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Plasma active vitamin D concentration in low birthweight infants with rickets and its response to vitamin D treatment
Insights
Low birthweight infants may develop rickets due to impaired vitamin D metabolism. Supplementation with vitamin D2 is recommended for those weighing 2000-2500g, while 1 alpha-OHD3 may be more effective for very low birthweight infants.
Area of Science:
- Pediatrics
- Endocrinology
- Nutritional Science
Background:
- Rickets is a significant concern in low birthweight infants.
- Impaired 25-hydroxylation is linked to rickets in infants weighing 2000-2500g.
- Impaired 1 alpha-hydroxylation may affect infants under 2000g.
Purpose of the Study:
- To investigate vitamin D metabolism in low birthweight infants.
- To determine optimal vitamin D supplementation strategies for preventing rickets in different birthweight categories.
Main Methods:
- Analysis of vitamin D metabolism pathways (25-hydroxylation and 1 alpha-hydroxylation) in relation to infant birthweight.
- Evaluation of the efficacy of vitamin D2 and 1 alpha-OHD3 supplementation.
Main Results:
- Infants weighing 2000-2500g may benefit from at least 500 IU of vitamin D2 daily.
- Infants weighing less than 2000g and born before 38 weeks gestation may require 1 alpha-OHD3 for effective rickets prevention.
Conclusions:
- Vitamin D supplementation needs vary based on infant birthweight and gestational age.
- Targeted vitamin D therapies, including vitamin D2 and 1 alpha-OHD3, are crucial for preventing rickets in vulnerable low birthweight populations.
Abstract:
Impairment of 25-hydroxylation may be a cause of rickets in infants of low birthweight, weighing between 2000 and 2500 g. In addition there may be impairment of 1 alpha-hydroxylation in infants weighing less than 2000 g. Our data show that a supplementary dose of vitamin D2 of at least 500 IU daily is a reasonable regimen for infants who weighed between 2000 and 2500 g at birth. However for infants who weighed less than 2000 g with a gestation of under 38 weeks, administration of 1 alpha-OHD3 may be more effective in preventing rickets.