Sequential calcium and phosphorus balance studies in preterm infants

Giles, M.; Fenton, MJ; Shaw, Barbara I.; Elton, R. A.; Clarke, M.; Lang, M.; Hume, Robert

doi:10.1016/s0022-3476(87)80559-0

Cited by 57 publications

(27 citation statements)

References 21 publications

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“…As noted earlier, preterm human infants demonstrate calcium absorption that is proportional to intake, with a linear relationship between intake and absorption; this is consistent with passive absorption of calcium (44,46,221,581). Absorption did not vary by vitamin D intake in preterm infants, which is also consistent with passive, non-vitamin D-dependent absorption (75).…”

Section: Human Datasupporting

confidence: 83%

“…However, a preterm baby at birth is the equivalent of a fetus of the same gestational age, and the functional capacity of a preterm neonate's intestines may inform about the functional capacity of the fetal intestines. Studies in preterm neonates have shown that calcium absorption is proportional to intake and does not reach a maximum (i.e., is nonsaturable); these findings suggest that passive absorption of calcium is the dominant mechanism by which calcium is absorbed in preterm fetuses (44,221,581). Calcium absorption did not vary by vitamin D intake in preterm infants, consistent with passive absorption being the dominant mechanism of absorption rather than active, calcitrioldependent mechanisms as seen in older infants and children (75).…”

Section: Human Datamentioning

confidence: 77%

“…Intestinal absorption and retention of calcium increase with both postnatal age and gestational age, with additional variations superimposed by the composition of the milk (45,221,256,485,604,613). These findings suggest a maturational effect toward an active, calcitriol-dependent, saturable mechanism of intestinal calcium absorption as seen in older children and adults.…”

Section: Human Datamentioning

confidence: 99%

See 2 more Smart Citations

Bone Development and Mineral Homeostasis in the Fetus and Neonate: Roles of the Calciotropic and Phosphotropic Hormones

Kovacs

2014

Physiological Reviews

211

188

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Mineral and bone metabolism are regulated differently in utero compared with the adult. The fetal kidneys, intestines, and skeleton are not dominant sources of mineral supply for the fetus. Instead, the placenta meets the fetal need for mineral by actively transporting calcium, phosphorus, and magnesium from the maternal circulation. These minerals are maintained in the fetal circulation at higher concentrations than in the mother and normal adult, and such high levels appear necessary for the developing skeleton to accrete a normal amount of mineral by term. Parathyroid hormone (PTH) and calcitriol circulate at low concentrations in the fetal circulation. Fetal bone development and the regulation of serum minerals are critically dependent on PTH and PTH-related protein, but not vitamin D/calcitriol, fibroblast growth factor-23, calcitonin, or the sex steroids. After birth, the serum calcium falls and phosphorus rises before gradually reaching adult values over the subsequent 24 -48 h. The intestines are the main source of mineral for the neonate, while the kidneys reabsorb mineral, and bone turnover contributes mineral to the circulation. This switch in the regulation of mineral homeostasis is triggered by loss of the placenta and a postnatal fall in serum calcium, and is followed in sequence by a rise in PTH and then an increase in calcitriol. Intestinal calcium absorption is initially a passive process facilitated by lactose, but later becomes active and calcitriol-dependent. However, calcitriol's role can be bypassed by increasing the calcium content of the diet, or by parenteral administration of calcium.

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Section: Human Datasupporting

confidence: 83%

Section: Human Datamentioning

confidence: 77%

Section: Human Datamentioning

confidence: 99%

See 1 more Smart Citation

Bone Development and Mineral Homeostasis in the Fetus and Neonate: Roles of the Calciotropic and Phosphotropic Hormones

Kovacs

2014

Physiological Reviews

211

188

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“…Additionally, an X-ray of the wrist was taken and serum alkaline phospha tase activity determined at discharge, and the latter repeated at 3 months. Bone mineral content, bone width, and the indi vidual increments of both parameters were significantly high er in infants fed the enriched formula at 3 months of age, but these differences were less pronounced at 6 months.The currently available formulas for hospi talized preterm infants provide amounts of calcium (Ca) and phosphorus (P) in the lower range of the ESPGAN recommendations vation that overdosage of enteral calcium can lead to life-threatening intestinal obstruction from soap formation [3], and the widespread opinion that it may not be necessary to achieve mineral accretion rates as in utero in order to prevent severe osteopenia and frac tures [4][5][6][7]. The consequence of these deliberProf.…”

mentioning

confidence: 99%

Effect of a Calcium and Phosphorus-Enriched Formula on Bone Mineralization and Bone Growth in Preterm Infants after Discharge from Hospital

Raupp

Poss²,

Kries³

et al. 1997

Ann Nutr Metab

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At discharge from hospital, 36 preterm infants (birthweight < 1,800 g) were randomized to be given either a standard formula or an identical formula enriched with calcium (47 vs. 80 mg/l00 ml) and phosphorus (30 vs. 45 mg/l00 ml) exclusively until they reached a corrected age of 3 months, thereafter beikost and other formulas were introduced into the diet. Weight, head circumference and radial and body length were measured and radial bone mineral content (BMC) and bone width (BW) determined by single photon absorptiometry at discharge, at 3 and at 6 months of corrected age. Additionally, an X-ray of the wrist was taken and serum alkaline phosphatase activity determined at discharge, and the latter repeated at 3 months. Bone mineral content, bone width, and the individual increments of both parameters were significantly higher in infants fed the enriched formula at 3 months of age, but these differences were less pronounced at 6 months.

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“…Calcium absorption in newborns is largely passive and nonsaturable [26,27]. The high lactose content of milk increases paracellular diffusion of calcium in the distal small bowel and net bioavailability of dietary calcium in humans [28,29] and rodents [30].…”

Section: Overview Of Fetal and Neonatal Mineral Metabolismmentioning

confidence: 99%

Bone Development in the Fetus and Neonate: Role of the Calciotropic Hormones

Kovacs

2011

Curr Osteoporos Rep

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During embryonic and fetal development much of the skeleton initiates as a cartilaginous scaffold, which is progressively resorbed and replaced by bone. Endochondral bone formation continues until the growth plates fuse during puberty. At all life stages adequate delivery of mineral is required for the skeleton to achieve and maintain appropriate mineral content and strength. During fetal development the placenta actively transports calcium, phosphorus, and magnesium. Postnatally passive and then active absorption from the intestines becomes the main supply of minerals to the skeleton. Animal and human data indicate that fetal bone development requires parathyroid hormone (PTH) and PTH-related protein but not vitamin D/calcitriol, calcitonin, or (possibly) sex steroids. During the postnatal period, when intestinal calcium absorption becomes an active process, skeletal development begins to depend upon vitamin D/calcitriol but this requirement can be bypassed by increasing the calcium content of the diet or by administering intermittent calcium infusions.

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Sequential calcium and phosphorus balance studies in preterm infants

Cited by 57 publications

References 21 publications

Bone Development and Mineral Homeostasis in the Fetus and Neonate: Roles of the Calciotropic and Phosphotropic Hormones

Bone Development and Mineral Homeostasis in the Fetus and Neonate: Roles of the Calciotropic and Phosphotropic Hormones

Effect of a Calcium and Phosphorus-Enriched Formula on Bone Mineralization and Bone Growth in Preterm Infants after Discharge from Hospital

Bone Development in the Fetus and Neonate: Role of the Calciotropic Hormones

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