1- Department of Nutritional Sciences, School of Health Related Professions, Rutgers, The State University of New Jersey, Newark, New Jersey, USA; 2 - Neonatal Intensive Care Unit, St. John Providence Children’s Hospital, Detroit, Michigan, USA; 3 - Neonatal Intensive Care Unit, Hospital Dona Estefania, Centro Hospitalar de Lisboa Central, Lisbon, Portugal; 4 - Division of Animal and Nutritional Sciences, West Virginia University, Morgantown, West Virginia, USA; 5 - Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA.
Artigo: Nutrition Reviews 2015;73:823-36.
Very preterm infants (< 32 weeks gestation) are at high risk for impaired skeletal development due to factors limiting extrauterine nutrient provision. Cumulative net deficiencies of calcium, phosphorus, docosahexaenoic acid (DHA), and arachidonic acid (ARA) are evident in these infants after prolonged administration of parenteral nutrition. This is significant because mineral as well as metabolites of DHA and ARA are important modulators for bone cell differentiation, lengthening of bone, and bone matrix deposition. Furthermore, diets containing only precursors for DHA and ARA result in suboptimal skeletal growth. With the emergence of new intravenous lipid emulsions, it is important to understand the impact of fatty acids on bone metabolism in the third trimester in order to optimize provision of parenteral nutrition in very preterm infants. The purpose of this review is to evaluate current evidence and to identify areas of research needed in regards to intravenous lipid emulsions and bone metabolism in very preterm infants receiving prolonged parenteral nutrition.
Palavras Chave: bone disease, intravenous lipid emulsion, LCPUFA, metabolic bone disease