Exposure to aluminum from IV feeding solutions may be linked to future bone loss

Preterm infants who receive intravenous (IV) feeding solutions containing aluminum, often to ensure their survival, may develop reduced lumbar spine and hip bone mass in adolescence, which could lead to osteoporosis later in life, according to new study findings.

In the 15-year study, which appears in the November issue of Pediatrics, British researchers studied the long-term effects of IV feeding solutions that contain a significant amount of aluminum.

The investigators followed 59 adolescents, aged 13 to 15 years, who were born preterm and received IV feeding solutions as infants. Half the group had received aluminum-depleted nutritional solution as a preterm infant, while the others received a standard intravenous solution containing aluminum, according to a press release.

The investigators measured the bone area and bone mineral content of the children’s lumbar spine, hip and whole body using dual radiograph absorptiometry.

Children who received the standard solution containing aluminum demonstrated lower lumbar spine bone mass than those who did not receive the formula, as explained by a concomitant decrease in bone size. In nonrandomized analyses, children who received more than 55 micrograms per kg (the threshold level for aluminum intake) had lower hip bone mass as adolescents, independent of bone or body size, according to the abstract.

Although the investigators acknowledged that the adverse effects from preterm infants not receiving IV nutrition may outweigh any potential detrimental effect from the aluminum, they also stressed the need to reduce aluminum in IV solutions for preterm infants. They also said more research is needed to more definitively assess the long-term effects of early aluminum exposure.

Reference:
Fewtrell MS, Bishop NJ, Edmonds CJ, et al. Aluminum exposure from parenteral nutrition in preterm infants: Bone health at 15-year follow-up. Pediatrics. 124;5:1372-1379.