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Low bone mineral density in small for gestational age infants: correlation with cord blood zinc concentrations
F Chunga Vega1, M J Gómez de Tejada, J González Hachero
1Department of Paediatrics, University Hospital, Virgen Macarena, Seville, Spain.
Insights
Small for gestational age (SGA) infants have lower bone mineral density, but normal cord serum zinc levels. Deficiencies in fetal growth and nutrition, not zinc, likely cause low bone density in SGA infants.
Area of Science:
- Pediatrics
- Neonatology
- Nutritional Science
Background:
- Small for gestational age (SGA) infants often exhibit altered growth and nutritional status.
- Bone mineral density (BMD) is a critical indicator of skeletal health in newborns.
Purpose of the Study:
- To investigate bone mineral density (BMD) and cord serum zinc concentrations in term SGA infants compared to appropriate for gestational age (AGA) infants.
- To explore the relationship between BMD, growth, and nutritional status in SGA infants.
Main Methods:
- Prospective study involving term SGA and AGA infants.
- Bone mineral density measured using dual-energy X-ray densitometry of the lumbar spine.
- Cord serum zinc, parathyroid hormone, osteocalcin, and vitamin D metabolites analyzed.
Main Results:
- SGA infants demonstrated significantly lower growth, nutritional status, and bone mineral density (BMD) compared to AGA infants.
- BMD in SGA infants showed a linear correlation with growth and nutritional parameters.
- Cord serum zinc concentrations were within the normal range and comparable between SGA and AGA groups.
Conclusions:
- SGA infants may not be zinc deficient, as evidenced by normal cord serum zinc levels.
- Low bone mineral density in SGA infants is likely attributable to deficiencies in fetal growth and nutrition.
- Reduced nutrient substrate supply to the fetus is a potential mechanism underlying these deficiencies.
Abstract:
Twenty eight term small for gestational age (SGA) infants and 18 term appropriate for gestational age (AGA) infants were studied prospectively to assess bone mineral density and cord serum zinc concentrations. Growth and nutritional status were evaluated, and bone mineral density was measured by dual energy x ray densitometry of the lumbar spine. Cord serum zinc, parathyroid hormone, osteocalcin, vitamin D metabolite and mineral concentrations were measured. Growth, nutritional status, and bone mineral density (mean (SD) 0.223 (0.032) vs 0.277 (0.032) g hydroxyapatite/cm2) were significantly low in SGA infants. Bone mineral density was linearly related to growth and nutritional measures. Cord serum zinc concentrations were in the normal range and similar in both groups (mean (SD) 13.86 (3.0) vs 13.43 (2.1) mumol/l). It is suggested that SGA infants may not be zinc deficient. Low bone mineral density could be caused by growth and nutritional status deficiencies, the mechanisms for which could be those that reduce nutrient substrate supply to the fetus.