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足月儿的矿物质营养与骨矿化

Mineral nutrition and bone mineralization in full-term infants.

作者信息

Steichen J J, Koo W W

机构信息

Department of Pediatrics, University of Cincinnati College of Medicine, Ohio 45267-0541.

出版信息

Monatsschr Kinderheilkd. 1992 Sep;140(9 Suppl 1):S21-7.

PMID:1435822
Abstract

Bone mineralization is an intricate and tightly regulated process. Calcium, magnesium and phosphorus are the main minerals and play a principal role in skeletal mineralization. The following conclusions can be derived from different clinical studies. The large differences in Ca/P ratio between different formulas and between formulas and human milk suggest that most healthy full-term infants can adjust to a wide range of Ca/P ratio in their diet. The differences in serum levels of mineral and of mineral-regulating hormones are rarely clinically significant and most probably reflect continued compensatory mechanisms activated in response to dietary differences to maintain these levels within clinically normal ranges. Thus in most cases, these compensatory mechanisms are sufficient to reverse both short-term and long-term consequences and to prevent clinical disease. In the case of neonatal tetany, the compensatory mechanisms are overwhelmed, resulting in clinical signs and disease. Vitamin D is known to play an essential role in bone mineralization. Our studies have shown significant differences in vitamin D status in breast-fed infants with and without vitamin D supplementation and in infants fed various "humanized" formulas, whether cow milk-based or soy protein-based. The major variables affecting bone mineralization are Ca/P ratio and mineral-regulating hormones. However, factors such as season, geography (i.e. sun exposure), race and sex may have a significant long-term influence on bone mineralization and mineral metabolism. Some biological differences such as differences in serum vitamin D metabolite level may directly effect Ca/P absorption and retention and thus bone mineralization and growth.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

骨矿化是一个复杂且受到严格调控的过程。钙、镁和磷是主要矿物质,在骨骼矿化中起主要作用。从不同的临床研究中可以得出以下结论。不同配方奶之间以及配方奶与母乳之间钙磷比的巨大差异表明,大多数健康的足月婴儿能够适应其饮食中广泛的钙磷比范围。矿物质血清水平和矿物质调节激素的差异在临床上很少具有显著意义,很可能反映了为应对饮食差异而激活的持续代偿机制,以将这些水平维持在临床正常范围内。因此,在大多数情况下,这些代偿机制足以扭转短期和长期后果并预防临床疾病。在新生儿手足搐搦的情况下,代偿机制不堪重负,从而导致临床症状和疾病。众所周知,维生素D在骨矿化中起重要作用。我们的研究表明,补充维生素D和未补充维生素D的母乳喂养婴儿以及喂养各种“人乳化”配方奶(无论是基于牛奶还是大豆蛋白)的婴儿在维生素D状态方面存在显著差异。影响骨矿化的主要变量是钙磷比和矿物质调节激素。然而,季节、地理(即阳光照射)、种族和性别等因素可能对骨矿化和矿物质代谢产生重大的长期影响。一些生物学差异,如血清维生素D代谢物水平的差异,可能直接影响钙磷的吸收和潴留,进而影响骨矿化和生长。(摘要截选至250字)

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