CALCIUM AND PHOSPHOROUS NUTRITION IN HIGH RISK INFANTS

高危婴儿的钙和磷营养

• 批准号: 3315567
• 负责人: REGINALD C TSANG
• 金额: $ 7.07万
• 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/3315567
• 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; intensive care; normal ossification; nursery; 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.

高危新生儿的存活率急剧增加， 过去十年。 每年有25万低出生体重婴儿 这些婴儿中的大多数现在都能从重症监护中存活下来 托儿所。 为这些高危婴儿提供营养支持， 营养学家的主要关注，矿物质营养支持是主要的 营养问题。 本研究的目的是确定 婴儿期骨骼矿化机制与供给 和钙、磷和维生素D的可用性， 高危新生儿常用的营养支持：肠外营养 (PN)和母乳喂养。 第一部分的具体目的是 确定高钙和磷含量与普通钙和磷含量的影响， 输注液对骨矿物质含量和血清Ca、P及促钙剂的影响 浓度的 我们建议检验高钙和高磷 满足于低剂量的维生素。肠外营养溶液中的D将 导致婴儿骨矿物质含量（BMC）增加， 那些对肠外营养液中常见的钙和磷含量具有相似 剂量的维生素D. 我们假设早产儿接受高剂量的 肠外营养方案将具有接近子宫内BMC的BMC， 而接受高剂量方案的足月婴儿的BMC类似于 正常婴儿母乳;此外，高钙和磷补充剂 低维生素。D不会导致血清Ca和P的异常。 将在前瞻性随机试验中对婴儿进行研究。 婴儿 体重和胃肠道异常情况都要匹配 物理 检查和血清钙、磷、镁、碱性磷酸酶和骨 GLA蛋白，25-羟基维生素D，1，25-二羟基维生素D， 24，25-二羟维生素D、D结合蛋白、甲状旁腺激素和 将测量降钙素。 婴儿适用光子吸收法测定BMC 并进行X光检查以检测佝偻病。 第II部所 目的是检验佝偻病和骨质疏松发生在 极低出生体重婴儿喂养母乳，即使补充 vit. D和佝偻病和骨质疏松症在这些婴儿可以预防， 补充钙和磷。一项前瞻性随机试验将 在50名出生体重小于1500克的婴儿中进行。匹配的 性别种族和体重 临床和实验室研究将 与第一部分类似。 将补充组与未补充组进行比较 用于佝偻病发生率、骨脱矿和血清Ca、P异常 和Ca调节剂。 从这些研究中，我们可以更好地了解 在高风险婴儿的骨矿化机制， 获得并提供了评估这种细胞中Ca调节机制的方法。 婴儿。