Changes in Biochemical Parameters of the Calcium-Phosphorus Homeostasis in Relation to Nutritional Intake in Very-Low-Birth-Weight Infants

Viola Christmann, Charlotte J.W. Gradussen, Michelle N. Körnmann, Nel Roeleveld, Johannes B. van Goudoever, Arno F.J. van Heijst

Research output: Contribution to journalArticleAcademicpeer-review

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.

Original languageEnglish
Article number764
JournalNutrients
Volume8
Issue number12
DOIs
Publication statusPublished - 2016

Cite this

Christmann, Viola ; Gradussen, Charlotte J.W. ; Körnmann, Michelle N. ; Roeleveld, Nel ; van Goudoever, Johannes B. ; van Heijst, Arno F.J. / Changes in Biochemical Parameters of the Calcium-Phosphorus Homeostasis in Relation to Nutritional Intake in Very-Low-Birth-Weight Infants. In: Nutrients. 2016 ; Vol. 8, No. 12.
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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.",
keywords = "blood, bone mineralization, minerals, monitoring, nutrition, renal tubular reabsorption, supplementation, urine",
author = "Viola Christmann and Gradussen, {Charlotte J.W.} and K{\"o}rnmann, {Michelle N.} and Nel Roeleveld and {van Goudoever}, {Johannes B.} and {van Heijst}, {Arno F.J.}",
note = "M1 - 12 ISI Document Delivery No.: ED8TP Times Cited: 0 Cited Reference Count: 55 Christmann, Viola Gradussen, Charlotte J. W. Kornmann, Michelle N. Roeleveld, Nel van Goudoever, Johannes B. van Heijst, Arno F. J. Mead Johnson Nutrition; Hero Kindervoeding, Breda, Netherlands This study was part of the {"}Early Nutrition Study{"} that was sponsored by Mead Johnson Nutrition, for which J.B.v.G. received a grant. The Early Supplementation Study was sponsored by Hero Kindervoeding, Breda, Netherlands, for which V.C. and A.v.H. received a grant. The sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data, the preparation of the manuscript and the decision to submit the manuscript for publication. All other authors declare that they do not have any conflict of interest and that they do not have anything to disclose. The first draft of the manuscript was written by V.C., who did not receive an honorarium or any other form of payment to produce the manuscript. All authors gratefully thank W.R.J.C. Jansen, research nurse of the Pediatric Drug Research Center Radboudumc, for the dedicated support in patient recruitment and data collection as well as T.A.J. Antonius, neonatologist at Radboudumc, for the development of the algorithm to calculate the nutritional intakes. 0 6 MDPI AG BASEL NUTRIENTS",
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Changes in Biochemical Parameters of the Calcium-Phosphorus Homeostasis in Relation to Nutritional Intake in Very-Low-Birth-Weight Infants. / Christmann, Viola; Gradussen, Charlotte J.W.; Körnmann, Michelle N.; Roeleveld, Nel; van Goudoever, Johannes B.; van Heijst, Arno F.J.

In: Nutrients, Vol. 8, No. 12, 764, 2016.

Research output: Contribution to journalArticleAcademicpeer-review

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