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新生儿出生体重、25-羟基维生素D浓度与骨矿物质状态之间的关系。

The relationship between birthweight, 25-hydroxyvitamin D concentrations and bone mineral status in neonates.

作者信息

Akcakus Mustafa, Koklu Esad, Budak Nurten, Kula Mustafa, Kurtoglu Selim, Koklu Selmin

机构信息

Department of Paediatrics, School of Medicine, Erciyes University, Kayseri, Turkey.

出版信息

Ann Trop Paediatr. 2006 Dec;26(4):267-75. doi: 10.1179/146532806X152782.

Abstract

BACKGROUND

Calcium (Ca), phosphorus (P) and 25-hydroxyvitamin D (25-OHD) are the major micronutrients for fetal skeletal development.

AIMS

To compare whole body bone mineral density (WB BMD) and bone mineral content (WB BMC) in different birthweights of term neonates and to determine correlations of biological criteria of bone health between neonates and their mothers.

SUBJECTS AND METHODS

Serum Ca, P, alkaline phosphatase (ALP) and 25-OHD levels were measured in 30 small-for-gestational-age (SGA, group 1), 40 appropriate-for-gestational-age (AGA, group 2) and 30 large-for-gestational-age (LGA, group 3) neonates and their mothers in winter. WB BMD and WB BMC of neonates were estimated by dual-energy X-ray absorptiometry (DEXA) in the 1st 24 hrs after delivery.

RESULTS

Mean (SD) serum 25-OHD levels in the mothers [8.7 (3.0), 8.6 (3.0) and 7.7 (2.8) microg/L, respectively] and their infants [6.3 (2.5), 6.0 (2.2) and 5.7 (1.8) microg/L, respectively] in groups 1, 2 and 3 were similar. Compared with the mothers, the mean 25-OHD levels of the neonates in all groups were significantly lower (p<0.05), and they were highly correlated (r=0.755, p<0.05). Ninety-three per cent of the neonates and 82% of their mothers had 25-OHD levels <10 microg/L, the lowest limit of normal. Mean (SD) WB BMD and WB BMC were higher in LGA infants [0.442 (0.025) g/cm(2), 71.6 (9.0) g, p<0.01, p<0.001, respectively] but lower in SGA [0.381 (0.027) g/cm(2), 29.1 (9.1) g, p<0.001, p<0.001, respectively] than in AGA infants [0.426 (0.022) g/cm(2), 53.7 (9.6) g, respectively]. The percentage of WB BMC was lower in SGA than in AGA and LGA infants. WB BMC and WB BMD were positively correlated with birthweight (r=0.910, p<0.05) and gestational age (r=0.707, p<0.05) but not with serum 25-OHD.

CONCLUSIONS

The neonates' bone indices increased significantly with gestational age and birthweight but this was not related to serum 25-OHD levels in the infants and their mothers.

摘要

背景

钙(Ca)、磷(P)和25-羟基维生素D(25-OHD)是胎儿骨骼发育的主要微量营养素。

目的

比较足月新生儿不同出生体重时的全身骨密度(WB BMD)和骨矿物质含量(WB BMC),并确定新生儿与其母亲之间骨骼健康生物学指标的相关性。

对象与方法

在冬季对30例小于胎龄儿(SGA,第1组)、40例适于胎龄儿(AGA,第2组)和30例大于胎龄儿(LGA,第3组)及其母亲测定血清钙、磷、碱性磷酸酶(ALP)和25-OHD水平。在出生后24小时内通过双能X线吸收法(DEXA)评估新生儿的WB BMD和WB BMC。

结果

第1、2和3组母亲的平均(标准差)血清25-OHD水平分别为[8.7(3.0)、8.6(3.0)和7.7(2.8)μg/L],其婴儿分别为[6.3(2.5)、6.(2.2)和5.7(1.8)μg/L],相似。与母亲相比,所有组新生儿的平均25-OHD水平均显著降低(p<0.05),且两者高度相关(r=0.755,p<0.05)。93%的新生儿及其82%的母亲25-OHD水平<10μg/L,即正常下限。LGA婴儿的平均(标准差)WB BMD和WB BMC较高[分别为0.442(0.025)g/cm²,71.6(9.0)g,p<0.01,p<0.001],而SGA婴儿较低[分别为0.381(0.027)g/cm²,29.1(9.1)g,p<0.001,p<0.001],AGA婴儿分别为[0.426(0.022)g/cm²,53.7(9.6)g]。SGA婴儿的WB BMC百分比低于AGA和LGA婴儿。WB BMC和WB BMD与出生体重(r=0.910,p<0.05)和胎龄(r=0.707,p<0.05)呈正相关,但与血清25-OHD无关。

结论

新生儿的骨骼指标随胎龄和出生体重显著增加,但这与婴儿及其母亲的血清25-OHD水平无关。

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