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CALCIUM AND PHOSPHORUS ECONOMY OF THE PRETERM INFANT AND ITS INTERACTION WITH VITAMIN D AND ITS METABOLITES
Author(s) -
SENTERRE J.,
SALLE B.
Publication year - 1982
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1982.tb09604.x
Subject(s) - vitamin d and neurology , medicine , calcium , calcium metabolism , vitamin , endocrinology , excretion , absorption (acoustics) , rickets , physics , acoustics
Senterre, J. and Salle, B. (Departments of Neonatology, University hospital, Liège, Belgium and Lyon, France). Calcium and phosphorus economy of the preterm infant and its interaction with vitamin D and its metabolites. Acta Paediatr Scand, Suppl. 296: 85, 1982.—One hundred and seventeen 3‐day metabolic balance studies were carried out in 69 preterm infants. Matched groups of infants were fed either banked human milk, an infant formula or a low birthweight infant formula with medium‐chain triglycerides. In addition groups were constituted according to the vitamin D intake or the administration of 1,25–dihydroxyvitamin D. In infants fed human milk, mean fat absorption was 77%. Calcium absorption was 49±11% with no vitamin D supplementation and it reached 70±11% with a daily oral dose of 30 g of vitamin D. However in this latter group urinary excretion of calcium was very high because of the low phosphorus intake. With infant formula, mean fat absorption was 73%. Calcium absorption was 20±11% with no vitamin D supplementation, 32±13% with 25 g of vitamin D per day and 49±10% with daily administration of 0.5 g of 1,25‐dihydroxyvitamin D. With low birthweight infant formula, mean fat absorption was 90%. Calcium absorption was 32±15% with no vitamin D supplementation, 45±13% with 25 g of vitamin D, 59±10% with 50 g of vitamin D and 58±6% with 0.5 g of 1,25‐dihydroxyvitamin D per day. However with this active metabolite of vitamin D, serum level and urinary excretion of calcium were significantly higher. Whatever the milk or the vitamin D intake, phosphorus absorption was about 90%. Phosphorus retention was related to nitrogen plus calcium retentions. This study indicates that vitamin D status is the major factor regulating intestinal absorption of calcium. Activation pathways of vitamin D and gut response to 1,25‐dihydroxyvitamin D are operative in preterm infant. However in populations where relative vitamin D deficiency is common as in the present study, it seems necessary to give preterm infants a daily oral dose of 30 to 50 g (1200–2000 IU) of vitamin D for achieving maximal calcium absorption. Preferably, plasma 25‐hydroxyvitamin D level should guide the clinician in estimating the sufficiency of vitamin D intake.