title: Changes in Biochemical Parameters of the Calcium-Phosphorus Homeostasis in Relation to Nutritional Intake in Very-Low-Birth-Weight Infants.
abstract: Preterm infants are at significant risk to develop reduced bone mineralization based on inadequate supply of calcium and phosphorus (Ca-P). Biochemical parameters can be used to evaluate the nutritional intake. The direct effect of nutritional intake on changes in biochemical parameters has not been studied. Our objective was to evaluate the effect of Ca-P supplementation on biochemical markers as serum (s)/urinary (u) Ca and P; alkaline phosphatase (ALP); tubular reabsorption of P (TrP); and urinary ratios for Ca/creatinin (creat) and P/creatinin in Very-Low-Birth-Weight infants on Postnatal Days 1, 3, 5, 7, 10, and 14. This observational study compared two groups with High (n= 30) and Low (n= 40) intake of Ca-P. Birth weight: median (IRQ) 948 (772-1225) vs. 939 (776-1163) grams; and gestational age: 28.2 (26.5-29.6) vs. 27.8 (26.1-29.4) weeks. Daily median concentrations of biochemical parameter were not different between the groups but linear regression mixed model analyses showed that Ca intake increased the uCa and TrP (p= 0.04) and decreased ALP (p= 0.00). Phosphorus intake increased sP, uP and uP/creat ratio and ALP (p≤ 0.02) and caused decrease in TrP (p= 0.00). Protein intake decreased sP (p= 0.000), while low gestational age and male gender increased renal excretion of P (p< 0.03). Standardized repeated measurements showed that biochemical parameters were affected by nutritional intake, gestational age and gender.
authors.affiliation: Department of Paediatrics, Subdivision of Neonatology, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen 6500HB, The Netherlands. viola.christmann@radboudumc.nl.
authors.forename: Viola
authors.initials: V
authors.lastname: Christmann
authors.affiliation: Department of Paediatrics, Subdivision of Neonatology, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen 6500HB, The Netherlands. charlotte.gradussen@radboudumc.nl.
authors.forename: Charlotte J W
authors.initials: CJ
authors.lastname: Gradussen
authors.affiliation: Department of Paediatrics, Subdivision of Neonatology, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen 6500HB, The Netherlands. michelle.kornmann@radboudumc.nl.
authors.forename: Michelle N
authors.initials: MN
authors.lastname: Körnmann
authors.affiliation: Department for Health Evidence, Radboud Institute for Health Science, Radboud University Medical Center, Nijmegen 6500HB, The Netherlands. nel.roeleveld@radboudumc.nl.|Department of Paediatrics, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen 6500HB, The Netherlands. nel.roeleveld@radboudumc.nl.
authors.forename: Nel
authors.initials: N
authors.lastname: Roeleveld
authors.affiliation: Department of Paediatrics, VU university medical center Amsterdam, Amsterdam 1081HV, The Netherlands. h.vangoudoever@vumc.nl.|Department of Paediatrics, Emma Children's Hospital-AMC Amsterdam, Amsterdam 1105AZ, The Netherlands. h.vangoudoever@vumc.nl.
authors.forename: Johannes B
authors.initials: JB
authors.lastname: van Goudoever
authors.affiliation: Department of Paediatrics, Subdivision of Neonatology, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen 6500HB, The Netherlands. arno.vanheijst@radboudumc.nl.
authors.forename: Arno F J
authors.initials: AF
authors.lastname: van Heijst
mesh_terms: D015519:Bone Density; D002118:Calcium / Q000378:metabolism* / Q000652:urine; D019587:Dietary Supplements; D005247:Feeding Behavior; D005260:Female; D006706:Homeostasis; D006801:Humans; D007225:Infant Food / Q000032:analysis; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D008297:Male; D010758:Phosphorus / Q000378:metabolism* / Q000652:urine
chemical_list: D010758:Phosphorus; D002118:Calcium
keywords: blood; bone mineralization; minerals; monitoring; nutrition; renal tubular reabsorption; supplementation; urine