Increased urinary excretion of inorganic sulfate in premature infants fed bovine milk protein

Greer, Frank R.; McCormick, Ann; Loker, Jeff

doi:10.1016/s0022-3476(86)80244-x

Cited by 15 publications

(7 citation statements)

References 26 publications

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“…Similar maturational patterns for the renal handling of lactate, urate and other organic anions have been reported [10,24], Furthermore, significant amounts of inorganic sulfate, which is freely filtered and actively reab sorbed by the proximal tubule, have been found in the urine of low birth weight pre mature infants [7,13]. As to the unmeasured ionic composition of neonatal urine, it should also be noted that in addition to the process of maturation, the infants' condi tion, dietary intake and acid-base balance may induce substantial but not always predictable variations [6,9,13,22,27]. From the present study we conclude that UAG is not a reliable index of urinary am monium excretion in neonates, and that its use in older infants, albeit more reliable, is of questionable clinical value.…”

Section: Resultssupporting

confidence: 61%

Relationship of Urinary Anion Gap to Urinary Ammonium Excretion in the Neonate

Sulyok

Guignard²

1990

Neonatology

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The present study was undertaken to define the relationship of urinary anion gap (UAG = sodium plus potassium minus chloride) to urine ammonium concentration in preterm and full-term neonates with spontaneous and NH₄Cl-induced metabolic acidosis. Studies were performed in 10 premature infants (mean birth weight: 1,618 g, gestational age: 30.8 weeks) weekly for 6 consecutive weeks, in 11 full-term neonates (mean birth weight: 3,085 g, gestational age: 38.6 weeks) on the 7th day of life and in 25 older control infants (mean age: 6.5 months, body weight: 6,802 g) before and after NH₄Cl-loading test.

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Section: Resultssupporting

confidence: 61%

Relationship of Urinary Anion Gap to Urinary Ammonium Excretion in the Neonate

Sulyok

Guignard²

1990

Neonatology

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“…In the present study only human milk proteins have been used to increase protein intake. A change in the protein quality which would occur if cow's milk formulas are used, would further change the amino acid profile of the infant (18)(19)(20) and may influence the cholestatic tendency found in VLBW-infants, especially those being SGA.…”

Section: Discussionmentioning

confidence: 99%

Metabolic Differences between AGA‐ and SGA‐Infants of Very Low Birthweight

et al. 1988

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Metabolic response to human milk feeding was studied in 12 appropriate (AGA) and 12 small for gestational age (SGA) infants of very low birthweight (VLBW) on the eighth day of life. Protein intake ranged from 1.98 to 2.47 g/kg/day and caloric intake from 94 to 126 kcal/kg/day with no significant differences between the groups. Alpha-amino-nitrogen, the total bile acid concentration in serum and total- as well as alpha-amino-nitrogen excretion in the urine were estimated. The alpha-amino-nitrogen and the total bile acid concentration in serum increased with increasing degree of intrauterine growth retardation. Also renal total- and alpha-amino-nitrogen excretion increased significantly in relation to the degree of intrauterine growth retardation. Thus, despite a relatively low protein intake in severely growth retarded VLBW-infants, metabolic changes could be found similar to those observed in AGA-infants on high protein intakes. The data suggest that during the first weeks of postnatal life VLBW-infants with intrauterine growth retardation have a decreased capacity to utilize or to metabolize protein when compared to AGA-infants with comparable birthweights. These metabolic differences have to be considered in the nutritional management of VLBW-infants.

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“…Of note, sulphate concentrations in human milk have been reported to be 13-fold lower than in formula milk [ 34 ]. Increased urinary excretion of sulphate has been associated with increased protein consumption (from fortified breast milk or formula) and associated methionine overload [ 35 ]. Dietary information was not collected in this study but must be a focus of future analyses.…”

Section: Discussionmentioning

confidence: 99%

An Explorative Study into the Aetiology of Developmental Dysplasia of the Hip Using Targeted Urine Metabolomics

et al. 2023

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Developmental dysplasia of the hip (DDH) is the most prevalent congenital musculoskeletal disorder, yet its cause remains unknown. Adequate nutrient provision and coordinated electron exchange (redox) processes are critical for foetal growth and tissue development. This novel study sought to explore specific biochemical pathways in skeletal development for potential involvement in the aetiology of DDH. Spot urine samples were collected from infants, aged 13–61 days, with and without DDH. Ion chromatography-mass spectrometry was used to quantify thiosulphate, sulphate, nitrate, and phosphate, whilst nitrite was quantified using high-performance liquid chromato-graphy. Thiobarbituric acid reactive substances (TBARS) were measured as markers of lipid peroxidation. Creatinine and osmolality were determined by a 96-well plate assay and micro-osmometer to potentially normalise values for renal function, lean body mass, and hydration status. Urine samples were analysed from 99 babies: 30 with DDH and 69 age-matched non-DDH controls. Thiosulphate, TBARS, and creatinine concentrations differed between the DDH group and the controls (p = 0.025, 0.015, and 0.004 respectively). Urine osmolality was significantly lower in DDH compared to the controls (p = 0.036), indicative of the production of a more diluted urine in DDH infants. Following adjustment for osmolality, significant differences became apparent in urinary sulphate levels in DDH (p = 0.035) whereas all other parameters were similar between the groups. This is the first study to assess the potential role of these inorganic anions in DDH. The higher levels of sulphate found in infants with DDH suggests either enhanced intake from milk, increased endogenous formation, or impaired renal reabsorption. This investigation demonstrates the power of urine metabolomics and highlights the importance of normalisation for hydration status to disentangle developmental disorders. Our results strongly suggest that DDH is a systemic disease associated with altered uptake, formation, or handling of sulphate. There is potential for new opportunities in the prevention or treatment of DDH via nutritional intervention.

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Increased urinary excretion of inorganic sulfate in premature infants fed bovine milk protein

Cited by 15 publications

References 26 publications

Relationship of Urinary Anion Gap to Urinary Ammonium Excretion in the Neonate

Relationship of Urinary Anion Gap to Urinary Ammonium Excretion in the Neonate

Metabolic Differences between AGA‐ and SGA‐Infants of Very Low Birthweight

An Explorative Study into the Aetiology of Developmental Dysplasia of the Hip Using Targeted Urine Metabolomics

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