Oxalate, citrate, and sulfate concentration in human milk compared with formula preparations: Influence on urinary anion excretion
Oxalate, citrate, and sulfate concentration in human milk compared with formula preparations: Influence on urinary anion excretion
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DOI：
10.1097/00005176-199810000-00002
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发表时间：
1998-10-01
影响因子：
2.9
通讯作者：
Langman, CB
中科院分区：
文献类型：
--
作者：
Hoppe, B;Roth, B;Langman, CB
背景：肾钙质沉着症在早产儿中并不罕见，尿草酸盐排泄增高是其主要危险因素之一。当发现配方奶粉中的草酸盐排泄量高于母乳喂养的婴儿时，人们认为配方奶粉中的草酸盐含量是罪魁祸首。方法：对16种配方制剂中的草酸盐浓度进行测定（21种样品在乳发生过程中获得，17种样品在哺乳期获得）。还测量了柠檬酸盐和硫酸盐的浓度，因为这两种阴离子都会影响尿饱和度。结果：人乳草酸盐的平均（+/- SE）含量从泌乳早期（70.4 +/- 6.4 mu mol/l）到泌乳期（96.4 +/- 9.5 mu mol/l, p < 0.05）增加了约27%。后者与配方草酸盐的平均浓度（98.2 +/- 11.4 mu mol/l）没有差异，但两组的测量范围均为四倍。母乳中柠檬酸盐的平均含量在乳发生早期仅略有增加（2.66 +/- 0.22 mmol/l），但仍显著低于配方奶（3.34 +/- 0.23 mmol/l, p < 0.05）。母乳中硫酸盐的平均浓度（52.1 +/- 9.5 mu mol/l）比配方奶粉（688.7 +/- 95.4 mu mol/l）低13倍（p < 0.0001）。结论：配方奶喂养的婴儿草酸盐排泄量较高并不是因为牛奶中草酸盐的浓度。尿中柠檬酸盐和硫酸盐的排泄可能受到配方制剂中其较高浓度的影响，这可能对有肾钙质病发展风险的人群具有临床重要性。
Background: Nephrocalcinosis is not uncommon in preterm infants, and elevated urinary oxalate excretion is known to be one of the main risk factors. When oxalate excretion was found to be higher in formula-fed than in human milk-fed infants, the formulas' oxalate content was thought to be responsible.Methods: The oxalate concentration in human milk (21 samples obtained during lactogenesis; 17 samples obtained during established lactation) and of 16 formula preparations was examined. Citrate and sulfate concentrations were also measured, because both anions influence urinary saturation.Results: The mean (+/- SE) oxalate content of human milk increased approximately 27% from early lactogenesis (70.4 +/- 6.4 mu mol/l) to established lactation (96.4 +/- 9.5 mu mol/l; p < 0.05). The latter was not different from the mean oxalate concentration of formula (98.2 +/- 11.4 mu mol/l), however a fourfold range of measurements was recorded in both groups. The mean citrate content of human milk increased only slightly after early lactogenesis (2.66 +/- 0.22 mmol/l), but remained significantly lower than in formula (3.34 +/- 0.23 mmol/l; p < 0.05). The mean sulfate concentration did not increase and was 13 times lower in human milk (52.1 +/- 9.5 mu mol/l) than in formula (688.7 +/- 95.4 mu mol/l; p < 0.0001).Conclusions: The higher oxalate excretion in formula-fed infants is not because of the milk's a oxalate concentration. Urinary citrate and sulfate excretion may be influenced by their higher concentrations in formula preparations, which may be of clinical importance in the population that is at risk for development of nephrocalcinosis.