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Infant bone mineralization relies on calcium and phosphorus. Deficiencies in these minerals, particularly in premature infants, are key causes of bone demineralization despite vitamin D supplementation.
Area of Science:
- Biochemistry
- Pediatrics
- Endocrinology
Background:
- Bone mineralization in infants is primarily regulated by calcium and phosphorus metabolism.
- This metabolism is influenced by birth stores and the absorption of dietary minerals.
- Calciotropic hormones (parathyroid hormone, calcitonin, 1,25 dihydroxyvitamin D) are crucial for balancing mineral homeostasis and bone health.
Purpose of the Study:
- To elucidate the primary factors controlling bone mineralization in infancy.
- To understand the role of calcium and phosphorus in infant bone demineralization, especially in premature infants.
Main Methods:
- Review of physiological controls of bone mineralization.
- Analysis of factors affecting calcium and phosphorus metabolism in infants.
- Examination of clinical data on bone demineralization in premature infants.
Main Results:
- Calcium and phosphorus are the major physiologic regulators of bone mineralization in infancy.
- Deficiencies in calcium and phosphorus are identified as a primary cause of clinical bone demineralization in extremely premature infants.
- The role of other factors like glucocorticoids in physiologic infant bone mineralization remains poorly understood.
Conclusions:
- Adequate calcium and phosphorus supply and absorption are critical for proper bone mineralization in infants.
- Calcium and phosphorus deficiency are major contributors to bone demineralization in extremely premature infants, even with vitamin D supplementation.
- Further research is needed to understand the broader physiological mechanisms influencing infant bone health.
Abstract:
The major physiologic control of bone mineralization in infancy involves calcium and phosphorus. Ca and P metabolism in turn is affected by endogenous stores at birth and the ability to deliver and absorb exogenous sources of these minerals. Calciotropic hormones (parathyroid hormone, calcitonin and 1,25 dihydroxyvitamin D) modulate the response of major end organs - intestine, kidney and bone - to balance the need to maintain a relatively stable extracellular biochemical environment with the need for adequate mineralization of the bone. Many other factors such as glucocorticoids under pathological circumstances may disturb bone mineralization; however, the mechanisms by which they control bone mineralization in infancy under physiologic circumstances is ill understood. Clinical bone demineralization occurs primarily in infants born with extreme prematurity. In the presence of conventional vitamin D supplementation, deficiency of calcium and phosphorus appears to play a major role in its causation.