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Inorganic sulfate metabolism in the very low birthweight infant
Insights
Vitamin D supplementation may influence inorganic sulfate metabolism in premature infants. Higher vitamin D doses correlated with increased serum sulfate levels in very low birth weight infants up to six weeks old.
Area of Science:
- Neonatal Medicine
- Biochemistry
- Pediatric Nutrition
Background:
- Very low birth weight (VLBW) infants exhibit distinct metabolic profiles compared to adults.
- Inorganic sulfate metabolism in VLBW infants is not well understood.
- Understanding sulfate homeostasis is crucial for VLBW infant development.
Purpose of the Study:
- To investigate the impact of vitamin D supplementation on inorganic sulfate metabolism in VLBW infants.
- To determine the relationship between vitamin D levels and serum sulfate concentrations.
- To explore factors influencing sulfate levels in the neonatal period.
Main Methods:
- Biweekly monitoring of serum and urinary sulfate in VLBW infants up to 6 weeks postnatal age.
- Comparison of infants receiving high-dose versus standard-dose vitamin D supplementation.
- Correlation analysis of sulfate levels with weight gain, renal function, and 25(OH)-vitamin D.
Main Results:
- Baseline serum sulfate was significantly higher in VLBW infants than adults.
- Urinary sulfate excretion increased to adult levels by 2 weeks.
- High-dose vitamin D group showed significantly higher serum sulfate at 6 weeks.
- Serum sulfate correlated positively with 25(OH)-vitamin D concentrations.
Conclusions:
- Vitamin D may play a role in modulating sulfate metabolism during the neonatal period.
- Factors beyond renal clearance significantly influence serum sulfate levels in VLBW infants.
- Further research is warranted to elucidate the mechanisms of vitamin D's effect on sulfate homeostasis.
Abstract:
The effect of vitamin D supplementation on inorganic sulfate metabolism was examined in very low birth weight (less than 1,500 g) infants at biweekly intervals after birth until 6 weeks of postnatal age. Baseline serum sulfate concentrations were significantly higher in all infants (471 +/- 24 mumol/l, n = 80) than in adults (299 +/- 25 mumol/l, n = 17). In controls, the levels did not change significantly over the ensuing 6 weeks, although serum creatinine declined. Urinary sulfate excretion rose significantly to near adult levels by 2 weeks. Both urine and serum sulfate were correlated with weight gain but not with estimated glomerular filtration rate, suggesting that factors other than renal clearance have a preponderant influence on serum sulfate in these infants. At 6 weeks, the mean serum sulfate in the high-dose group (receiving 2,170 +/- 23 U/day of vitamin D, n = 41) was significantly higher than in controls (receiving 360 +/- 22 U/day, n = 40). In all infants, there was a significant correlation (r = 0.36, p less than 0.001) between serum sulfate and 25(OH)-vitamin D concentrations, but not other analytes or clinical variables, suggesting that vitamin D may be one of the factors modulating sulfate metabolism in the newborn period.