Disproportionate alterations in body composition of large for gestational age neonates.

OBJECTIVE: The objective was to compare dual-energy x-ray absorptiometry-measured body composition between large (LGA) and appropriate (AGA) birth weight for gestational age neonates. STUDY DESIGN: LGA term infants (n = 47) with birth weights > or =4000 g were compared with 47 gestational age-matched AGA infants; 11 LGA infants were born to mothers with gestational (9) or pregestational diabetes (2). Dual-energy x-ray absorptiometry scans were performed at 1.8 +/- 1.0 days after birth. RESULTS: Body weight and length were the dominant predictors of body composition in LGA and AGA neonates. However, LGA neonates had significantly (P <.001, all comparisons) higher absolute amounts of total body fat, lean body mass, and bone mineral content and had significantly (P <.001, all comparisons) higher proportions of total body fat and bone mineral content but lower lean body mass as a percent of body weight. The changes for total body fat and lean body mass as a percent of body weight were greatest (P <.001) in LGA infants whose mothers had impaired glucose tolerance. CONCLUSION: LGA neonates have higher body fat and lower lean body mass than AGA infants. Impaired maternal glucose tolerance exaggerated these body composition changes.

Body composition in human infants at birth and postnatally.

The predictive values of anthropometric measurements, race, gender, gestational and postnatal ages, and season at birth and at study for the total body dual energy X-ray absorptiometry (DXA)-derived lean mass (LM), fat mass (FM) and fat mass as a percentage of body weight (%FM) were determined in 214 singleton appropriate birth weight for gestational age infants [101 Caucasian (60 boys, 41 girls) and 113 African American (55 boys, 58 girls)]. Gestational ages were 27-42 wk and the infants were studied between birth and 391 d, weighing between 851 and 13446 g. In addition, predictive value of body weight, LM and FM for DXA bone measurements was also determined. Scan acquisition used Hologic QDR 1000/W densitometer and infant platform and scans without significant movement artifacts were analyzed using software 5.64p. Body weight, length, gender and postnatal age were significant predictors of LM (adjusted R:(2) >0. 94) and FM (adjusted R:(2) >0.85). Physiologic variables had little predictive value for %FM except in the newborns (adjusted R:(2) 0. 69). Body weight was the dominant predictor of LM and FM, although length had similar predictive value for LM with increasing postnatal age. Female infants had less LM and more FM throughout infancy (P: < 0.01). LM or FM offered no advantage over body weight in the prediction of bone mass measurements. DXA is a useful means with which to determine body composition, and our data are important in the design and assessment of nutritional intervention studies.

Maternal calcium supplementation and fetal bone mineralization.

OBJECTIVE: To determine the effect of maternal calcium supplementation during pregnancy on fetal bone mineralization. METHODS: Healthy mothers with early ultrasound confirmation of dates and singleton pregnancies were enrolled in a double-masked study and randomized before 22 weeks' gestation to 2 g/day of elemental calcium or placebo until delivery. Maternal dietary intake at randomization and at 32-33 weeks' gestation was recorded with 24-hour dietary recalls. Dual-energy x-ray absorptiometry measurements of the whole body and lumbar spine of the neonates were performed before hospital discharge. RESULTS: The infants of 256 women (128 per group) had dual-energy x-ray absorptiometry measurements during the first week of life. There were no significant differences between treatment groups in gestational age, birth weight, or length of the infants, or in the total-body or lumbar spine bone mineral content. However, when bone mineral content was analyzed by treatment group within quintiles of maternal dietary calcium intake, total body bone mineral content (mean +/- standard error of the mean) was significantly greater in infants born to calcium-supplemented mothers (64.1+/-3.2 versus 55.7+/-2.7 g in the placebo group) in the lowest quintile of dietary calcium intake (less than 600 mg/day). The effect of calcium supplementation remained significant after adjustment for maternal age and maternal body mass index and after normalization for skeletal area and body length of the infant. CONCLUSION: Maternal calcium supplementation of up to 2 g/day during the second and third trimesters can increase fetal bone mineralization in women with low dietary calcium intake. However, calcium supplementation in pregnant women with adequate dietary calcium intake is unlikely to result in major improvement in fetal bone mineralization.

The comparative role of 1,25-dihydroxycholecalciferol and phorbol esters in the differentiation of the U937 cell line.

The active metabolite of cholecalciferol, 1,25-dihydroxycholecalciferol (1,25-DHCC), is a mononuclear phagocyte product with immunoregulatory properties which can influence not only surrounding T cells but also other mononuclear phagocytes; and which acts in an autocrine fashion. In this study we have used the U937 cell line as a starting point model to investigate further the comparative role of 1,25-DHCC and phorbol myristate acetate (PMA) upon growth, differentiation and phenotype in the mononuclear phagocyte system, and have correlated our findings with changes in 1,25-DHCC metabolism and receptor expression. Both 1,25-DHCC and PMA inhibit growth and differentiate U937 cells in a dose-dependent fashion. When used together, however, at low doses of PMA, 1,25-DHCC protects against the PMA-induced growth inhibition. At high concentrations of both compounds there is a decrease (1,25-DHCC) or an increase (PMA) in 1,25-DHCC receptor expression, with either 24-OHase (1,25-DHCC) or 1-OHase (PMA) synthesis. If the compounds are used in combination the receptor levels are equivalent to controls, and both enzymes are produced. The phenotype of the 1,25-DHCC-induced cells shows light adherence, class I+, increase in CD4 and CD14 and decrease in CD71. The PMA-induced cell is tightly adherent, class I+, and strongly positive for CD13 with a concomitant decrease in both CD4 and CD71. These findings suggest another role for 1,25-DHCC in the mononuclear phagocyte system, as a potential mitogenic agent. They also suggest that 1,25-DHCC may act at both membrane and nuclear levels within this model of the mononuclear phagocyte pathway and demonstrate one possible way in which physiological peripheral macrophage heterogeneity might be induced, i.e. due to the nature of the signals which are implicated during differentiation. The presence of increased CD4 and decreased CD13 on the surface of 1,25-DHCC-differentiated cells, and vice versa on PMA-differentiated cells, illustrates how this may then be reflected in functional mononuclear phagocyte heterogeneity, which may in turn be reflected in differential peripheral function.

Binding of the receptor for 1,25-dihydroxyvitamin D3 to the 5'-flanking region of the bovine parathyroid hormone gene.

Receptors for 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3) were prepared from bovine parathyroid glands and incubated with fragments of DNA of the 5'-flanking region of the bovine parathyroid hormone (PTH) gene covering 1700 base pairs (bp) upstream of the initiation site. In filter binding assays, incubation of the DNA fragment spanning -700 to +50 bp with 200 micrograms cytosolic protein gave 288 +/- 63% (mean +/- S.D.) of binding in the absence of protein. In contrast, there was no significant reaction with the -1350 to -700 bp fragment, nor was there binding of the receptor to a fragment of DNA covering the coding region of the PTH gene. Substitution of bovine serum albumin for the receptor preparation did not induce binding to the -700 to +50 bp fragment. The receptor-binding site was further defined to -700 to -100 bp as deletion of the -100 to +50 bp did not reduce receptor binding. Reaction of receptors further purified by sucrose density ultracentrifugation with a monoclonal antibody in immunoblots revealed a single species with a molecular mass of approximately 50,000 Da, which was absent in preparations of cos-1 cells. Autoradiography following incubation of receptors immobilized on nitrocellulose filters with the -700 to +50 bp fragment indicated a single reactive band coincident with the band in the immunoblot. The DNA fragment did not bind to filters containing preparations of cos-1 cells. Extraction of the receptors in the presence or absence of 1,25-(OH)2D3 (4 nmol/l) or the presence of KCl (150 mmol/l) in the incubation medium had no significant effect on DNA binding to the protein in this assay. (ABSTRACT TRUNCATED AT 250 WORDS)

Penetration and survival of mesocercariae (Alaria spp.) in the mammalian eye.

A Canadian woman presented with a motile, intra-retinal worm, which by appearance and movement was strikingly similar to the mesocercaria of Alaria sp., a trematode from frogs. Using these mesocercariae and rabbits this study set out to establish 1) whether these mesocercariae can penetrate the cornea, 2) how long they might survive within the eye, and 3) what reaction is produced. It was found that some penetrated the cornea readily and, after injection, were capable of prolonged survival within the eye. Little overt reaction was produced though histologically the expected chronic inflammatory reaction with eosinophils occurred.