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Serum 1,25-dihydroxyvitamin D concentrations in premature infants: preliminary results
Insights
Premature infants maintain normal or high vitamin D metabolite (1,25(OH)2D) levels, which increase with age. Higher vitamin D2 supplements were linked to lower levels in these infants.
Area of Science:
- Pediatrics
- Endocrinology
- Neonatology
Background:
- Vitamin D is crucial for calcium homeostasis and bone health.
- Premature infants are at risk for vitamin D deficiency and related complications.
- Understanding 1,25(OH)2D regulation in preterm neonates is vital for optimizing care.
Purpose of the Study:
- To investigate serum 1,25(OH)2D concentrations in premature infants.
- To explore factors influencing 1,25(OH)2D levels, including age and vitamin D supplementation.
- To compare 1,25(OH)2D regulation in preterm versus mature infants.
Main Methods:
- Serial serum samples collected from 19 premature infants (gestation 29.6 ± 1.3 weeks).
- 1,25(OH)2D concentrations measured and correlated with infant age.
- Impact of vitamin D2 dosage (400 IU vs. 800 IU) and feeding method (breast milk) analyzed.
Main Results:
- Serum 1,25(OH)2D levels were consistently normal or elevated in preterm infants.
- Mean 1,25(OH)2D concentrations increased with postmenstrual age.
- Higher vitamin D2 intake correlated with lower 1,25(OH)2D levels; no sustained effect of breastfeeding observed.
Conclusions:
- Premature infants appear to regulate 1,25(OH)2D production similarly to older infants and children.
- Further research is needed to determine gastrointestinal and bone responsiveness to these levels.
- The clinical significance of elevated 1,25(OH)2D in preterm infants requires additional investigation.
Abstract:
Serum 1,25(OH)2D concentrations were measured in serial serum samples from 19 premature infants of 29.6 +/- 1.3 weeks gestation and 1,129 +/- 159 g birthweight. 1,25(OH)2D was always normal or elevated and mean concentrations increased with age (adult, 55.2 +/- 13; infants, 1-2 weeks, 81.5 +/- 37.7 pg/mg; 3 weeks, 65 +/- 21; 6 weeks, 90.0 +/- 17.3; 9 weeks, 99.0 +/- 25.1; 12 weeks, 103.3 +/- 26.6 pg/ml). No correlation was seen with 25-OHD. Infants given 800 IU D2 supplements had lower 1,25(OH)2D levels than infants given 400 IU D2. Breast fed infants had initially higher 1,25(OH)2D levels; however, this was not sustained. These preliminary data suggest that premature infants regulate 1,25(OH)2D production similar to more mature infants and children. Whether the premature infant has a normal gastrointestinal and/or bone responsiveness to 1,25(OH)2D and whether these elevated 1,25(OH)2D concentrations are "adequately elevated" requires further study.