title: Bone metabolism in very preterm infants receiving total parenteral nutrition: do intravenous fat emulsions have an impact?
abstract: Very preterm infants (<32 weeks' gestation) are at high risk for impaired skeletal development because of factors that limit the provision of extrauterine nutrients. Cumulative net deficiencies of calcium, phosphorus, docosahexaenoic acid (DHA), and arachidonic acid (ARA) are evident in these infants after prolonged administration of total parenteral nutrition (TPN). This is significant because minerals as well as metabolites of DHA and ARA are important modulators of bone cell differentiation, lengthening of bone, and bone matrix deposition. Furthermore, diets containing only precursors of DHA and ARA result in suboptimal skeletal growth. With the emergence of new intravenous lipid emulsions, it is important to understand the impact of fatty acids on bone metabolism in the third trimester in order to optimize the provision of TPN in very preterm infants. The purpose of this review is to evaluate current evidence regarding intravenous lipid emulsions and bone metabolism in very preterm infants receiving prolonged TPN and to identify areas of research needed.
authors.affiliation: K.M. Bridges and J. Ziegler are with the Department of Nutritional Sciences, School of Health Related Professions, Rutgers, The State University of New Jersey, Newark, New Jersey, USA. K.M. Bridges is with the Neonatal Intensive Care Unit, St John Providence Children's Hospital, Detroit, Michigan, USA. L. Pereira-da-Silva is with the Neonatal Intensive Care Unit, Hospital Dona Estefania, Centro Hospitalar de Lisboa Central, Lisbon, Portugal. J.C. Tou is with the Division of Animal and Nutritional Sciences, West Virginia University, Morgantown, West Virginia, USA. L. Brunetti is with the Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA. kbridges2@iamtouchpoint.com.
authors.forename: Kayla M
authors.initials: KM
authors.lastname: Bridges
authors.affiliation: K.M. Bridges and J. Ziegler are with the Department of Nutritional Sciences, School of Health Related Professions, Rutgers, The State University of New Jersey, Newark, New Jersey, USA. K.M. Bridges is with the Neonatal Intensive Care Unit, St John Providence Children's Hospital, Detroit, Michigan, USA. L. Pereira-da-Silva is with the Neonatal Intensive Care Unit, Hospital Dona Estefania, Centro Hospitalar de Lisboa Central, Lisbon, Portugal. J.C. Tou is with the Division of Animal and Nutritional Sciences, West Virginia University, Morgantown, West Virginia, USA. L. Brunetti is with the Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA.
authors.forename: Luis
authors.initials: L
authors.lastname: Pereira-da-Silva
authors.affiliation: K.M. Bridges and J. Ziegler are with the Department of Nutritional Sciences, School of Health Related Professions, Rutgers, The State University of New Jersey, Newark, New Jersey, USA. K.M. Bridges is with the Neonatal Intensive Care Unit, St John Providence Children's Hospital, Detroit, Michigan, USA. L. Pereira-da-Silva is with the Neonatal Intensive Care Unit, Hospital Dona Estefania, Centro Hospitalar de Lisboa Central, Lisbon, Portugal. J.C. Tou is with the Division of Animal and Nutritional Sciences, West Virginia University, Morgantown, West Virginia, USA. L. Brunetti is with the Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA.
authors.forename: Janet C
authors.initials: JC
authors.lastname: Tou
authors.affiliation: K.M. Bridges and J. Ziegler are with the Department of Nutritional Sciences, School of Health Related Professions, Rutgers, The State University of New Jersey, Newark, New Jersey, USA. K.M. Bridges is with the Neonatal Intensive Care Unit, St John Providence Children's Hospital, Detroit, Michigan, USA. L. Pereira-da-Silva is with the Neonatal Intensive Care Unit, Hospital Dona Estefania, Centro Hospitalar de Lisboa Central, Lisbon, Portugal. J.C. Tou is with the Division of Animal and Nutritional Sciences, West Virginia University, Morgantown, West Virginia, USA. L. Brunetti is with the Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA.
authors.forename: Jane
authors.initials: J
authors.lastname: Ziegler
authors.affiliation: K.M. Bridges and J. Ziegler are with the Department of Nutritional Sciences, School of Health Related Professions, Rutgers, The State University of New Jersey, Newark, New Jersey, USA. K.M. Bridges is with the Neonatal Intensive Care Unit, St John Providence Children's Hospital, Detroit, Michigan, USA. L. Pereira-da-Silva is with the Neonatal Intensive Care Unit, Hospital Dona Estefania, Centro Hospitalar de Lisboa Central, Lisbon, Portugal. J.C. Tou is with the Division of Animal and Nutritional Sciences, West Virginia University, Morgantown, West Virginia, USA. L. Brunetti is with the Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA.
authors.forename: Luigi
authors.initials: L
authors.lastname: Brunetti
mesh_terms: D001846:Bone Development / Q000187:drug effects*; D001842:Bone and Bones / Q000378:metabolism*; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000378:metabolism*; D010289:Parenteral Nutrition, Total
chemical_list: D005217:Fat Emulsions, Intravenous
keywords: LC-PUFA; intravenous fat emulsion; metabolic bone disease; very preterm infants