CALCIUM AND PHOSPHOROUS NUTRITION IN HIGH RISK INFANTS

高危婴儿的钙和磷营养

• 批准号: 3315569
• 负责人: REGINALD C TSANG
• 金额: $ 6.73万
• 依托单位: UNIVERSITY OF CINCINNATI
• 依托单位国家: 美国
• 财政年份: 1985
• 资助国家: 美国
• 起止时间: 1985-01-01 至 1987-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3315569
• 关键词: 1,25 dihydroxycholecalciferol; 25 hydroxycholecalciferol; bone metabolism disorder; calcification stimulant; calcitonin; clinical chemistry; computer graphics /printing; developmental nutrition; dietary calcium; dietary constituent; dietary supplements; disease /disorder proneness /risk; gender difference; human birth weight; human milk; human subject; normal ossification; nutrition related tag; parenteral feedings; phosphorus; premature infant human; racial /ethnic difference; rickets; short bowel syndrome; vitamin D

Dramatic increases in survival of high risk neonates have occurred in the last decade. Each year a quarter of a million low birth weight infants are born in the U.S. Most of these infants now survive from intensive care nurseries. Nutritional support for these high risk infants is now the major concern of neonatologists, and mineral nutrient support is the major nutritional concern. The purpose of the present study is to determine the mechanisms of skeletal mineralization in infancy in relation to provision and availability of calcium, phosphorus and vitamin D with two modes of nutrient support commonly used in high risk neonates: parenteral nutrition (PN) and human milk feeding. In Part I the specific purpose is to determine the effect of high versus usual calcium and phosphorus content in infusates on bone mineral content and on serum Ca, P and calciotropic agent concentrations. We propose to test the hypothesis that high Ca and P content with low doses of vit. D in parenteral nutrition solutions will result in increased bone mineral content (BMC) in infants when compared to those on usual Ca and P content in parenteral nutrition fluids with similar doses of vit. D. We hypothesize that preterm infants receiving the high parenteral nutrition regimen will have BMC that approaches BMC in utero, and term infants receiving the high regimen will have BMC that resembles normal infants on human milk; furthermore, high Ca and P supplementation with low vit. D will not result in serum abnormalities of Ca and P. Fifty infants will be studied in a prospective randomized trial. The infants will be matched for weight and gastrointestinal abnormalities. Physical examination and serum Ca, P, magnesium, alkaline phosphatase and bone GLA-protein, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, 24,25-dihydroxyvitamin D, D binding protein, parathyroid hormone, and calcitonin will be measured. BMC by infant adapted photon absorptiometry and x-ray studies for detection of rickets will be performed. In Part II the purpose is to test the hypothesis that rickets and osteopenia occurs in very low birth weight infants fed human milk even with supplementation with vit. D and that rickets and osteopenia in such infants can be prevented by supplementing with Ca and P. A prospective randomized trial will be performed in 50 infants with birth weights less than 1500 gm. matched for sex, race and weight. Clinical and laboratory investigations will be similar to Part I. Supplemented group will be compared with unsupplemented for rate of rickets, bone demineralization and abnormalities in serum Ca, P and Ca regulatory agents. From these studies, an improved understanding of mechanisms involved in bone mineralization in high risk infants will be obtained and provide a means of assessing Ca regulatory mechanisms in such infants.

高风险新生儿的存活率显着增加 最近十年。 每年四分之一的低出生体重婴儿是 出生于美国，大多数这些婴儿现在都从重症监护 托儿所。 这些高风险婴儿的营养支持现在是 新生儿学家和矿物营养支持的主要关注点是主要关注点 营养问题。 本研究的目的是确定 婴儿期骨骼矿化的机制 以及具有两种模式的钙，磷和维生素D的可用性 高风险新生儿通常使用的营养支持：肠胃外营养 （PN）和人牛奶喂养。 在第一部分中，具体目的是 确定高钙和磷含量在 注入骨矿物质含量以及血清CA，P和钙化剂上 浓度。 我们建议检验高CA和P的假设 含有低剂量的vit。 d在肠胃外营养解决方案将 与 那些在肠胃外营养液中使用的CA和P含量相似 剂量的vit。 D.我们假设早产婴儿接受了高 肠胃外营养方案将具有在子宫内接近BMC的BMC 接受高方案的婴儿的学期婴儿将具有类似于的BMC 人牛奶的正常婴儿；此外，高CA和P补充 vit低。 D不会导致Ca和P. fifty的血清异常 婴儿将在一项前瞻性随机试验中进行研究。 婴儿 重量和胃肠道异常将匹配。 身体的 检查和血清CA，P，镁，碱性磷酸酶和骨骼 GLA蛋白，25-羟基维生素D，1,25-二羟基维生素D， 24,25-二羟基维生素D，D结合蛋白，甲状旁腺激素和 降钙素将被测量。 BMC由婴儿改编的光子吸收法 将进行检测Rickets的X射线研究。 在第二部分 目的是检验rick和骨质减少症的假设 即使补充了人性牛奶的出生体重很低 VIT。 D和此类婴儿中的rick和骨质减少症可以通过 补充CA和P。 在50名婴儿小于1500克的婴儿中进行。匹配 性，种族和体重。 临床和实验室调查将是 与第一部分类似 对于rick的速率，血清Ca的骨骼脱矿化和异常 和CA监管代理。 从这些研究中，对 高风险婴儿中涉及骨矿化的机制将是 获得并提供了一种评估CA调节机制的方法 婴儿。

项目成果

Sequential bone mineral content in small preterm infants with and without fractures and rickets.

有或没有骨折和佝偻病的小早产儿的连续骨矿物质含量。

• DOI: 10.1002/jbmr.5650030211
• 发表时间: 1988
• 期刊: Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
• 作者: Koo,WW;Sherman,R;Succop,P;Oestreich,AE;Tsang,RC;Krug-Wispe,SK;Steichen,JJ
• 通讯作者: Steichen,JJ

Vitamin D requirement in infants receiving parenteral nutrition.

接受肠外营养的婴儿的维生素 D 需求。

• DOI: 10.1177/0148607187011002172
• 发表时间: 1987
• 期刊: JPEN. Journal of parenteral and enteral nutrition
• 作者: Koo,WW;Tsang,RC;Steichen,JJ;Succop,P;Oestreich,AE;Noseworthy,J;Farrell,MK
• 通讯作者: Farrell,MK

Stability of vitamin D2, calcium, magnesium, and phosphorus in parenteral nutrition solution: effect of in-line filter.

肠外营养液中维生素 D2、钙、镁和磷的稳定性：在线过滤器的影响。

• DOI: 10.1016/s0022-3476(86)80906-4
• 发表时间: 1986
• 期刊: The Journal of pediatrics
• 作者: Koo,WW;Hollis,BW;Horn,J;Steiner,P;Tsang,RC;Steichen,JJ
• 通讯作者: Steichen,JJ

Response of preterm infants to aluminum in parenteral nutrition.

早产儿对肠外营养中铝的反应。

• DOI: 10.1177/0148607189013005516
• 发表时间: 1989
• 期刊: JPEN. Journal of parenteral and enteral nutrition
• 作者: Koo,WW;Kaplan,LA;Krug-Wispe,SK;Succop,P;Bendon,R
• 通讯作者: Bendon,R

Sequential concentrations of copper and ceruloplasmin in serum from preterm infants with rickets and fractures.

患有佝偻病和骨折的早产儿血清中铜和铜蓝蛋白的连续浓度。

• 发表时间: 1991
• 期刊: Clinical chemistry
• 影响因子: 9.3
• 作者: Koo,WW;Succop,P;Hambidge,KM
• 通讯作者: Hambidge,KM