CALCIUM AND PHOSPHOROUS NUTRITION IN HIGH RISK INFANTS

高危婴儿的钙和磷营养

• 批准号: 3315568
• 负责人: REGINALD C TSANG
• 金额: $ 5.68万
• 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/3315568
• 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.

高危新生儿存活率的急剧增加发生在 过去十年。每年有25万低出生体重儿 出生在美国。这些婴儿中的大多数现在都在重症监护下存活下来 托儿所。对这些高危婴儿的营养支持现在是 新生儿医生的主要关注，而矿物质营养支持是主要的 营养方面的问题。本研究的目的是确定 婴儿期骨骼矿化机制与供给的关系 和钙、磷和维生素D的利用率有两种模式 高危新生儿常用的营养支持：肠外营养 (PN)和母乳喂养。在第一部分中，具体目的是 确定高钙和高磷对人体健康的影响 对骨矿含量及血清钙、磷和促钙剂的影响 浓度。我们建议对高钙和高磷的假设进行检验 用低剂量的维生素T满足。D在肠外营养液中将 导致婴儿骨矿含量(BMC)增加 肠外营养液中常见钙、磷含量的比较 剂量的维他命。D.我们假设早产儿会接受高潮 肠外营养方案将有接近子宫内BMC的BMC， 接受高剂量治疗的足月儿的BMC类似于 正常婴儿吃母乳；此外，高钙和高磷补充剂 低维他命值。D不会导致血清钙和磷的异常。 婴儿将在前瞻性随机试验中进行研究。婴儿们 会与体重和胃肠道异常相匹配。物理 检查和血清钙、磷、镁、碱性磷酸酶和骨 GLA-蛋白质、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。婴幼儿适应光子吸收法检测骨髓基质细胞 并将进行检测软骨病的X光研究。在第II部 其目的是检验这样一种假设，即软骨病和骨质减少症发生在 即使补充母乳也能喂养极低出生体重儿 维特。这些婴儿中的软骨病和骨质减少症可以通过以下方法预防 补充钙和磷一项前瞻性随机试验将是 对50名出生体重小于1500克的婴儿进行了检查。与之匹配 性别、种族和体重。将进行临床和实验室检查 与第一部分类似，补充组与未补充组进行比较 软骨病、骨脱矿和血清钙、磷异常的发生率 和钙调控剂。通过这些研究，提高了对 参与高危婴儿骨矿化的机制将是 获得并提供了一种评估这种情况下钙调节机制的方法 婴儿。