Kulkarni P B, Dorand R D, Bridger W M, Payne J H, Montiel D C, Hill J G
South Med J. 1984 Jan;77(1):13-6, 20. doi: 10.1097/00007611-198401000-00005.
To study the role of formula as a cause of rickets, we randomly assigned 46 very-low-birth-weight (VLBW) infants (less than or equal to 1,500 gm) to one of three groups receiving either Isomil, a soy isolate formula, Similac with Iron, a common milk-based formula, or Similac 24 LBW, a hypercaloric milk-based formula designed for low-birth-weight infants during the first three to four months of life. Postnatal changes in serum calcium, phosphorus, alkaline phosphatase, and albumin were monitored during this study. Radiologic diagnosis of rickets was made in 60% of infants fed Isomil and 5% fed Similac with Iron. Significantly low levels of serum phosphorus and high levels of serum alkaline phosphatase were also seen in infants fed Isomil. The exact cause of the biochemical changes and the high incidence of rickets among infants fed Isomil is not clear. Poor solubility and possibly the decreased bioavailability of minerals in soy isolate formula may be important. We conclude that rickets occurs with high frequency among VLBW infants fed soy isolate, but not milk-based formulas. We suggest that prolonged feeding of soy isolate formulas should be avoided in VLBW infants.
为研究配方奶作为佝偻病病因的作用，我们将46名极低出生体重（VLBW）婴儿（小于或等于1500克）随机分为三组，分别接受以下三种配方奶之一：伊索米尔（一种大豆分离蛋白配方奶）、含铁的Similac（一种常见的基于牛奶的配方奶）或Similac 24 LBW（一种为低出生体重婴儿设计的高热量基于牛奶的配方奶），用于婴儿出生后的头三到四个月。在这项研究中监测了血清钙、磷、碱性磷酸酶和白蛋白的产后变化。接受伊索米尔喂养的婴儿中有60%被诊断为佝偻病，而接受含铁的Similac喂养的婴儿中这一比例为5%。接受伊索米尔喂养的婴儿还出现了血清磷水平显著降低和血清碱性磷酸酶水平升高的情况。尚不清楚接受伊索米尔喂养的婴儿中生化变化和佝偻病高发病率的确切原因。大豆分离蛋白配方奶中矿物质的溶解性差以及可能的生物利用度降低可能是重要因素。我们得出结论，在喂养大豆分离蛋白配方奶而非基于牛奶配方奶的极低出生体重婴儿中，佝偻病的发生率很高。我们建议应避免在极低出生体重婴儿中长期喂养大豆分离蛋白配方奶。
