건강한 영아에서 수유종류에 따른 골무기질함량 및 칼슘조절호르몬의 변동

Abstract

[한글]

우리나라는 식습관상 수유모가 칙식을 주로하며 vitamin D 제제복용이 거의 없는 실정이므로 모유수유군이 vitamin D 및 무기질을 보강시킨 분유를 섭취하는 분유수유군에 비해 골밀도가 낮으며 체내 무기질대사의 변동이 관련될 것이라는 가설을 세웠다. 이어 저자는 수유종류에 따른 골무기질함량 및 칼슘조절호르몬의 변등에 관해 알아 보고자. 생후 2-5개월된 만삭(37-41주)으로 출생한 정상체중아중 모유수유군 18명과 분유수유군 17명을 대상으로 골무기질함량 (bene mineral content) 및 혈청 intact-parathyroid hormone,

25-hydroxyvitamin D, 1, 25-dihydroxyvitamin D, 칼슘, 인 및 마그네슘 농도를 측정하여 다음과 같은 결과를 얻었다.

1. 골무기질함량은 모유수유군에서 0.62±0.20 g/cm. 분유수유군어서 0.65±0.15 g/cm로 두 군간에 유의한 차이는 없었고. 체중과 유의한 상관관계가 있었다 (Bone mineral content=-0.055+0.098[body weight]: r=0.817, p=0.001).

2.혈청 칼슘, 인 및 마그네슘 농도는 두 군간에 유의한 차이는 없었다. Intact-parathyroid hormone 농도는 모유수유군에서 23.79±29.07 ng/L, 분유수유군에서 13.06±10.16 ng/L, 1, 25-dihydroxyvitamin D 농도는 모유수유군에서 95.60±25.36 pmol/L, 분유수유군에서 109.90±46.40 pmol/L로 두 군간에 유의한 차이가 없었다.

3. 혈청 25-hydroxyvitamin D 농도는 모유수유군에서 39.86±28.18 nmol/L, 분유수유군에서 72.46±22.19 nmol/L로 모유수유군에서 유의하게 낮았고(P=0.001), 정상이하의 25-OHD농도( <28.0 nmol/L )를 보인 환아의 비율도 모유수유군에서 43.8 %, 분유수유군에서 5.95로 모유수유군에서 유의하게 많았다 ( P=0.01 ).

이상의 결과에서, 모유수유군과 분유수유군 사이에 골무기질함량 및 칼슘조절호르몬농도어 유의한 차이가 없어 수유종류어 따른 골무기질대사에 변동은 없었으나, 체내 vitamin D 영양상태의 지표인 혈청 25-hydroxyvitamin D 농도는 모유수유군에서 분유수유군에

비해 유의하게 낮으므로, 수유모에게 혹은 전적으로 모유수유를 하는 생후 첫 6개월 이전의 영아에게는 vitamin D의 보충투여를 고려해야 하리라 사료된다.

Bone mineral content and calcium regulating hormones in healthy term human milk

versus cow milk-based formula-fed infants

Mijung Park

Department of Medical Science The Graduate school, Yonsei University

( Directed by Professor Duk Hi Kim )

The purpose of this study was to evaluate the possible differences of bone

mineral content and calcium regulating hormones between breast-fed and cow

milk-based formula-fed infants. Thirty-five healthy term appropriate for gestatonal

age infants were studied. Bone mineral content was performed by dual energy x-ray

absorptiometry. Serum calcium, phosphorous, magnesium, intact-parathyroid hormone,

1, 25-dihydroxyvitamin D, 25-hydroxyvitamin D concentrations were measured.

The results were as follows:

1. The bone mineral content was not different between human milk-fed group and

cow milk-based formula group (0.62±0.20 vs. 0.65±0.15 g/cm, respectively). The

bone mineral content correlated with body weight( r=0.817: P=0.001).

2. There were no differences in serum calcium, phosphorous, magnesium,

intact-parathyroid hormone and 1, 25-dihydroxyvitamin D concentrations between the

two feeding groups .

3. Serum 25-hydroxyvitamin D concentrations in the human milk-fed group were

significantly lower than in the cow milk-fed groups ( 39.86±28.18 vs. 72.46±22.19

nmol/L, p=0.001). The percentage of infants wi th low 25-hydroxyvi tamin D

concentrations( < 28.0 nmol/L) in the human milk-fed groups were significantly

higher than in the cow milk-fed groups ( 43,8 vs. 5.9 %, p=0.01),

In conclusion, no significant differences were found in serum calcium,

phosphorous, magnesium, intact-parathyroid hormone and 1,25-dihydroxyvitamin D

concentrations between two feeding groups. However, serum 25-hydroxyvitamin D

concentrations were significantly lower in the human milk-fed groups than in cow

milk-fed groups. Thus, vitamin D supplementation may be considered in infants aged

less than 6 months who fed exclusively human milk

[영문]

The purpose of this study was to evaluate the possible differences of bone mineral content and calcium regulating hormones between breast-fed and cow milk-based formula-fed infants. Thirty-five healthy term appropriate for gestatonal

age infants were studied. Bone mineral content was performed by dual energy x-ray absorptiometry. Serum calcium, phosphorous, magnesium, intact-parathyroid hormone, 1, 25-dihydroxyvitamin D, 25-hydroxyvitamin D concentrations were measured.

The results were as follows:

1. The bone mineral content was not different between human milk-fed group and cow milk-based formula group (0.62±0.20 vs. 0.65±0.15 g/cm, respectively). The bone mineral content correlated with body weight( r=0.817: P=0.001).

2. There were no differences in serum calcium, phosphorous, magnesium, intact-parathyroid hormone and 1, 25-dihydroxyvitamin D concentrations between the two feeding groups .

3. Serum 25-hydroxyvitamin D concentrations in the human milk-fed group were significantly lower than in the cow milk-fed groups ( 39.86±28.18 vs. 72.46±22.19 nmol/L, p=0.001). The percentage of infants wi th low 25-hydroxyvi tamin D concentrations( < 28.0 nmol/L) in the human milk-fed groups were significantly higher than in the cow milk-fed groups ( 43,8 vs. 5.9 %, p=0.01),

In conclusion, no significant differences were found in serum calcium, phosphorous, magnesium, intact-parathyroid hormone and 1,25-dihydroxyvitamin D concentrations between two feeding groups. However, serum 25-hydroxyvitamin D concentrations were significantly lower in the human milk-fed groups than in cow

milk-fed groups. Thus, vitamin D supplementation may be considered in infants aged less than 6 months who fed exclusively human milk