21, 22, 23 and 24 The present study demonstrated, through evaluat

21, 22, 23 and 24 The present study demonstrated, through evaluation by DXA, that PTNs reach BMC and BMD similar to those of FTNs after 6 months of corrected age. The study sample consisted of 14 PTNs, of whom 50% had very-low birth weight. Nutritional support was required for proper growth of these infants weighing less than 1,500 g, with a high supply of calcium, phosphorus, and protein, as these infants show an accelerated bone-remodeling rate. At birth, www.selleckchem.com/products/pifithrin-alpha.html these PTNs had lower BMC and BMD in relation to FTNs, which persisted until 6 months of corrected age. This observation is in agreement with the literature, where there are reports of PTNs who, although receiving human

milk and supplementation, did not significantly improve bone mineralization until they reached full term.4 This study demonstrated, through analysis by DXA, that the process of bone mineralization showed a significant acceleration in PTNs, but was still far from that observed in FTNs up to 6 months of corrected age, suggesting that mineral supplementation selleck inhibitor should be carried out for a prolonged period in very-low birth weight newborns. In PTNs, calcium and

phosphorus urinary concentrations depend on a complex interaction between ingestion, absorption, and renal function in these infants. Some authors recommend a urinalysis of these ions as a method to determine the need for supplementation, aiming to improve BMC and reduce the incidence of metabolic bone disease. However, clonidine these analyses do not appear to substitute the direct measurement of BMC and BMD.9 and 25 In fact, the present study demonstrated that the BMC

and BMD were significantly lower in PTNs when compared to FTNs, even in infants with normal urinary and serum measurements. Among serum markers of metabolic bone disease, the most widely used is alkaline phosphatase. However, the cutoff value for osteopenia definition varies widely in the literature, between 300 and 1,200 IU/L. In this sense, Figueras-Aloy et al. evaluated alkaline phosphatase and BMD in 336 PTNs and considered metabolic bone disease when both variables were altered (alkaline phosphatase > 500 IU/L and BMD < 0.068 g/cm2) at hospital discharge.26 Although metabolic bone disease of prematurity is a self-limiting process, the rapid recovery of BMC (catch up) has many advantages: better growth in height and head circumference, prevention of fractures, and reduction of osteopenia in adulthood.27 Lean mass also normalized in PTNs at 6 months of corrected postnatal age, a finding similar to that reported by Cooke et al., albeit in children assessed at 12 months of corrected age.28 These authors found that lean mass was lower in PTNs when corrected for age. However, when corrected for weight, PTNs had lean mass values similar to the reference values for the FTNs.

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