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15 - Normal bone and mineral physiology and metabolism

Published online by Cambridge University Press:  10 December 2009

Patti J. Thureen
By
Oussama Itani  and
Reginald Tsang
Edited by
William W. Hay
Patti J. Thureen
Affiliation:
University of Colorado at Denver and Health Sciences Center
Oussama Itani
Affiliation:
Michigan State University and Kalamazoo Center for Medical Studies, and Borgess Medical Center, Kalamazoo, MI
Reginald Tsang
Affiliation:
Department of Pediatrics, Children’s Hospital Medical Center, Cincinnati, OH
William W. Hay
Affiliation:
University of Colorado at Denver and Health Sciences Center
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Summary

Introduction

Perinatal calcium (Ca), phosphorus (P), and magnesium (Mg) metabolism involves an intricate and complex biological system of interrelated hormones and growth factors that regulate the concentrations of these minerals in the tissues of the mother, fetus, and neonate. Mineral metabolism depends on the availability of mineral substrates and interactions with hormones and growth factors including parathyroid hormone (PTH), calcitonin (CT), 1,25 dihydroxyvitamin D (1,25(OH)2D), insulin-like growth factors (IGFs) and possibly leptins. Understanding of the perinatal physiology of these minerals is important in the prevention and management of mineral disorders in the neonate.

In this chapter we review the perinatal physiology of Ca, P, and Mg metabolism in the fetus and neonate and offer a practical approach to the pathophysiology and management of Ca, P, and Mg disorders. We also review the current nutritional requirements of these minerals for enteral as well as parenteral nutrition. Finally, we review normal bone physiology, and discuss the pathophysiology, prevention, and management of metabolic bone disease or rickets/ osteopenia of prematurity.

Mineral, vitamin D and bone physiology

Body mineral content

Calcium is the fifth most abundant inorganic element in the human body. The adult human body contains about 1200 g of calcium (19 g of Ca per kg body weight). The total body Ca content in a full-term newborn is approximately 28 g, almost all of which (99%) resides in bone (8 g of Ca per kg body weight) where it serves structural and metabolic functions.

Type
Chapter
Information
Neonatal Nutrition and Metabolism , pp. 185 - 228
Publisher: Cambridge University Press
Print publication year: 2006

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  • Normal bone and mineral physiology and metabolism
    • By Oussama Itani, Michigan State University and Kalamazoo Center for Medical Studies, and Borgess Medical Center, Kalamazoo, MI, Reginald Tsang, Department of Pediatrics, Children’s Hospital Medical Center, Cincinnati, OH
  • Patti J. Thureen, University of Colorado at Denver and Health Sciences Center
  • Edited by William W. Hay, University of Colorado at Denver and Health Sciences Center
  • Book: Neonatal Nutrition and Metabolism
  • Online publication: 10 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544712.016
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  • Normal bone and mineral physiology and metabolism
    • By Oussama Itani, Michigan State University and Kalamazoo Center for Medical Studies, and Borgess Medical Center, Kalamazoo, MI, Reginald Tsang, Department of Pediatrics, Children’s Hospital Medical Center, Cincinnati, OH
  • Patti J. Thureen, University of Colorado at Denver and Health Sciences Center
  • Edited by William W. Hay, University of Colorado at Denver and Health Sciences Center
  • Book: Neonatal Nutrition and Metabolism
  • Online publication: 10 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544712.016
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Normal bone and mineral physiology and metabolism
    • By Oussama Itani, Michigan State University and Kalamazoo Center for Medical Studies, and Borgess Medical Center, Kalamazoo, MI, Reginald Tsang, Department of Pediatrics, Children’s Hospital Medical Center, Cincinnati, OH
  • Patti J. Thureen, University of Colorado at Denver and Health Sciences Center
  • Edited by William W. Hay, University of Colorado at Denver and Health Sciences Center
  • Book: Neonatal Nutrition and Metabolism
  • Online publication: 10 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544712.016
Available formats
×