Bone Turnover and Parenteral Nutrition

Iaso Maternity Hospital, Athens, Greece

Status: Completed

Conditions: Bone Turnover Rate Disorder

Treatments: Dietary Supplement: MCT/ω-3-PUFA; Dietary Supplement: Soybean Based

Study type: Observational

Funder types: Other

Identifiers

NCT03618394

29042015

Details and patient eligibility

About

Evaluation of changes in biochemical markers of bone metabolism. Fat profile. Evaluation of the overall body development. Assessment of parenteral nutrition protocols.

Full description

Osteopenia is very common in premature infants, particularly in preterm infants born at extremely low birth weight This is probably related to inadequate calcium and phosphorus intake, which is considerably less than the accretion of these minerals during the last trimester of pregnancy In addition, severe morbidity during the neonatal period (e.g. bronchopulmonary dysplasia [BPD]), chronic drug therapy (e.g. diuretics and systemic steroids), the need for total parenteral nutrition and prolonged immobility increase the risk of bone demineralization.

Total parenteral nutrition is associated with osteopenia in preterm infants. Insufficient calcium and phosphate are likely causes; aluminum contamination is another possible contributing factor as this adversely affects bone formation and mineralization.

The DHA+ARA-supplemented formulas supported normal growth and bone mineralization in premature infants who were born at <33 wk gestation. Smof lipid emulsion has a high density of this fatty acids, while Intra lipid does not contain any traces of DHA. Evidence has shown that long-chain polyunsaturated fatty acids (LCPUFA), especially the ω-3 fatty acids such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are beneficial for bone health and turnover.

Enrollment: 66 patients

Sex: All

Ages: 1 to 3 days old

Volunteers: No Healthy Volunteers

Inclusion criteria

• gestational age <32 weeks
• birth weight <1500g (VLBW infants)
• in need of Parenteral Nutrition support

Exclusion criteria

• >32 weeks of gestation
• chromosomal or other abnormalities
• parenteral nutrition <80% of calorie/fluid needs
• primary liver disease

Trial design

66 participants in 2 patient groups

Smoflipid

Description:

premature neonates receiving MCT/ω-3-PUFA-containing lipid emulsion

Treatment:

Dietary Supplement: MCT/ω-3-PUFA

Intralipid

Description:

premature neonates receiving Soybean Based lipid emulsion

Treatment:

Dietary Supplement: Soybean Based