1
p.141 Aluminium (Al) in infant sarum and formulae --_---- --..__-_-..-_-..- _--------I -_ Ph. Goyens, D. Erasseur, M. Robert, C. Delhsz, H.L. VIs - Brussels Children’s Hospital . Bdglum ________-_-__.-~.~~.~~-~~~-_~-_ __... . ..__...-.__..__..._.. _... -_-_~..-__~-_~~----_~-_~~. Long term accumulation in the body of oral or/and psrenlsrsl Al can lead lo metabolic bone dissass and chronic en~ephalopalhy. Such symptoms have been mostly documented in patients with chronic renal fsilurs (hsmodialysis) and in preterm Infants on total parsntsral nutritior receiving contamined solutions. Modern infant formulae are known to bs s potential source of significant Al overload. The Al oonlenl 01 5 widely prescribed fomulae was measured by electrothermal atomic speclromelry. The ssrum Al levels of some infants fed lhess formulas wers simultaneously measured. A content mcgtl (range) Serum A Number of mog/l (range) CSSSS Tap waler 4 (2-6) Whole cow milk 21 (12.31) 5.6 (O-15) 6 Adapted milk 155 9.7 (2-24) IO Hypoallergenic milk 224 _. Protein hydrolysale 305 (250-360) 11.3 (O-14) 9 Soy milk 1094 (105.1134) 15.0 (3.34) 6 Modern infant formulae, mainly the soya milks, can be highly cOnlaminated with Al; significant amounls are also found in protein hydrolysates. In infants, Al loading differed up lo 100 limes or more, according lo diets end intakes : however serum Al did not significantly differ after 2 weeks 01 stable diet between low and high Al consumers, all having a normal renal function. So in this common range of intakes no correlation can be observed between Al consumption and serum levels. The effects on the bone slruclure of such variable and sometimes Ion9 lasting Al intakes should be further invesligated in order to determine whether these Al amounts are a health hazard in infants with a normal kidney function. p.142 Plasma Zinc (Zn) and Copper (Cu) levels in premalure infants on 2 aminoacid (AA) solutions : Yvan Vandenplas, Daniel Brasoeur, Liliane SacrB. Children’s Hospital of the Frae Universities (VUS + ULB) of Brussels, Blgium. .-_.-I- _-- 11__1_ _.I_.___ -_- ____. I _______ _ ________. -..___--_-_____________ The pool (for Zn) and the storage (for Cu) are limited in premature infants, so that lracs elements (TE) shortage or deficiency can develop particularly during prolonged total perenlsral nutrition (TPN). The optimal TE supplsmenlalions remain unprecisa Since dependent upon various parameters. Among these, the key role is devoted to the slimina tion, in TPN the urine (U) route. The renal handling of TE is influenced by the composition of the AA solution. i.e. hislidine and the sulphur conlalning AA, displaying specific TE- binding capacities and QlOmurelar filtration rates. We compared the effects on plasma (P).TE levels of 2 AA solutions : Vamin N (VN) and Vami?olact OR) with laurine more closely formulated lo mother milk. Ws expected better Zn and Cu balances on more suitable AA formulations, and possibly different P-TE levels though we know P-and U concentrations lo be unrelated. Nine very premature newborns (birth weights : 800~1750 g) on TPN were stabilized during 4 days (D) and investigated during the 10 next days (D 5, 10, 15) when on full TPN. Dally TE-inlakes per kg consisted in a standard TE solution containing 437 mcg of Zn and 50 mcg of Cu. Even (G I) and uneven (GII) patients started (D 1) on Vamin N and Vamlnolact respecllvely till D 10 and were then switched lo the other solution lill D 15. WeiQht gain and total protein evolution in serum were comparable on both AA Solutions. P-Cu remained stable and similar in both groups during the study period. Zn evolution changes ars shown on the table .-____.-..-__-_______-~~..~.~ __... _...-._____ DsY 05 D 10 D 15 _____________._-__._--..~.._..- . . ..__ __ ____.._._____ _______ GI 125.6 (VN) 132.6 (VN) 164.6 o/L) mcg/dl G II 160.5 (VL) 163.5 (VL) 123.0 (‘IN) P-Zn was significantly higher (p < 0.05) when on VL, containing about 20 % less cystelne and histidine, the 2 main Zn-binders involved in urinary excretion. We conclude that higher P-Zn In premature Infants infused s AA solution closely formulated to human milk is possibly related to its Zn-sparing effect rather than lo a lower lissular Incorporation. 128

Aluminium (Al) in infant serum and formulae

  • Upload
    dangnhu

  • View
    214

  • Download
    0

Embed Size (px)

Citation preview

p.141 Aluminium (Al) in infant sarum and formulae

--_---- --..__-_-..-_-..- _--------I -_

Ph. Goyens, D. Erasseur, M. Robert, C. Delhsz, H.L. VIs - Brussels Children’s Hospital . Bdglum ________-_-__.-~.~~.~~-~~~-_~-_ __... . ..__...-.__..__..._.. _... -_-_~..-__~-_~~----_~-_~~.

Long term accumulation in the body of oral or/and psrenlsrsl Al can lead lo metabolic bone dissass and chronic en~ephalopalhy. Such

symptoms have been mostly documented in patients with chronic renal fsilurs (hsmodialysis) and in preterm Infants on total parsntsral nutritior

receiving contamined solutions. Modern infant formulae are known to bs s potential source of significant Al overload. The Al oonlenl 01 5 widely

prescribed fomulae was measured by electrothermal atomic speclromelry. The ssrum Al levels of some infants fed lhess formulas wers

simultaneously measured.

A content

mcgtl (range)

Serum A Number of

mog/l (range) CSSSS

Tap waler 4 (2-6)

Whole cow milk 21 (12.31) 5.6 (O-15) 6

Adapted milk 155 9.7 (2-24) IO

Hypoallergenic milk 224 _.

Protein hydrolysale 305 (250-360) 11.3 (O-14) 9

Soy milk 1094 (105.1134) 15.0 (3.34) 6

Modern infant formulae, mainly the soya milks, can be highly cOnlaminated with Al; significant amounls are also found in protein hydrolysates. In

infants, Al loading differed up lo 100 limes or more, according lo diets end intakes : however serum Al did not significantly differ after 2 weeks 01

stable diet between low and high Al consumers, all having a normal renal function. So in this common range of intakes no correlation can be

observed between Al consumption and serum levels. The effects on the bone slruclure of such variable and sometimes Ion9 lasting Al intakes

should be further invesligated in order to determine whether these Al amounts are a health hazard in infants with a normal kidney function.

p.142 Plasma Zinc (Zn) and Copper (Cu) levels in premalure infants on 2 aminoacid (AA) solutions :

Yvan Vandenplas, Daniel Brasoeur, Liliane SacrB.

Children’s Hospital of the Frae Universities (VUS + ULB) of Brussels, Blgium.

.-_.-I- _-- 11__1_ _.I_.___ -_- ____. I _______ _ ________. -..___--_-_____________

The pool (for Zn) and the storage (for Cu) are limited in premature infants, so that lracs elements (TE) shortage or deficiency can develop

particularly during prolonged total perenlsral nutrition (TPN).

The optimal TE supplsmenlalions remain unprecisa Since dependent upon various parameters. Among these, the key role is devoted to the

slimina tion, in TPN the urine (U) route.

The renal handling of TE is influenced by the composition of the AA solution. i.e. hislidine and the sulphur conlalning AA, displaying specific TE-

binding capacities and QlOmurelar filtration rates. We compared the effects on plasma (P).TE levels of 2 AA solutions : Vamin N (VN) and

Vami?olact OR) with laurine more closely formulated lo mother milk. Ws expected better Zn and Cu balances on more suitable AA formulations,

and possibly different P-TE levels though we know P-and U concentrations lo be unrelated.

Nine very premature newborns (birth weights : 800~1750 g) on TPN were stabilized during 4 days (D) and investigated during the 10 next days

(D 5, 10, 15) when on full TPN. Dally TE-inlakes per kg consisted in a standard TE solution containing 437 mcg of Zn and 50 mcg of Cu. Even

(G I) and uneven (GII) patients started (D 1) on Vamin N and Vamlnolact respecllvely till D 10 and were then switched lo the other solution lill D

15. WeiQht gain and total protein evolution in serum were comparable on both AA Solutions. P-Cu remained stable and similar in both groups

during the study period. Zn evolution changes ars shown on the table

.-____.-..-__-_______-~~..~.~ __... _...-._____

DsY 05 D 10 D 15 _____________._-__._--..~.._..- . . ..__ __ ____.._._____ _______

GI 125.6 (VN) 132.6 (VN) 164.6 o/L) mcg/dl

G II 160.5 (VL) 163.5 (VL) 123.0 (‘IN)

P-Zn was significantly higher (p < 0.05) when on VL, containing about 20 % less cystelne and histidine, the 2 main Zn-binders involved in urinary

excretion.

We conclude that higher P-Zn In premature Infants infused s AA solution closely formulated to human milk is possibly related to its Zn-sparing

effect rather than lo a lower lissular Incorporation.

128