Bone mineral content measured by DEXA scan in preterm neonates receiving total parentral nutrition with and without phosphorus supplementation.
Intravenous phosphorus preparation was not available in Egypt till recently. So we aimed to prove the positive effect of adding intravenous phosphorus to total parentral nutrition (TPN) on calcium (Ca) and phosphorus (PO4) metabolism ofpreterm neonates by measuring bone mineral content (BMC) using DEXA scan. A case-control study was conducted in NICU of Obstetric and Gynecology Hospital of Ain Shams University which is a tertiary care unit in Cairo. Thirty preterm infants were prospectively enrolled in the study divided into 2 groups; 15 preterm infants received TPN with phosphorus supplementation (group 1) and 15 preterm received TPN without phosphorus supplementation (group 2). Serum Ca, PO4 and alkaline phosphatase (ALP) assay were done together with urinary calcium/creatinine (Ca/Cr) ratio, abdominal ultrasound and DEXA scan. There were no significant difference regarding serum Ca and PO4 between group 1 and 2. Yet there were highly significant increase in serum ALP and urinary Ca/Cr ratio in group 2 compared to group 1 (p = 0.001). Also group 1 had significantly higher BMC compared to group 2 even with TPN duration less than 15 days (p = 0.001). BMC was significantly positively correlated with G.A and B.W in both groups and was significantly negatively correlated with serum ALP in group 2 and with urinary calcium/creatinine ratio in group 1. Duration of TPN as short as 2 weeks can affect negatively the BMC as documented by DEXA scan in preterm infants receiving TPN without phosphorus supplementation.
Department of Pediatric, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
H A
HA
Awad
T M
TM
Farid
S M
SM
Khafagy
R I
RI
Nofal
D015502:Absorptiometry, Photon; D015519:Bone Density; D016022:Case-Control Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D010289:Parenteral Nutrition, Total; D010758:Phosphorus / Q000008:administration & dosage*
D010758:Phosphorus