the preterm SGA group (p=0.014) and the preterm SGA group displayed lower expression than the preterm AGA group (p=0.048). The H19 DMR methylation level was higher in both term SGA (p=0.044) and term LGA infants (p=0.027) compared to term AGA infants. Conclusions: IGF-II was associated with birth weight and expressed at high levels, which suggests that IGF-II may continue to play an important role after birth. H19 DMR methylation may be involved in controlling IGF-II expression.
    Journal of pediatric endocrinology & metabolism: JPEM 12/2014; DOI:10.1515/jpem-2014-0269 · 0.71 Impact Factor
  • Weiwei Lin, Chao Chen
    Zhonghua er ke za zhi. Chinese journal of pediatrics 10/2014; 52(10):763-6.
  • Bi Ze, Chao Chen
    Zhonghua er ke za zhi. Chinese journal of pediatrics 10/2014; 52(10):760-3.
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    ABSTRACT: Objectives: To investigate plasma ghrelin and obestatin levels, and ghrelin/obestatin prepropeptide gene polymorphisms, in sequentially enrolled small for gestational age (SGA) infants. Methods: Neonates were sequentially enrolled into this study and were then subdivided into different groups, according to different study aims and availability of study materials. Consequently, plasma ghrelin and obestatin levels were measured in term SGA, term appropriate for gestational age (AGA), term large for gestational age (LGA), preterm SGA and preterm AGA neonates. Levels of both peptides were also measured in AGA infants of different gestational ages, and in term AGA neonates at different days following birth. Three ghrelin/obestatin prepropeptide gene single nucleotide polymorphisms (SNPs), Arg51Gln, Leu72Met, and Gln90Leu, were measured in neonates. Results: The study involved a total cohort of 581neonates. Out of 150 neonates (30 term AGA, 30 term SGA, 30 term LGA, 30 preterm AGA, and 30 preterm SGA), plasma obestatin levels were significantly higher in term SGA versus term LGA neonates (0.21 +/- 0.02 ng/ml versus 0.17 +/- 0.01 ng/ml, respectively). Out of a wider cohort, there were no significant differences in genotypes and allele frequencies of Arg51Gln, Leu72Met, and Gln90Leu SNPs between term SGA and AGA neonates, or between preterm SGA and AGA neonates. Conclusions: Ghrelin/obestatin prepropeptide polymorphisms were not found to be associated with SGA status in neonates; however, ghrelin and obestatin levels may be involved in growth and development. Further studies are required to understand the relationship between ghrelin, obestatin and prenatal development.
    The Journal of international medical research 09/2014; 42(6). DOI:10.1177/0300060514533525 · 1.10 Impact Factor
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    ABSTRACT: Background Human toll-like receptor 4 (TLR4) is an important receptor in innate immunity, particularly against gram-negative bacterial infection (GNBI). In our study, we evaluated associations of TLR4 single nucleotide polymorphisms (SNPs) with GNBI in Han Chinese neonates. Patients and Methods Polymorphisms in TLR4 were genotyped in 201 neonates with GNBI and 279 gestational age and birth weight-matched controls without GNBI. Polymorphism analyses were applied to allele frequencies of the detected TLR4 SNPs and their associations with various clinical entities, including premature birth and GNBI were assessed. Results A total of six SNPs with more than 5% frequency were found in several promoter sequences, including rs10759931, rs2737190, rs10116253, rs10983755, rs1927914, and rs10759932. Mutation allele frequencies ranged from 23 to 41%. There were no SNPs with a frequency greater than 5% in exon analyses. Allele G rs2737190 mutations and GGCGGC haplotypes were more frequent among preterm GNBI neonates (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.02-1.71 and OR, 1.89; 95% CI, 1.19-3.00, respectively). No specific alleles or haplotypes were associated with GNBI status among term neonates. Conclusion In this study population of Han Chinese, there was a significant association between an ethnical unique SNP in the TLR4 promoter region and preterm neonatal GNBIs.
    American Journal of Perinatology 09/2014; 32(04). DOI:10.1055/s-0034-1387929 · 1.60 Impact Factor
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    ABSTRACT: Objectives: Tryptophan not only is an amino acid essential to protein synthesis but also serves as a precursor in 2 important metabolic pathways: the serotonin and the kynurenine pathways. Tryptophan is related to sleeping patterns. The objective of the present study was to determine the tryptophan requirement of term infants using the indicator amino acid oxidation (IAAO) method with L-[1-C-13] phenylalanine as the indicator. Methods: Enterally fed infants were randomly assigned to tryptophan intakes ranging from 0.5 to 73 mg . kg(-1) . day(-1) as part of an elemental diet. After 1-day adaptation to the test diet, [C-13]bicarbonate and L-[1-C-13]phenylalanine tracers were given enterally. Breath samples were collected at baseline and during isotopic plateaus. The mean tryptophan requirement was determined by using the biphasic linear regression crossover analysis on the fraction of 13 CO2 recovery from L-[1-C-13]phenylalanine oxidation ((FCO2)-C-13). Data are presented as mean +/- standard deviation. Results: A total of 30 term neonates (gestational age 39 +/- 1 weeks) were studied at 9 +/- 4 days. (FCO2)-C-13 decreased until a tryptophan intake of 15 mg . kg(-1) . day(-1); additional increases in tryptophan intake did not affect F-13 CO2. Mean requirement was determined to be 15 mg . kg(-1) . day(-1). Conclusions: The mean tryptophan requirement for elemental formula-fed term infants is 15 mg .kg(-1) . day(-1). This requirement is lower than the present recommended intake of 29 mg . kg(-1) . day(-1), which is based on the average intake of a breastfed infant.
    Journal of Pediatric Gastroenterology and Nutrition 09/2014; 59(3):374-379. DOI:10.1097/MPG.0000000000000434 · 2.87 Impact Factor
  • International Conference of Information Science and Management Engineering; 09/2014
  • Pediatrics & Neonatology 08/2014; 56(1). DOI:10.1016/j.pedneo.2014.05.003 · 0.88 Impact Factor
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    ABSTRACT: Sparse representation classification method has been increasingly used in the fields of computer vision and pattern analysis, due to its high recognition rate, little dependence on the features, robustness to corruption and occlusion, and etc. However, most of these existing methods aim to find the sparsest representations of the test sample y in an overcomplete dictionary, which do not particularly consider the relevant structure between the atoms in the dictionary. Moreover, sufficient training samples are always required by the sparse representation method for effective recognition. In this paper we formulate the classification as a group-structured sparse representation problem using a sparsity-inducing norm minimization optimization and propose a novel sparse representation-based automatic target recognition (ATR) framework for the practical applications in which the training samples are drawn from the simulation models of real targets. The experimental results show that the proposed approach improves the recognition rate of standard sparse models, and our system can effectively and efficiently recognize targets under real environments, especially, where the good characteristics of the sparse representation based classification method are kept.
    SPIE Defense + Security; 06/2014
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    ABSTRACT: This paper is aiming at applying sparse representation based classification (SRC) on face recognition with disguise or illumination variation. Having analyzed the characteristics of general object recognition and the principle of the classifier of SRC method, authors focus on evaluating blocks of a probe sample and propose an optimized SRC method based on position-preserving weighted block and maximum likelihood model. Principle and implementation of the proposed method have been introduced in the article, and experiments on Yale and AR face database have been given too. From experimental results, it can be seen that the proposed optimized SRC method works well than existing methods.
    SPIE Defense + Security; 06/2014
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    ABSTRACT: Objetivo validar de forma prospectiva um nomograma de bilirrubina transcutânea (BTc) para identificar hiperbilirrubinemia grave em neonatos a termo e pré‐termo tardios saudáveis na China. Métodos foi realizado um estudo multicêntrico que incluiu 9174 neonatos a termo e pré‐termo tardios saudáveis em oito unidades da China. Foram realizadas dosagens de BTc utilizando um bilirrubinômetro. Os valores de BTc foram traçados em um nomograma de BTc para identificar a capacidade de predição de hiperbilirrubinemia significativa. Resultados 972 recém‐nascidos (10,6%) desenvolveram hiperbilirrubinemia significativa. O percentil 40 de nosso nomograma pode identificar todos os recém‐nascidos com risco de hiperbilirrubinemia significativa, porém com baixo valor preditivo positivo (VPP) (18,9%). De 453 recém‐nascidos acima do percentil 95, 275 recém‐nascidos desenvolveram posteriormente hiperbilirrubinemia significativa, com VPP elevado (60,7%), porém com baixa sensibilidade (28,3%). O percentil de 75 foi altamente específico (81,9%) e moderadamente sensível (79,8%). A área sob a curva (ASC) de nosso nomograma de BTc foi de 0,875. Conclusões este estudo validou o nomograma de BTc, que pode ser utilizado para prever hiperbilirrubinemia significativa em neonatos a termo e pré‐termo tardios saudáveis na China. Contudo, combinar o nomograma de BTc e fatores de risco clínicos pode melhorar a precisão de predição da hiperbilirrubinemia grave, o que não foi avaliado neste estudo. São necessários estudos adicionais para confirmar essa combinação.
    Jornal de pediatria 05/2014; 90(3). DOI:10.1016/j.jped.2013.08.013 · 0.94 Impact Factor
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    ABSTRACT: AimHypoglycaemia is a significant problem in high-risk neonates and predominant parieto-occipital lobe involvement has been observed after severe hypoglycaemic insult. We explored the use of flash visual evoked potentials (FVEP) in detecting parieto-occipital lobe involvement after significant hypoglycaemia.Methods Full-term neonates (n=15) who underwent FVEP from January 2008 to May 2013 were compared with infants (n=11) without hypoglycaemia or parietal-occipital lobe injury. Significant hypoglycaemia was defined as being symptomatic or needing steroids, glucagon or a glucose infusion rate of ≥12mg/kg/min.ResultsThe hypoglycaemia group exhibited delayed latency of the first positive waveform on FVEP. The initial detected time for hypoglycaemia was later in the eight subjects with seizures (median 51-hours-old) than those without (median 22- hours-old) (P=0.003). Magnetic Resonance Imaging showed that 80% of the hypoglycaemia group exhibited occipital-lobe injuries and they were more likely to exhibit abnormal FVEP morphology (P=0.007) than the controls. FVEP exhibited 100% sensitivity, but only 25% specificity, for detecting injuries to the parieto-occipital lobes.Conclusion Flash visual evoked potential (FVEP) was sensitive, but not sufficiently specific, in identifying parieto-occipital lobe injuries among term neonates exposed to significant hypoglycaemia. Larger studies exploring the potential role of FVEP in neonatal hypoglycaemia are required.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 05/2014; 103(8). DOI:10.1111/apa.12673 · 1.84 Impact Factor
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    ABSTRACT: This paper considers the scenario where multiple clusters of Virtual Machines (i.e., termed Virtual Clusters) are hosted in a Cloud system consisting of a cluster of physical nodes. Multiple Virtual Clusters (VCs) cohabit in the physical cluster, with each VC offering a particular type of service for the incoming requests. In this context, VM consolidation, which strives to use a minimal number of nodes to accommodate all VMs in the system, plays an important role in saving resource consumption. Most existing consolidation methods proposed in the literature regard VMs as “rigid” during consolidation, i.e., VMs’ resource capacities remain unchanged. In VC environments, QoS is usually delivered by a VC as a single entity. Therefore, there is no reason why VMs’ resource capacity cannot be adjusted as long as the whole VC is still able to maintain the desired QoS. Treating VMs as “moldable” during consolidation may be able to further consolidate VMs into an even fewer number of nodes. This paper investigates this issue and develops a Genetic Algorithm (GA) to consolidate moldable VMs. The GA is able to evolve an optimized system state, which represents the VM-to-node mapping and the resource capacity allocated to each VM. After the new system state is calculated by the GA, the Cloud will transit from the current system state to the new one. The transition time represents overhead and should be minimized. In this paper, a cost model is formalized to capture the transition overhead, and a reconfiguration algorithm is developed to transit the Cloud to the optimized system state with low transition overhead. Experiments have been conducted to evaluate the performance of the GA and the reconfiguration algorithm.
    Future Generation Computer Systems 03/2014; 32:69–81. DOI:10.1016/j.future.2012.05.015 · 2.64 Impact Factor
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    ABSTRACT: To explore the changes of outcome and morbidity in extremely low birth weight (ELBW) infants. A retrospective study was performed for ELBW infants admitted into Children's Hospital, Fudan University within 24 hours after birth from January 2007 to December 2011. The maternal and neonatal data were collected by reviewing the medical charts and entered into the dataset. A total of 105 ELBW infants (54 males, 51 females) were enrolled. The average gestational age was (28.4 ± 2.6)weeks and birth weight was (860 ± 121)g. Neonatal respiratory syndrome (NRDS) (n = 89, 84.8%), apnea(n = 58, 55.2%), sepsis (n = 47, 44.8%) and patent ductus arteriosus (n = 46, 43.8%) remained their major complications.Sepsis was the commonest cause of mortality (7/17) excluding social factors. The incidence of extrauterine growth restriction (46/51, 90.2%) was significantly high at discharge. And the use of antenatal steroids was merely 40.8% (42/103) in ELBW infants at a gestation age under 34 weeks. The number of ELBW infants has increased dramatically. Antenatal steroids, noninvasive respiratory support, prevention of infections and optimal nutrition supports are key factors of improving the survival rate, short and long-term outcomes of ELBW infants.
    Zhonghua yi xue za zhi 02/2014; 94(6):446-8.
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    ABSTRACT: This paper is aiming at applying sparse representation based classification (SRC) on general objects of a certain scale. Authors analyze the characteristics of general object recognition and propose a position-weighted block dictionary (PWBD) based on sparse presentation and design a framework of SRC with it (PWBD-SRC). Principle and implementation of PWBD-SRC have been introduced in the article, and experiments on car models have been given in the article. From experimental results, it can be seen that with position-weighted block dictionary (PWBD) not only the dictionary scale can be effectively reduced, but also roles of image blocks taking in representing a whole image can be embodied to a certain extent. In reorganization application, an image only containing partial objects can be identified with PWBD-SRC. Besides, rotation and perspective robustness can be achieved. Finally, a brief description on some remaining problems has been proposed in the article.
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    ABSTRACT: Knowledge of essential amino acid requirements in infants is important because excessive intake of protein can lead to increased long-term morbidity such as obesity. A deficient intake may lead to suboptimal growth and impaired neurodevelopment. The current recommended branched-chain amino acid requirements in infants aged 0-1 mo are based on the amino acid content of human milk. We quantified the requirements for isoleucine, leucine, and valine for term neonates by using the indicator amino acid oxidation method with [1-(13)C]phenylalanine as the indicator. Fully enterally fed term infants received randomly graded amounts of isoleucine (5-216 mg ⋅ kg(-1) ⋅ d(-1)), leucine (5-370 mg ⋅ kg(-1) ⋅ d(-1)), or valine (5-236 mg ⋅ kg(-1) ⋅ d(-1)) as part of an elemental formula. Data are expressed as means ± SDs. Eighty-three Asian, term neonates (birth weight: 3.3 ± 0.4 kg; gestational age 39.4 ± 1.3 wk) were studied at a postnatal age of 13 ± 5 d. Mean requirements for isoleucine, leucine, and valine (measured in boys only) were 105 mg ⋅ kg(-1) ⋅ d(-1) (r(2) = 0.61, P < 0.001), 140 mg ⋅ kg(-1) ⋅ d(-1) (r(2) = 0.26, P < 0.01), and 110 mg ⋅ kg(-1) ⋅ d(-1) (r(2) = 0.35, P = 0.001), respectively. Current human milk-based recommendations for isoleucine and valine in term infants aged 0-1 mo are correct. However, the current recommendation for leucine (166 mg ⋅ kg(-1) ⋅ d(-1)) is higher than the mean requirement of 140 mg ⋅ kg(-1) ⋅ d(-1) that we determined in this study. This trial was registered at www.trialregister.nl as NTR1610.
    American Journal of Clinical Nutrition 11/2013; 99(1). DOI:10.3945/ajcn.112.038927 · 6.92 Impact Factor