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Analysis of Minerals Produced by hFOB 1.19 and Saos-2 Cells Using Transmission Electron Microscopy with Energy Dispersive X-ray Microanalysis
Published on: June 24, 2018
Insights
Preterm infants often experience hypocalcemia and rickets due to calcium-phosphate deficiency. Supplementing with phosphate alongside vitamin D is crucial for preventing these conditions in vulnerable newborns.
Area of Science:
- Neonatal physiology
- Pediatric nutrition
- Mineral metabolism
Context:
- Preterm infants have unique calcium-phosphate metabolism challenges.
- Gestational age significantly impacts fetal calcium accumulation.
- Postnatal hypocalcemia is more prevalent in preterm infants.
Purpose:
- To review the physiological and clinical aspects of calcium-phosphate metabolism in preterm infants.
- To highlight the prevalence and indicators of hypocalcemia and rickets in this population.
- To discuss optimal supplementation strategies.
Summary:
- Calcium accumulation is highest in late gestation, making preterm infants susceptible to hypocalcemia.
- Low serum phosphate levels, despite vitamin D supplementation, are common and linked to rickets.
- Increased alkaline phosphatase activity serves as an early indicator of rickets.
Impact:
- Emphasizes the inadequacy of vitamin D supplementation alone for preterm infants.
- Recommends combined vitamin D and phosphate supplementation for preventing rickets.
- Informs clinical practice regarding nutritional support for preterm neonates.
Abstract:
Physiological and clinical aspects are discussed in this review on calcium-phosphate metabolism in pre-term infants. Calcium accumulation in the bone mass of the foetus is related to the gestational age, and mainly occurs during the last weeks of gestation. Therefore, after birth, hypocalcemia is more frequent in pre-term than term infants. However, clinical symptoms of hypocalcemia, e.g. attacks of apnea, hyperexcitability and hypotonia, are rarely observed. Such symptoms depend upon the serum concentration of ionized calcium and this concentration is influenced by various metabolic factors. During the first two weeks of life phosphate is elevated in comparison to later periods. In spite of sufficient vitamin D supplementation low serum phosphate levels occur due to insufficient supply of phosphate. This correlates with evidence of rickets. An increased alkaline phosphatase activity can be considered an early and sensitive indicator. Pre-term infants develop rickets more frequently than term infants due to calcium-phosphate deficiency. Vitamin D supplementation alone is insufficient and should be combined with phosphate, as had been stated previously.
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