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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Aluminum exposure from parenteral nutrition in preterm infants: bone health at 15-year follow-up.
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Aluminum exposure from parenteral nutrition in preterm infants: bone health at 15-year follow-up.

机译：早产儿肠外营养中铝的暴露：15年随访中的骨骼健康。

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OBJECTIVE: Aluminum has known neurotoxicity and may impair short-term bone health. In a randomized trial, we showed reduced neurodevelopmental scores in preterm infants who were previously exposed to aluminum from parenteral nutrition solutions. Here, in the same cohort, we test the hypothesis that neonatal aluminum exposure also adversely affects long-term bone health, as indicated by reduced bone mass. METHODS: Bone area (BA) and bone mineral content (BMC) of lumbar spine, hip, and whole body were measured with dual radiograph absorptiometry in 13- to 15-year-olds who were born preterm and randomly assigned standard or aluminum-depleted parenteral nutrition solutions during the neonatal period. RESULTS: Fifty-nine children (32% of survivors) were followed. Those who were randomly assigned to standard parenteral nutrition solution had lower lumbar spine BMC, apparently explained by a concomitant decrease in bone size. In nonrandomized analyses, children who were exposed to neonatal aluminum intakes above the median (55 microg/kg) had lower hip BMC (by 7.6% [95% confidence interval: 0.12-13.8]; P = 0.02), [corrected] independent of bone (or body) size. CONCLUSIONS: Neonates who are exposed to parenteral aluminum may have reduced lumbar spine and hip bone mass during adolescence, potential risk factors for later osteoporosis and hip fracture. These findings need confirmation in larger, more detailed studies. Nevertheless, given our previous finding of adverse developmental outcome in these individuals and the sizeable number of contemporary infants who undergo intensive neonatal care and are still exposed to aluminum via parenteral feeding solutions, the potential adverse long-term consequences of early aluminum exposure now deserve renewed attention.
机译：目的：铝具有已知的神经毒性，并可能损害短期骨骼健康。在一项随机试验中，我们显示先前从肠胃外营养液中接触过铝的早产儿神经发育评分降低。在同一队列中，我们测试了这样一个假设：新生儿铝的暴露也会对长期的骨骼健康产生不利影响，如减少的骨量所表明的那样。方法：采用双射线X线吸收法对13至15岁早产，随机分配标准或贫铝的年龄的腰椎，臀部和全身的骨面积（BA）和骨矿物质含量（BMC）进行测量。新生儿期间的肠胃外营养解决方案。结果：随访了59名儿童（幸存者的32％）。那些随机分配到标准肠胃外营养液中的人的腰椎BMC较低，显然可以通过伴随骨尺寸的减小来解释。在非随机分析中，接触新生儿铝摄入量高于中位数（55微克/千克）的儿童的髋部BMC较低（降低了7.6％[95％置信区间：0.12-13.8]; P = 0.02），[校正]与骨骼（或身体）大小。结论：暴露于肠胃外铝的新生儿可能在青春期减少腰椎和髋骨量，这是后来发生骨质疏松症和髋部骨折的潜在危险因素。这些发现需要在更大，更详细的研究中得到证实。然而，鉴于我们先前在这些个体中发现不良的发育结局，以及大量接受重症新生儿护理且仍通过肠胃外喂养溶液接触铝的当代婴儿，现在应重新考虑早期铝暴露的潜在长期不良后果注意。

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