Achievement of in utero retention of calcium and phosphorus accompanied by high calcium excretion in very low birth weight infants fed a fortified formula |
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| Authors: | J C Rowe C A Goetz D E Carey E Horak |
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| Affiliation: | 1. INSERM, Sorbonne Université, Université de Paris, Centre de Recherche des Cordeliers, F-75006 Paris, France;2. CNRS, ERL 8228, F-75006 Paris, France;3. AP-HP, Service de Physiologie, Hôpital Européen Georges Pompidou, F-75015 Paris, France;4. Unité d''Endocrinologie Maladies Osseuses, Hôpital des Enfants, CHU de Toulouse, France;5. Université Paul Sabatier, Université de Toulouse, Toulouse, France;6. Centre de Physiopathologie de Toulouse Purpan (CPTP) UMR INSERM 1043 CNRS 5282, France;7. Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphate, France;1. APHP, Endocrinology and Diabetology for Children, Bicêtre Paris Sud Hospital, Le Kremlin-Bicêtre, France;2. APHP, Reference Center for Rare Disorders of Calcium and Phosphate Metabolism, filière OSCAR, Paris, France;3. APHP, Platform of Expertise for Rare Disorders Paris-Sud, Bicêtre Paris Sud Hospital, Le Kremlin-Bicêtre, France;4. Center for Chronic Sick Children, Pediatric Endocrinology, Charité, University Medicine Berlin, Germany;5. Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom;6. Department of Pediatrics and Adolescent Medicine, Johannes Kepler University Linz, Linz, Austria |
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| Abstract: | Calcium and phosphorus retention was evaluated in 13 very low birth weight infants who were fed an experimental formula designed to deliver quantities of calcium and phosphorus sufficient to meet the intrauterine accretion rates for these minerals. Retention of calcium and phosphorus in slight excess of these rates was achieved without any apparent difficulties for the infants. Biochemical measurements demonstrated normal serum calcium (9.8 +/- 8 mg/dL) and alkaline phosphatase (242 +/- 51.6 IU) values. However, there was evidence of high tubular reabsorption of phosphate (98.1% +/- 3.3%), hypercalciuria (7.2 +/- 3.8 mg/kg/d), and a relatively low serum phosphorus concentration (5.7 +/- 0.6 mg/dL). This biochemical picture is similar to that seen in phosphorus deficiency except for the low alkaline phosphatase activity. The latter finding, in concert with the high retention of calcium and phosphorus in these balance studies, makes such a diagnosis unlikely. We speculate that this biochemical picture is the result of an inappropriately high calcium/phosphorus ratio. |
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